主 办:北 京 中 医 药 大 学
ISSN 2095-6606 CN 10-1157/R
30 July 2020, Volume 27 Issue 4 Previous Issue   
Case report of COVID-19 and thoughts of differential treatment by Wang Qingguo*
Zhao Hui, Wu Xiaodong, Wang Xueqian, Song Jinling, Pan Lei, Shen Jianguo, Tutor: Wang Qingguo
2020, 27 (4):  1-7.  doi: 10.3969/j.issn.2095-6606.2020.04.001
Abstract ( 140 )   PDF (1660KB) ( 33 )  
COVID-19 falls into the scope of pestilence in traditional Chinese medicine. Prof. Wang Qingguo thinks that its core pathogenesis is dampness pathogens and at the disease onset, it can be combined with the cold pathogen, heat pathogen, as well as fluid consumption, and so on. During the treament, its pathogenesis is complex. It may transform into heat, or into dryness, and it may impair yin or stir up blood. Some may recover after pathogens are dispelled from the surface, some may penetrate into the interior due to mistreatment, and some may stay in the position of half exterior and half interior for a prolonged period of time. Among those with transition into the interior, some may affect the lung, some may affect the spleen and stomach, Jueyin pericardium may be affected in some. Internal closure and external detachment are important disease mechanism in the critical stage. Thick and greasy coating on the tongue is the typical tongue image of the disease, therefore, the coating change on the tongue plays an important role in judging the patient's condition. Early treatment is critical. Ideal curative effects can be obtained by sticking to the principle of eliminating evils and avoiding using the herbs(medicines)that are too cold or too hot in nature. This paper analyzed 4 confirmed or suspected cases of COVID-19 treated by Professor Wang Qingguo in order to provide references for the clinical treatment of the disease in traditional Chinese medicine.
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Practice and thinking of remote expert consultation for diagnosis and treatment of COVID-19: Two case reports of deep integration of traditional Chinese medicine and Western medicine*
He Weili, Wu Zhengrong, Wang Tong, Meng Jie, Wu Huayang, Chen Zhengguang, Hua Haiqin, Hao Xuezeng, Liu Ning, Du Jian, Dong Fei, Ma Dayong, Liu Tiegang, Liang Tengxiao, Ding Xia Remote Consultation Tutor:Wang Qi, Wang Qingguo, Jiang Liangduo, Gu Xiaohong
2020, 27 (4):  8-12.  doi: 10.3969/j.issn.2095-6606.2020.04.002
Abstract ( 129 )   PDF (1223KB) ( 20 )  
Beijing University of Chinese Medicine (BUCM) organized the National Chinese Medical Team to Wuhan to participate in the front-line effort against COVID-19. In order to better assist the medical team in treating and managing patients in critical conditions, and improve curative effects, BUCM has organized video consultations allowing the medical team in Wuhan to engage in remote expert consultations. BUCM specialists were invited to take part in on-line “face-to-face” meetings with on-site team members to discuss patient cases and advise in diagnosis and treatment. This article took 2 severe cases of COVID-19 on February 14th, 2020 as examples, introducing how consulting experts analyzed challenges and navigated treatment thought processes according to specific cases. This reflects the role of the remote consultation model applied to COVID-19 and has promoted the widespread application of traditional Chinese medicine in the treatment of COVID-19.
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Study on differential expression of T helper cells in psoriasis with syndrome of blood stasis*
Zhang Yisheng, Chen Ruoxi, Zhao Yajing, Hang Xiaohan, Li Yuanwen, Sun Zhanxue
2020, 27 (4):  13-16.  doi: 10.3969/j.issn.2095-6606.2020.04.003
Abstract ( 106 )   PDF (1227KB) ( 18 )  
Objective To observe the different expression of T helper cells(Th) in serum of psoriasis with syndrome of blood stasis. Methods Levels of interferon-gamma (INF-γ), interleukin-4( IL-4 ),interleukin-17A( IL-17A ),interleukin-10( IL-10 ) and interleukin-22( IL-22) in serum of 30 patients with psoriasis with syndrome of blood stasis and 30 healthy controls were detected by enzyme-linked immuno sorbent assay(ELISA). Psoriasis area severity index(PASI) scores were calculated to assess the severity.Relevances were analysed with the cytokines and the PASI scores. Results IFN-γ and IL-17A were significantly higher in 30 patients than in healthy controls(P<0.05).The differences of IL-4,IL-10 and IL-22 between the two groups were not statistically significant(P>0.05).IL-17/IL-10 was positively related to the PASI scores significantly(r=0.455,P<0.05).There was no correlation between serum IFN-γ,IL-4,IL-17A,IL-10,IL-22,IFN-γ/IL-4 and PASI scores(P>0.05). Conclusions Th1 and Th17 may be in the dominant response state in psoriasis with syndrome of blood stasis. While Th2,T regulatory cell(Treg) and Th22 may not have abnormal expression.Th17/Treg drift may play a dominant role in psoriasis with syndrome of blood stasis.
