Lung cancer is one of the malignant tumors that poses the greatest threat to human health and life. Below I have compiled relevant knowledge about traditional Chinese medicine prescriptions for lung cancer, I hope it can help you!
Traditional Chinese medicine prescriptions for lung cancer
(1) Syndrome differentiation of spleen deficiency and weak qi.
The treatment method is to nourish the spleen, replenish qi, resolve phlegm and dampness, and help fight cancer. The recipe is called Lung Tumor Recipe No. 1.
Composition: 9 grams of Codonopsis pilosula, 9 grams of Astragalus membranaceus, 9 grams of Atractylodes macrocephala, 15 grams of Poria cocos, 15 grams of Polyporus polyporus, 5 grams of raw Yiyi Ren, 9 grams of tangerine peel, 30 grams of Hedyotis diffusa, and 30 grams of Houttuynia cordata. , iron leaves 30 grams. Usage: Decoction in water, 1 dose per day, 3 times a day. Provenance: Gaolingshanfang.
(2)
Syndrome: Insufficient lung yin, deficiency of fire and inflammation.
The treatment method is to nourish yin and reduce fire. Qingjin protects the lungs and helps fight cancer. The recipe is called Lung Tuoma Recipe No. 2.
Composition: 12 grams of southern ginseng, 12 grams of northern ginseng, 9 grams of asparagus, 9 grams of Ophiopogon japonicus, 15 grams of lily, 15 grams of rhizome, 15 grams of silver flowers, 9 grams of skullcap, and 30 grams of Imperata root. , 30 grams of Hedyotis diffusa, 30 grams of Houttuynia cordata, 30 grams of iron leaves, 5 grams of raw Yiren, and 9 grams of tangerine peel. Usage: Decoction in water, 1 dose per day, 3 times a day. Provenance: Gaolingshanfang.
(3)
Diagnosis of Qi and Yin deficiency.
The treatment method is to replenish qi and nourish yin, clear away heat and resolve phlegm. The recipe is called Flavored Shengmai Decoction.
It consists of 9 grams of Codonopsis pilosula, 9 grams of Ophiopogon japonicus, 9 grams of yam, 9 grams of Rehmannia glutinosa, 9 grams of Sichuan Fritillary scallops, 9 grams of Adenophora adenophora and 6 grams of Schisandra chinensis. Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: "Surgery".
(4)
Diagnosis of Qi deficiency and Yin deficiency. The treatment method replenishes qi and nourishes yin. The recipe name is Fu Fei Jian.
Composition: 10 grams of raw sun-dried ginseng, 30 grams of roasted astragalus, 12 grams of Nansha ginseng, 12 grams of Pu Shizi, 10 grams of Panax notoginseng, 15 grams of medlar leaves, 10 grams of Scrophulariaceae, and 10 grams of lily. , 10 grams of Ophiopogon japonicus, 15 grams of reed root, 15 grams of Curcuma zedoary, 3 centipedes, 8 grams of platycodon, and 6 grams of tangerine peel. Usage: Decoction in water, 1 dose per day, 2 times a day. Source: "Chinese Medical Journal".
(5)
Diagnosis of yin deficiency, poisonous heat.
The treatment method is to moisten the lungs and resolve phlegm, detoxify and remove blood stasis. The prescription is Qingdu Lifei Decoction.
Composition: 30 grams of southern ginseng, 30 grams of northern ginseng, 15 grams of asparagus, 9 grams of peach kernel, 9 grams of almond, 9 grams of Sichuan clam, 9 grams of Zhejiang clam, 15 grams of Digu bark, Prunella vulgaris 15 grams, 30 grams of clam shells, 30 grams of Trichosanthes trichosanthes, 9 grams of Pediculus, 12 grams of Aster, 30 grams of Hedyotis diffusa, 30 grams of Scutellaria barbata, 30 grams of Caohe Che, and 30 grams of dendrobium. Usage: Decoction in water, 1 dose per day, 2 times a day. Source: Beijing Hospital of Traditional Chinese Medicine
Causes of Lung Cancer
1. Smoking
Smoking is currently considered to be the most important high-risk factor for lung cancer. Tobacco contains There are more than 3,000 chemical substances, among which poly-chain aromatic hydrocarbons (such as benzopyrene) and nitrosamines have strong carcinogenic activity. Poly-chain aromatic hydrocarbons and nitrosamines can cause DNA damage in bronchial epithelial cells through various mechanisms, activating oncogenes (such as Ras gene) and inactivating tumor suppressor genes (such as p53, FHIT gene, etc.), thereby causing cell damage. transformation and ultimately canceration.
