Professor Xu Li’s Experience In Differentiating And Treating Non-small Cell Lung Cancer (NSCLC) With The "Three Stages And Six Discriminations" Method

Research PurposeThis paper analyze the clinical experience and academic thinking of Professor.Xu Li based on his long-term clinical practice on treating and demarcating of non-small cell lung cancer(NSCLC)with emphasis on his pioneering "three stages and six discrimination" method in the hope of helping guide the use of Chinese medicine in treating this type of cancer.Research Method1.The literature review.(1)Ancient Chinese medical literature are collated for the understanding of the naming,etiology,pathogenesis,syndrome differentiation and treatment of non-small cell lung cancer.(2)Modern research data on non-small cell lung cancer during the past decade are also retrieved to summarize its research trends and progress.Followed by a review on this subject.(3)An analysis of Prof.Xu Li’s view on the etiology,pathogenesis and differentiation of non-small cell lung cancer according to Chinese medicine theories.2.Clinical review.(1)A collection of data from all non-small cell lung cancer patients treated by Professor Xu Li in the past three years were been collated and analyzed to summarize his experience and characteristics in treating NSCLC according to the "three stages and six discriminations" method.(2)An analysis of Professor Xu Li’s experience of differentiating and treating NSCLC and of various common symptoms such as cough,pleural effusion,brain metastasis,bone metastasis,liver metastasis and so on.Followed by a discussion on Professor Xu Li’s clinical approach of treating the disease from various perspectives and on the advantages of Chinese medicine in treating this type of cancer.(3)Microsoft Excel 2010 is used to analyze the data from all non-small cell lung cancer patients treated by Prof.Xu Li in the past three years.This analysis focuses on the distribution of the following properties;the patient’s’ age,gender,symptoms,number and frequency of herbs been used,herbs used in conjunction with squamous-cell carcinoma drugs,lung adenocarcinoma drugs,pleural effusion drugs,chemotherapy and molecular-targeted therapy,herbal categories of four qi,five flavours and meridian distribution.3.Discussion.Analysis of clinical cases are presented with explanations and discussions on classical theories and personal experiences in treating NSCLC to further deliberate Professor Xu Li’s thinking on herbal formula mechanism and syndrome differentiating to establish a structured treatment mechanism and guideline.Research Result1.It discusses Professor Xu Li’s view on the etiology and pathogenesis of non-small cell lung cancer.This part elaborates on Professor Xu Li’s understanding of NSCLC:vital qi and lung deficiency,weakened qi-yin are the root and primary concerns of the pathological changes whereas cancer poison,phlegm,stagnated blood and suppressed heat are the results and secondary concerns.Phlegm,blood stasis,suppression,heat and cancer poison can interact and form a vicious circle that results in a physical mass in the form of a malignant tumor.The tumor seizes the essence and harms the body,resulting in a mixture of deficiency and excess in which cancer poison being the core of its pathogenesis..2.It introduces Professor Xu Li’s experience of treating various common symptoms and metastasis of NSCLC,such as cough,pleural effusion,brain metastasis,bone metastasis,liver metastasis and so on.Followed by a discussion on Professor Xu Li’s thinking and herbal formula usage for treating these symptoms.3.There were 95 clinical symptoms among 77 patients and 321 different herbs were used in total.The main categories of herbs been used were herbs that can replenish qi,improve water metabolism and reduce swelling,nourish yin,clear heat and detoxification,clear and dissolve heat phlegm,stop cough and relieve asthma.Removing dampness and smooth meridian herbs are used for adenocarcinoma.Clearing and dissolve heat phlegm herbs are used for squamous cell carcinoma.Strengthen spleen and kidney herbs,soothing stomach and stop vomiting herbs are used in conjunction with chemotherapy.Molecular-targeted therapy usually paired with drying dampness and sooth stomach herbs,nourish blood and removing stagnation herbs.Purging heat in lung and improve water metabolism is the main guidance in treating pleural effusion.Commonly used herbs are warm or middle in the four qi category,bitter and sweet in the five flavours category and usually belong to liver or lung meridians.Research ConclusionThe pathogenesis of non-small cell lung cancer is "vital qi and lung deficiency,weakened spleen and kidney,cancer poison covers hypochondrium with phlegm,stagnated blood and suppressed heat" and "cancer poison harms the vital qi" being its core.In terms of treatment,Prof.Li’s use of the "three stages and six discrimination" method can be summarized by the following three points "combine Chinese and Western medicine,use three stages method throughout the whole treating process","use six discrimination to find the pathogenesis,combine ancient and modern knowledge to treat","Multi-function and grand herbal formula to truncate the disease,emphasize on both blocking the root and clearing the path".Coughing and fatigue are the early signs of NSCLC and pleural effusion is most common symptom.Main kinds of herbs used for treating NSCLS are the ones that can strengthen spleen,lung,kidney;and the ones that can clear and purge phlegm,stagnated blood and poison.Strengthening qi and yin are the main focus when using the nourishing method.Promoting water circulation and detoxication are the main focus when using the purging method.