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A retrospective study of EEG manifestations in 200 children with tic disorder*
Yin Lei, Wei Li, Zhang Kaiwen, Li Youqiong, Jiang Bing, Ji Xiaoxiao, Chen Hong, Huang Xunyan, Tutor: Wang Sumei
2020, 27 (4):  17-20.  doi: 10.3969/j.issn.2095-6606.2020.04.004
Abstract ( 125 )   PDF (1158KB) ( 14 )  
Objective To observe the electroencephalogram (EEG) manifestations of children with tic disorder (TD) and its related factors. Methods According to the results of EEG, 200 children with TD were assigned to the normal EEG group, borderline EEG group and abnormal EEG group. The EEG manifestations of 200 children with TD were observed, and the age, gender, TD type, YGTSS score and TCM syndrome distribution of three groups were compared. Results Among 200 children with TD, 176 cases (88.0%) had normal EEG, 6 cases (3.0%) had borderline EEG and 18 cases (9.0%) had abnormal EEG. There were 24 cases with boundary EEG and abnormal EEG, accounting for 12.0%. 6 cases showed irregular α wave with poor rhythm. Among 18 cases with abnormal EEG, 15 cases showed non-specific abnormality such as increased slow waves and increased frequency of θ wave, accounting for 7.5% of the 200 cases. 3 cases showed suspicious scattered spike-and-slow wave complex and sharp wave, accounting for 1.5% of the 200 cases. There was no significant difference in age, gender, TD type, YGTSS score or TCM syndrome distribution among the three groups (P>0.05). Conclusions Some children with TD had nonspecific abnormal EEG. EEG can be used as an exclusive examination method. If there is no abnormality such as epileptiform discharge in children with TD, it is not necessary to review EEG regularly. However, for children with significantly abnormal EEG or a long course of disease, it is necessary to further review EEG to determine their brain function.
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Clinical observation of inner heating needle therapy for lumbar facet joint disease*
Zhao Yujie, Liu Jing, Wang Yingyan, Li Jing, Shao Haiyue, Wang Xiyou
2020, 27 (4):  21-24.  doi: 10.3969/j.issn.2095-6606.2020.04.005
Abstract ( 103 )   PDF (1220KB) ( 25 )  
Objective To observe the clinical efficacy of inner heating needle therapy in the treatment of lumbar facet joint disease. Methods 130 patients with lumbar facet joint disease were randomly assigned to the treatment group and control group with 65 cases in each group. There were 60 cases in the treatment group and 52 cases in the control group after the shedding cases were excluded. The treatment group received the inner heating needle therapy while the control group took ibuprofen sustained-release capsules. The visual analogue scale (VAS) and the Oswestry disability index were observed. Results VAS scores after treatment declined in both groups (P<0.05), sinificanly more in the treatment group than in the control group(P<0.05).The treatment group was superior than the control group. The Oswestry disability index after treatment was significantly lowered, as compared with those before treatment in both groups(P<0.05), more obvious in the treatment group than the control group(P<0.05). The treatment group was superior than the control group. Conclusions The inner heating needle therapy can effectively relieve low back pain and improve the function of lumbar vertebrae in the lumbar facet joint disease.