2. Occupational and environmental exposure
Lung cancer is the most important type of occupational cancer. It is estimated that about 10% of lung cancer patients have a history of environmental and occupational exposure. The following nine occupational environmental carcinogens have been proven to increase the incidence of lung cancer: by-products of aluminum products, arsenic, asbestos, bis-chloromethylether, chromium compounds, coke ovens, mustard gas, nickel-containing impurities, and vinyl chloride. Long-term exposure to beryllium, cadmium, silicon, formalin and other substances can also increase the incidence of lung cancer. Air pollution, especially industrial waste gas, can cause lung cancer.
3. Ionizing radiation
The lungs are organs that are more sensitive to radiation.
The first evidence that ionizing radiation causes lung cancer comes from the data of the Schneeberg-joakimov mine. The high concentration of radon and its progeny in the air in the mine mostly induced small cell carcinoma of the bronchus. It has been reported in the United States that 70% to 80% of miners mining radioactive ores died from occupational lung cancer caused by radiation, mainly squamous cell carcinoma. The time from the beginning of exposure to the onset of disease ranged from 10 to 45 years, with an average time of 25 years and an average age of onset. is 38 years old. When the accumulated dose of radon and its progeny exceeds 120 working level days (WLM), the incidence rate begins to increase, and when it exceeds 1800 WLM, the incidence rate increases significantly by 20 to 30 times. Exposing mice to gases and dust from these mines can induce lung tumors. There is a significant increase in lung cancer among Japanese atomic bomb survivors. Beebe's lifelong follow-up of survivors of the Hiroshima atomic bombing found that survivors who were less than 1,400m away from the center of the blast had significantly more deaths from lung cancer than survivors who were 1,400-1,900m and 2,000m away from the center of the blast.
4. In patients with previous chronic lung infection
For example, in patients with tuberculosis, bronchiectasis, etc., the bronchial epithelium may metamorphose into squamous epithelium and cause cancer during the chronic infection process, but this is relatively rare. .
5. Genetic and other factors
Family aggregation, genetic susceptibility, reduced immune function, metabolic and endocrine dysfunction may also play a role in the occurrence of lung cancer
play an important role. Many studies have demonstrated that genetic factors may play an important role in the susceptibility of populations and/or individuals to environmental carcinogens.
6. Air pollution
The incidence of lung cancer is high in developed countries. The main reason is due to the combustion of petroleum, coal and internal combustion engines and asphalt road dust in developed industrial and transportation areas. It contains benzopyrene, carcinogenic hydrocarbons and other harmful substances that pollute the atmosphere. Air pollution and smoking may promote each other and have a synergistic effect on the incidence of lung cancer.
Clinical manifestations of lung cancer
The clinical manifestations of lung cancer are relatively complex. The presence and severity of symptoms and signs, as well as the sooner or later they appear, depend on the site of tumor occurrence, pathological type, whether there is metastasis and There are differences in the presence or absence of complications, as well as in patient response and tolerability. Early symptoms of lung cancer are often mild and may even cause no discomfort. The symptoms of central lung cancer appear early and are severe, while the symptoms of peripheral lung cancer appear late and are mild, or even asymptomatic, and are often discovered during physical examination. The symptoms of lung cancer are roughly divided into: local symptoms, systemic symptoms, extrapulmonary symptoms, infiltration and metastasis symptoms.
(1) Local symptoms
Local symptoms refer to symptoms caused by the tumor itself stimulating, blocking, infiltrating and compressing tissues when it grows locally.