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Literature study on distribution of TCM syndromes of tension-type headache*
Fu Guojing, Liu Shaojiao, Liang Xiao, Shen Wei, Liu Hongxi, Zhang Yunling
2020, 27 (4):  25-30.  doi: 10.3969/j.issn.2095-6606.2020.04.006
Abstract ( 109 )   PDF (1175KB) ( 18 )  
Objective To explore the distribution of TCM syndromes of tension-type headache and to provide evidence for specification differentiation of tension-type headache. Methods Literature related to TCM syndromes of tension-type headache from 2000 to 2019 was collected and a database was established. SPSS for windows 20.0 statistical software was used for statistical analysis of the reference criteria of TCM syndrome diagnosis, syndrome distribution, syndrome factors, syndrome target distribution, syndrome combination and symptom distribution of the common syndromes. Results A total of 146 literature met the inclusion criteria. There were 56 kinds of syndromes, 16 syndrome factors and 12 syndrome targets. The major syndromes included liver-yang hyperactivity, blood stasis in the brain, brain confusion due to phlegm, and deficiency of both qi and blood. The major syndrome factors included blood stasis, phlegm and yang-hyperactivity. The major syndrome targets included the liver, brain (collaterals) and kidney. The form of single syndrome factor and form of two syndrome factors were the combination of common syndrome factors. Among the forms of single syndrome factor, the most common ones were yang-hyperactivity, blood stasis and phlegm. Among the forms of two syndrome factors, the most common ones were qi deficiency combined with blood deficiency and qi stagnation combined with blood stasis. The liver and brain (collaterals) were the most common syndrome targets combined with the single and two syndrome factors. Among the combination of single syndrome factor and syndrome target, the most common one was yang-hyperactivity combined with the liver, and secondary ones were blood stasis combined with the brain(collaterals)and phlegm combined with the brain(collaterals). Among the combination of two syndrome factors and syndrome targets, the most common ones were qi stagnation and blood stasis combined with the liver, and secondary ones were phlegm and blood stasis combined with the brain. Conclusions The main TCM syndromes of tension-type headache were liver-yang hyperactivity, blood stasis in the brain, brain confusion due to phlegm, deficiency of both qi and blood. Through summarizing the distribution of TCM syndromes of tension-type headache, the TCM syndromes of tension-type headache were standardized, which can provide references for the clinical diagnosis and treatment of tension-type headache.
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Difference in tongue image distribution in patients with hypertension*
Li Shijia, Ye Yixiang, Wu Fengzhi, Guan Jing
2020, 27 (4):  31-35.  doi: 10.3969/j.issn.2095-6606.2020.04.007
Abstract ( 106 )   PDF (1228KB) ( 18 )  
Objective To provide basis for differentiation and treatment of hypertension in traditional Chinese medicine in different regions, we analyzed the differences in the distribution of tongue images of patients with hypertension in the North and South China. Methods We searched the clinical research literatures related to tongue images of hypertension from 2000 to 2019 in China National Academic Magazine Data-Base (CNKI), Wanfang Database and Chinese Science and Technology Journal Database(VIP). After screening, the 24 literatures were divided into the Northern group and Southern group and sorted out systematically. After that, the statistical software was used to analyze the data. Tongue color, common tongue body shape, coating color, common tongue coating proper and greasy coating were compared between the two groups. Results A total of 12, 296 patients with hypertension were collected from 24 literatures, including 8, 208 patients in the Northern group and 4, 088 patients in the Southern group. The distribution of light red tongue, puffy tongue, tooth-marked tongue, fissured tongue, white coating, little/no coating and greasy coating in the Southern group was higher than that in the Northern group(P<0.05), while the distribution of pale tongue, red and deep red tongue, thin tongue, yellow coating and thick coating was lower than that in the Northern group(P<0.05). Conclusions There are significant differences in the distribution of tongue images in patients with hypertension in the South and North China, which indicates that the hypertensive liver-fire syndrome and syndrome of deficiency of both yin and yang in patients with hypertension in the North is higher than that in the South. However, syndrome of yin deficiency and yang hyperactivity and syndrome of excessive accumulation of phlegm-dampness in patients with hypertension in the South is higher than that in the North, which is related to the climate, innate endowment and dietary habits. Therefore, the relevant factors should be considered in TCM treatment.
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Chief physician Wang Dajing's experience with stage-based treatment of rheumatoid arthritis*
Li Ping, Ma Cong, Wen Bo, Zhang Qin, Lu Suyan, Wang Bei
2020, 27 (4):  36-38.  doi: 10.3969/j.issn.2095-6606.2020.04.008
Abstract ( 120 )   PDF (1201KB) ( 47 )  
Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic erosive polyarthritis. Its pathological manifestations are synovitis, formation of pannus, and vasculitis. Chief physician Wang Dajing has unique insights into the diagnosis and treatment of rheumatoid arthritis in traditional Chinese medicine(TCM). He believes that the core pathogenesis of rheumatoid arthritis is “toxin” resulting in this disease. With reference to the lab test results, he carried out stage-based TCM syndrome differentiation. The attack stage can be divided into partial heat syndrome, partial cold syndrome and cold-heat mixed syndrome. As the treatment of partial heat syndrome, clearing heat, removing blood stasis and dredging collaterals are the treatment method and recommended formula is Fengyin Dang; as for the treatment of partial cold syndrome, warming the meridians, expelling cold and promoting blood circulation to remove meridian obstruction are the treatment methods, and recommended formula is Yanghe Dang plus Fuzi; as for treatment of mixed cold and heat syndrome, the treatment method is the simulateous use of cold and heat, detoxifing and expelling cold, and recommended formulas are Yanghe Tang in combination with modified Xianfanghuoming Yin. The stable period is classified as the syndrome of qi and blood deficiency and mutual obstruction of phlegm and blood stasis, which is mainly treated by tonifying qi, nourishing blood and solidifying the foundation, supplemented by dredging collaterals and detoxification, dredging joints, and taking pills. He emphasizes syndrome differentiation of cold and heat and functional exercise, with good clinical efficacy.
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Prof. Guo Weiqin's clinical experience with hypertension in the elderly*
Li Qianqian, Fan Xiaodan, Zhao Yilin, Hu Chaoqun, Wang Wenjie, Ge Mingli, Liang Jinpu
2020, 27 (4):  39-42.  doi: 10.3969/j.issn.2095-6606.2020.04.009
Abstract ( 133 )   PDF (1154KB) ( 31 )  
According to its clinical symptoms, hypertension in the elderly falls into the categories of “vertigo” and “headache” in Chinese medicine. Pro. Guo Weiqin believes that elderly hypertensive diseases are mostly caused by liver yang hyperactivity resulting from liver-kidney deficiency and water failing to enrich wood. This disease is often accompanied by dampness resulting from spleen deficiency and Qingyang failing to ascend. She emphasizes that blood stasis runs through the disease. In clinical treatment, Prof. Guo nourishes the liver and kidney to eradicate the root cause, calms the liver and clears the liver to treat the symptoms, promotes blood circulation and removes blood stasis to unblock the vessels, attaches importance to strengthening the spleen and removing dampness, and flexibly uses insect drugs to form her own unique characteristics of syndrome differentiation and treatment. Combined with clinical cases, this paper introduces Pro. Guo's thinking and experience in the treatment of hypertension in the elderly.
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Prof. Li Yueqing's clinical experience in treating male climacteric syndrome with Kaiyu Zhishen Decoction*
Dai Hengheng, Feng Junlong, Wang Jisheng, Bao Binghao, Deng Sheng, Zhao Qi, Wang Bin, Li Haisong
2020, 27 (4):  43-45.  doi: 10.3969/j.issn.2095-6606.2020.04.010
Abstract ( 115 )   PDF (1142KB) ( 34 )  
Male climacteric syndrome is more common in middle-aged and elderly men, and can be classified into the depression pattern and intestinal dryness pattern in traditional Chinese medicine according to its symptoms. Professor Li Yueqing believes that the male climacteric syndrome in elderly men is closely related to the kidney, liver and spleen. The main pathogenesis is kidney deficiency, liver stagnation, and binding of dampness and heat. Professor Li took the treatment method of nourishing the kidney and liver, clearing fire and removing dampness, and clinically used Kaiyu Zhishen Decoction, with good clinical efficacy. With clinical cases, Professor Li's diagnosis and treatment of male climacteric syndrome in elderly men and medication experience are introduced.