1. Cough
Cough is the most common symptom, accounting for 35% to 75% of patients with cough as the first symptom. Cough caused by lung cancer may be related to changes in bronchial mucus secretion, obstructive pneumonia, pleural invasion, atelectasis and other intrathoracic complications. When tumors grow in the bronchial mucosa above segments with larger diameters and are sensitive to external stimuli, they can produce coughs similar to those caused by foreign body-like stimuli. The typical manifestation is paroxysmal irritating dry cough, which is often difficult to control with ordinary cough suppressants. When the tumor grows in the smaller bronchial mucosa below the segment, the cough is often indistinct or even non-existent. For patients who smoke or suffer from chronic bronchitis, if their cough worsens, becomes more frequent, or changes in nature such as a high-pitched metallic sound, especially the elderly, they should be highly alert to the possibility of lung cancer.
2. Blood in sputum or hemoptysis
Blood in sputum or hemoptysis are also common symptoms of lung cancer, accounting for about 30% of cases where this is the first symptom. Because tumor tissue has a rich blood supply and is brittle in texture, blood vessels may rupture during severe coughing and cause bleeding. Hemoptysis may also be caused by local tumor necrosis or vasculitis. The characteristics of lung cancer hemoptysis are intermittent or persistent, repeated small amounts of blood-streaked sputum, or small amounts of hemoptysis. Occasionally, large blood vessels rupture, large cavities form, or tumors rupture into the bronchus and pulmonary blood vessels, resulting in uncontrollable hemoptysis. Hemoptysis.
3. Chest pain
Approximately 25% of patients have chest pain as the first symptom. It often presents as irregular dull pain or dull pain in the chest.
In most cases, peripheral lung cancer invades the parietal pleura or chest wall, which can cause sharp and intermittent pleural pain. If it continues to develop, it will evolve into a constant drilling pain. Mild chest discomfort that is difficult to locate is sometimes related to central lung cancer invading the mediastinum or involving blood vessels and peribronchial nerves, while 25% of patients with malignant pleural effusion complain of dull chest pain. Persistent, sharp and severe chest pain that is not easily controlled by medication often indicates extensive pleural or chest wall invasion. Persistent pain in the shoulder or chest and back indicates the possibility of tumor invasion in the inner lung lobe near the mediastinum.
4. Chest tightness and shortness of breath
About 10% of patients have this as the first symptom, which is more common in central lung cancer, especially in patients with poor lung function. The main causes of dyspnea include: ① Late-stage lung cancer, extensive metastasis of mediastinal lymph nodes, and compression of the trachea, carina or main bronchi, causing shortness of breath and even suffocation symptoms. ② When a large amount of pleural effusion compresses the lung tissue and severely shifts the mediastinum, or when there is pericardial effusion, chest tightness, shortness of breath, and dyspnea may also occur, but the symptoms can be relieved after fluid extraction. ③ Diffuse bronchioloalveolar carcinoma and bronchial disseminated adenocarcinoma reduce the breathing area and impair gas diffusion, leading to severe ventilation/blood flow ratio imbalance, causing gradually worsening dyspnea, often accompanied by cyanosis. ④Others: including obstructive pneumonia. Atelectasis, lymphangitis lung cancer, tumor microemboli, upper airway obstruction, spontaneous pneumothorax, and combined chronic lung diseases such as COPD.
5. Hoarseness
5% to 18% of lung cancer patients have hoarseness as the first complaint, usually accompanied by cough. Hoarseness generally indicates direct mediastinal invasion or lymph node enlargement involving the ipsilateral recurrent laryngeal nerve, resulting in left vocal cord paralysis. Vocal cord paralysis can also cause varying degrees of upper airway obstruction.
(2) Systemic symptoms
1. Fever
This is the first symptom in 20% to 30% of people. There are two causes of fever caused by lung cancer. One is inflammatory fever. When the tumor of central lung cancer grows, it often blocks the segment or bronchial opening first, causing obstructive pneumonia or atelectasis in the corresponding lung lobe or segment and causing fever. At around 38°C, rarely exceeding 39°C, antibiotic treatment may be effective and the shadow may be absorbed, but due to poor drainage of secretions, relapses often occur. About 1/3 of patients may develop pneumonia repeatedly in the same site within a short period of time. Peripheral lung cancer often causes fever in the late stages due to inflammation caused by tumor compression of adjacent lung tissue. The second is cancerous fever, which is mostly caused by tumor necrotic tissue being absorbed by the body. Anti-inflammatory drugs for this kind of fever are ineffective, and hormones or indole drugs have certain effects.
2. Weight loss and cachexia
In the late stage of lung cancer, loss of appetite caused by infection and pain, increased consumption caused by tumor growth and toxins, and increased levels of TNF, Leptin and other cytokines in the body can cause Causes severe weight loss, anemia, and cachexia.
(3) Extrapulmonary symptoms
Due to certain special active substances (including hormones, antigens, enzymes, etc.) produced by lung cancer, patients may have one or more extrapulmonary symptoms. Symptoms often appear before other symptoms, and may subside or appear with the growth and decline of tumors. Clinically, pulmonary osteoarticular hyperplasia is more common.
1. Pulmonary osteoarticular hyperplasia
The main clinical manifestations are periosteal hyperplasia, new bone formation, and swelling and pain in the distal long bones of the fingers (toes) and affected joints. and tenderness. The long bones are the tibia, humerus and metacarpal bones, and the joints are mostly large joints such as the knee, ankle, and wrist. The incidence rate of oak-shaped fingers and toes is about 29%, mainly seen in squamous cell carcinoma; the incidence rate of proliferative osteoarthropathy is 1% to 10%, mainly seen in adenocarcinoma, and small cell carcinoma rarely has this manifestation. The exact cause is not yet completely clear, but may be related to estrogen, growth hormone or neurological function. Cancer can be relieved or regressed after surgical removal, but it can reappear when it recurs.
2. Tumor-related ectopic hormone secretion syndrome
About 10% of patients may have such symptoms, which may appear as the first symptom. Although some patients have no clinical symptoms, one or several increased plasma ectopic hormones can be detected. Such symptoms are more common in small cell lung cancer.
(1) Ectopic adrenocorticotropic hormone (ACTH) secretion syndrome: Due to the tumor secreting active substances of ACTH or adrenocorticotropic hormone-releasing factor, plasma cortisol increases. The clinical symptoms are roughly similar to Cushing's syndrome, which may include progressive muscle weakness, peripheral edema, hypertension, diabetes, hypokalemic alkalosis, etc. It is characterized by rapid progression of the disease, severe mental disorders, and The skin is pigmented, but central obesity, sanguinity, and purple lines are not obvious. This syndrome is more common in lung adenocarcinoma and small cell lung cancer.
(2) Ectopic gonadotropin secretion syndrome is caused by tumors autonomously secreting LH and HCG to stimulate gonadal steroid secretion. It usually manifests as bilateral or unilateral breast development in men and can occur in lung cancer of various cell types, with undifferentiated carcinoma and small cell carcinoma being the most common. Priapism of the penis is occasionally seen. In addition to being related to abnormal secretion of hormones, it may also be caused by penile blood vessel embolism.
(3) Ectopic parathyroid hormone secretion syndrome is caused by tumors secreting parathyroid hormone or an osteolytic substance (polypeptide). Clinically, it is characterized by hypercalcemia and hypophosphatemia, with symptoms including loss of appetite, nausea, vomiting, abdominal pain, polydipsia, weight loss, tachycardia, arrhythmia, irritability, and mental confusion. More common in squamous cell carcinoma.
(4) Ectopic insulin secretion syndrome clinically manifests as subacute hypoglycemia syndrome, such as confusion, hallucinations, headaches, etc. The reason may be related to the tumor's large consumption of glucose, secretion of body fluid substances with insulin-like activity, or secretion of insulin-releasing peptides.
(5) Carcinoid syndrome is caused by tumors secreting 5-hydroxytryptamine. Manifestations include bronchospasm asthma, skin flushing, paroxysmal tachycardia, and watery diarrhea. More common in adenocarcinoma and oat cell carcinoma.