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Prof. Han Zucheng's clinical experience with insomnia treatment*
Wang Yuan, Wang Cui, Tutor: Han Zucheng
2020, 27 (4):  46-49.  doi: 10.3969/j.issn.2095-6606.2020.04.011
Abstract ( 120 )   PDF (1150KB) ( 49 )  
Insomnia is characterized by inability to obtain normal sleep, which is equivalent to primary insomnia in Western medicine. Professor Han Zucheng has unique views on the syndrome differentiation and treatment of insomnia. Professor Han believes that the principal syndrome differentiation of insomnia should be the differentiation of deficiency and excess and the major treatment method should be the tonification of deficiency, purgation of the excess and adjustment of the visceral yin and yang. In his opinion, insomnia is divided into five patterns such as patterns of heart fire harrassing the spirit, liver heat, liver depression and spleen deficiency, liver yang hyperactivity and heart and spleen deficiency. For the pattern of heart fire harrassing the spirit, its treatment is to clear the heart fire, nourish heart yin and quiet the mind, and the suggested formula is the self-made Wuxin Ningxin Decoction. For the pattern of liver heat, its treatment is to soothe the liver and clear heat, nourish blood and quiet the mind and the suggested formula is the self-made Jieyu Anshen Formula.For the pattern of liver depression and spleen deficiency, its treatment is to soothe the liver and fortify the spleen, nourish the blood and quiet the mind, and the suggested formula is the self-made Liqi Anshen Formula. For the pattern of liver yang hyperactivity, its treatment is to tonify and replenish the liver and kidney, pacify the liver and quiet the mind and the suggested formula is the modified Tianma Gouteng Beverage. For the pattern of heart and spleen deficiency, its treatment is to fortify the spleen and calm the heart, nourish the blood and quiet the mind and the suggested formula is the modified Guipi Decoction.Combined with the case records, this paper introduced Professor Han's train of thoughts about the diagnosis and treatment for insomnia as well as his clinical experience with the use of medicinals.
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A cross-sectional study on the Tao and Shu-integrated inheriting elements of traditional Chinese medicine*
Yu He, Li Xunxin, Liu Zhaolan, Ma Xueyan, Bai Junjie, Sun Yuxin, Wu Yufeng, Liu Guo, Cao Huijuan, Liu Tiegang, Zhao Yansong, Gu Xiaohong
2020, 27 (4):  50-56.  doi: 10.3969/j.issn.2095-6606.2020.04.012
Abstract ( 106 )   PDF (1181KB) ( 20 )  
Objective To explore the status of inheriting elements of traditional Chinese medicine (TCM) by integrated Tao and Shu, as well as the key points of TCM inheritance, in order to provide basis for innovation and efficiency of TCM education. Methods A questionnaire survey was designed by using the cross-sectional research method to investigate disciples and college students. It mainly involved baseline information, inheriting elements, efficacy elements, and quality elements, etc. Results A total of 35 disciples and 100 college students completed the questionnaire. According to the disciples' rating about importance of 28 inheritance elements, the factors with a full score of 5 that more than 70.0% people selected were core prescriptions, diagnostic process, medication characteristics, information collection, a command of classics, diagnostic and therapeutic techniques, and earnestness and prudence. According to the disciples' feedback about importance degree of 28 inheritance elements, the factors with a full score of 5 that more than 70.0% people selected were core prescriptions, diagnostic process, medication characteristics, diagnostic and therapeutic techniques, earnestness and prudence, and information collection. According to the college students' feedback about importance degree of 29 inheritance elements, doctor-patient communication and earnestness and prudence were the factors with a median score of 9; equal treatment, kindness and how to treat gain or loss and distinguish right from wrong were the factors with a median score of 8.5. The efficacy elements that inheriting disciples consented were: doctor-patient communication, diagnostic and therapeutic techniques, doctor-patient trust, patient compliance, medical advice, humanistic care, psychological intervention, diagnostic and therapeutic environment. The quality elements that inheriting disciples consented were: a solid foundation of traditional Chinese medicine, a serious learning attitude, a diligent spirit, rich experience of learning under teachers, savvy, like-minded ambition, a sense of responsibility and mission, loyal character, multiple inheritance methods and dedication. Conclusions The inheriting elements include Tao and Shu aspects. Nowadays, the emphasis on inheritance was different between disciples and college students. Disciples and college students should pay attention to both Tao and Shu in the process of inheriting, and efficacy elements were key issues involved. The inheriting elements of master-apprentice education should be fully integrated into modern Chinese medicine institutionalized education and all above inheritance elements should be seriously considered to build an innovative inheritance model and better train TCM talents.