(6) Neuromuscular syndrome (Eaton-Lambert syndrome) is caused by tumors secreting curareotoxic-like substances. It manifests as decreased voluntary muscle strength and easy fatigue. More common in small cell undifferentiated carcinoma. Others include peripheral neuropathy, dorsal ganglion cell and neurodegeneration, subacute cerebellar degeneration, cortical degeneration, polymyositis, etc., which may cause extremity pain and weakness, dizziness, nystagmus, ataxia, and gait impairment. Difficulties and dementia.
(7) Ectopic growth hormone syndrome manifests as hypertrophic osteoarthropathy, which is more common in adenocarcinoma and undifferentiated carcinoma.
(8) Syndrome of abnormal secretion of antidiuretic hormone is caused by cancer tissue secreting large amounts of ADH or polypeptide substances with antidiuretic effects. Its main clinical features are hyponatremia, accompanied by low osmolarity of serum and extracellular fluid (<270 mOsm/L), continuous renal excretion, urine osmolarity greater than plasma osmolality (urine specific gravity >1.200), and water intoxication. More common in small cell lung cancer.
3. Other manifestations
(1) Skin lesions acanthosis nigricans and dermatitis are more common in adenocarcinoma, and skin pigmentation is caused by tumors secreting melanocyte-stimulating hormone (MSH) , more common in small cell carcinoma. Others include scleroderma and palmoplantar skin hyperkeratosis.
(2) Various types of lung cancer in the cardiovascular system may cause abnormal coagulation mechanisms, resulting in migrating venous thrombosis, phlebitis and non-bacterial embolic endocarditis, which may occur several times before the diagnosis of lung cancer. The moon appears.
(3) The hematology system may have chronic anemia, purpura, polycythemia, and leukemia-like reactions. It may be caused by reduced iron absorption, impaired erythropoiesis, shortened lifespan, capillary osmotic anemia, etc. In addition, DIC can occur in lung cancer of various cell types, which may be related to the release of procoagulant factors by tumors. Patients with lung squamous cell carcinoma may be accompanied by purpura.
(4) Symptoms of external invasion and metastasis
1. Lymph node metastasis
The most common ones are mediastinal lymph nodes and supraclavicular lymph nodes, mostly on the same side of the lesion. A few can be on the contralateral side, most of which are hard, with single or multiple nodules. Sometimes they can be the first complaint and go to the doctor. Enlarged lymph nodes near the trachea or under the carina can compress the airway and cause chest tightness. Shortness of breath or even suffocation. Compression of the esophagus can cause difficulty swallowing.
2. Pleural invasion and/metastasis
The pleura is a common invasion and metastasis site of lung cancer, including direct invasion and implantation metastasis. Clinical manifestations vary depending on the presence or absence of pleural effusion and the amount of pleural effusion. In addition to direct invasion and metastasis, the causes of pleural effusion also include lymph node obstruction and associated obstructive pneumonia and atelectasis. Common symptoms include dyspnea, cough, chest tightness and chest pain, etc., or there may be no symptoms at all; physical examination shows full intercostal space, widened intercostal space, decreased breath sounds, decreased tremor, solid sounds on percussion, mediastinal shift, etc. , Pleural effusion can be serous, serous-bloody or bloody, and most of it is exudate. Malignant pleural effusion is characterized by rapid growth and mostly bloody. Spontaneous pneumothorax can occur in extremely rare lung cancer. The mechanism is direct invasion of the pleura and obstructive emphysema rupture. It is more common in squamous cell carcinoma and has a poor prognosis.
3. Superior Vena Cava Syndrome (SVCS)
Tumor directly invades or mediastinal lymph node metastasis compresses the superior vena cava, or intraluminal embolism makes it narrow. Or occlusion, causing blood reflux obstruction, resulting in a series of symptoms and signs, such as headache, facial swelling, cervical and thoracic varicose veins, increased pressure, dyspnea, cough, chest pain and difficulty swallowing, and often syncope or dizziness when bending over. . Anterior thoracic and epigastric veins may have compensatory varicose veins, reflecting the timing of superior vena cava obstruction and the anatomical location of the obstruction. Signs and symptoms of superior vena cava obstruction are related to its location. If the innominate vein on one side is blocked, the blood flow from the head, face, and neck can return to the heart through the innominate vein on the opposite side, and the clinical symptoms will be mild. If the obstruction of the superior vena cava occurs below the entrance of the azygos vein, in addition to the dilation of the above-mentioned veins, there are also distended abdominal veins, through which blood flows into the inferior vena cava. If the obstruction develops rapidly, cerebral edema may occur with headache, drowsiness, agitation, and changes in consciousness.