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Exploration of Ye Tianshi's cough treatment in Case Records as a Guide to Clinical Practice*
Li Niuniu, Wu Xiaohong, Shi Liqing, Dong Shangjuan, Ma Jianling, Ji Kun, Bai Yichen, Li Jiashan, Song Huan
2020, 27 (4):  63-66.  doi: 10.3969/j.issn.2095-6606.2020.04.016
Abstract ( 92 )   PDF (1157KB) ( 32 )  
Case Records as a Guide to Clinical Practice, as the representative work of Ye Tianshi for clinical experience, had lots of discussions on cough with 144 cough cases in it. It particularly reflected his clinical experience and academic ideas of treatment on cough. By classifying and analyzing the cases on cough, we aimed to summarize the classification, etiology and pathogenesis, syndrome differentiation and treatment and characteristics of medication of cough by Ye Tianshi. Our findings showed that Ye Tianshi classified cough into exogenous cough and internal injury cough. In addition, he held that the disease location was in the lung and treatment should be based on pattern identification. For exogenous cough, importance was attached to the removal of pathogens and to care and protection of yin fluids. For internal injury cough, priority was given to zang-fu theory, particularly the relationship between the lung and spleen, the lung and kidney, and the lung and liver, etc. As for cough treatment, Ye Tianshi made the best use of classic prescriptions and he was innovative, not confined by it.
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Application of pueraria root in the treatment of rheumatism*
Gao Nannan, Yi Bowen, Wu Yufeng, Tang Jinyang
2020, 27 (4):  67-71.  doi: 10.3969/j.issn.2095-6606.2020.04.017
Abstract ( 106 )   PDF (1168KB) ( 37 )  
Pueraria root is a commonly used traditional Chinese medicine in clinical practice, which is widely used to treat a variety of diseases including rheumatism with certain curative effect. Cases of ankylosing spondylitis, Sjogren's syndrome and gout were introduced to explore the TCM theoretical and modern pharmacological basis, as well as clinical efficacy and related concerns of using pueraria root in the treatment of rheumatism.
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Theoretical thoughts and investigation of guiding fire to origin to support yang and strengthen body resistance in the treatment of colorectal cancer*
Zhang Yuwei, Zhou Qin, Wang Chaoran, Li Binbin, Wang Yitong, Jiang Lujian, Wu Na, Zuo Minghuan
2020, 27 (4):  72-76.  doi: 10.3969/j.issn.2095-6606.2020.04.018
Abstract ( 109 )   PDF (1251KB) ( 72 )  
Colorectal cancer is a common malignant tumor of the digestive system. The treatment of colorectal cancer in traditional Chinese medicine has its unique advantages. As a treatment principle extended from Huangdi Neijing (The Yellow Emperor's Inner Classic), guiding fire to origin provides us train of thoughts for treatment based on syndrome differentiation and enhanced therapeutic efficacy. The occurrence and development of colorectal cancer is related to the phase of fire separation, insufficiency of the spleen and kidney, and deficiency of yang qi. The inadequate innate endowment, coupled with the invasion of external pathogens, makes it easy for fire to leave its position, resulting in deficiency of the spleen and kidney and the deficiency of yang qi. As a result, pathological products are increasingly accumulated in the body, which can easily lead to the formation and development of colorectal cancer. The cancerous toxin injures the body's yang qi. Moreover, yang deficiency becomes even worse following surgery, chemotherapy and other treatments, the spleen and kidney are deficient, and the dislocated phase of fire cannot return to its original position, forming a vicious circle and increasingly aggravating the disease. As an important part of the fuyang method, guiding fire to origin can guide the dislocated phase of fire downward, warm up the spleen and kidney, and aid the yang qi. The representative prescriptions of treating colorectal cancer with guiding fire to origin method are Shenqi Pill, Qianyang Fengsui Pill and Yinhuo Decoction, which can be modified flexibly according to symptoms to improve the clinical efficacy.
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