4. Kidney metastasis
About 35% of patients who die from lung cancer are found to have kidney metastasis, which is also the most common metastasis site in patients who die within one month after surgical resection of lung cancer. Most renal metastases are asymptomatic, sometimes manifesting as low back pain and renal insufficiency.
5. Gastrointestinal metastasis
Liver metastasis can manifest as loss of appetite, pain in the liver area, sometimes accompanied by nausea, serum ?-GT is often positive, and AKP is progressively increased. During physical examination, it was found that the liver was enlarged, hard, and nodular. Small cell lung cancer is prone to pancreatic metastasis and may cause symptoms of pancreatitis or obstructive jaundice. Lung cancer of various cell types can metastasize to the liver, gastrointestinal tract, adrenal glands and retroperitoneal lymph nodes. It is often clinically asymptomatic and is often discovered during physical examination.
6. Bone metastasis
The common sites of bone metastasis from lung cancer include ribs, vertebrae, ilium, femur, etc., but the ribs and vertebrae on the same side are more common and manifest as local pain. There is also fixed point tenderness and percussion pain. Spinal metastases can compress the spinal canal causing obstruction or compression symptoms. Joint involvement may cause joint effusion, and cancer cells may be detected by puncture.
7. Central nervous system symptoms
(1) The incidence of metastasis to the brain, meninges and spinal cord is about 10%, and the symptoms may vary depending on the location of metastasis. Common symptoms include increased intracranial pressure, such as headache, nausea, vomiting, and changes in mental status. Rare symptoms include epileptic seizures, cranial nerve involvement, hemiplegia, ataxia, aphasia, and sudden fainting. Meningeal metastases are less common than brain metastases and often occur in patients with small cell lung cancer. Their symptoms are similar to those of brain metastases.
(2) The main manifestations of encephalopathy and cerebellar cortical degeneration are dementia, mental illness and organic lesions. The main manifestations of cerebellar cortical degeneration are acute or subacute limb dysfunction, difficulty in limb movement, tremor, and pronunciation. Difficulties, dizziness, etc. There are reports that the above symptoms can be relieved after tumor resection.
8. Heart invasion and metastasis
It is not uncommon for lung cancer to involve the heart, especially central lung cancer. Tumors can invade the heart through direct spread, or they can spread retrogradely through lymphatic vessels, blocking the lymphatic drainage vessels of the heart and causing pericardial effusion. Patients with slower development may be asymptomatic, or may only have pain in the precordium, subcostal arch, or upper abdomen. Those who develop rapidly may present with typical symptoms of cardiac tamponade, such as rapid heartbeat, palpitations, distended neck and facial veins, enlarged heart circles, low and distant heart sounds, hepatomegaly, and ascites.
9. Peripheral nervous system symptoms
Cancer compresses or invades the cervical sympathetic nerve, causing Horner's syndrome, which is characterized by miosis on the affected side, ptosis, enophthalmos and No sweating on the face, etc. Brachial plexus compression sign occurs when the brachial plexus is compressed or violated, manifesting as burning radiating pain in the ipsilateral upper limb, local paresthesia, and nutritional atrophy. When the tumor invades the phrenic nerve, it may cause paralysis of the diaphragm, causing chest tightness and shortness of breath. Paradoxical movement of the diaphragm can be seen under X-ray fluoroscopy. Compression or violation of the recurrent laryngeal nerve can cause vocal cord paralysis and hoarseness. Tumors at the apex of the lung (superior sulcus tumors) invade the cervical 8th and thoracic 1st nerves, brachial plexus, sympathetic ganglia and adjacent ribs, causing severe shoulder and arm pain, abnormal sensation, paralysis or weakness of one arm, and muscle atrophy. The so-called Pancoast syndrome.