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Lung Cancer in TCM

Generally Description
Lung cancer ,also called primary bronchogenic carcinoma ,is a malignant pulmonary tumor primarily originating from bronchial mucosa and glands,manifested mainly by irritable cough,blood-stained sputum or hemoptysis,chest pain and oppression,shortness of breath,fever,etc.Its incidence is the highest of all tumors in males and takes the second place in females.With an ominous prognosis ,it has a very high mortality.Its average survival rate of fiveyears is about 10% after various treatments .
The etiology and mechanism of lung cancer is not completely clear .It is believed that the disease is related to some inherent factors of the body and some environment factors ;and in particular,the lung is the organ exposed to the environment,so environment factors should not be ignored.It is already known that all the carcinogenic factors can cause lung cancer ,for instance ,cigarette smoking,air pollution,etc,Other factors related to it ,to some degree,are immunologic hypofunction,metabolic disorder,endocrine dysfunction and heredity .
In TCM ,according to its clinical manifestations,lung cancer belongs to the categories of “kaxue”(hemoptysis), “feiji”(lung mass), “xiben”(hypochondrium lumps), “xulao”(consumptive disease),etc .The exopathic factors are the six exogenous pathogenic factors that invade the lung.The endopathic ones include weak constitution,smoking and drinking,dust,emotional upset and overstrain.The main pathogenesis involves deficiency of anti-pathogenic factors with accumulation of phlegm and blood stasis in the lung.Generally ,this disease is characterized by principal defifiency and secondary excess.The excess refers to qi accumulation,blood stasis ,phlegm,dampness and toxic fire in the lung locally,and the deficiency denotes disorder of the whole body involving qi,blood ,yin and yang .


Essentials for Diagnosis

Irritable cough,blood stained sputum or heoptysis,chest pain and oppression, shortness of breath and fever are the chief manifestations .

Exfoliated cell examination in sputum may find cancer cells.If hydrothorax exists,cancer cells may be found in the smear of centrifuged and precipitated pleural effusion.

Space-occupying lesions found in X-ray,CT,and bronchography are healpful to diagnosis;bronchoscopy,isotope scanning,and biopsy examination are also helpful .

Males above 30 years with a long smoking history should be taken into consideration .


Syndrome Differentiation and Treatment
Syndromes of this disease are clinically classified as yin deficiency and toxic heat ,deficiency of lung qi and spleen qi ,accumulation of phlegm-dampness in the lung ,qi stagnation and blood stasis,deficiency of qi and yin,and deficiency of yin and yang .The therapeutic principle is strengthening the body resistance and eliminating the pathogenic factors .According to the state of the deficiency of body resistance or the excess of pathogenic factors ,treatment methos such as clearing away heat and resolving phlegm,activating collaterals and dissipating blood stasis,removing toxic substance and softening hard masses ,nourishing yin and moistening the lung,and invigorating qi and warming yang are used respectively .


Yin Deficiency and Toxic Heat

Chief Manifestations : Dry cough with little or no sputum,or blood-stained sputum,or frequent hemoptysis,low fever ,night sweating,dry mouth ,yellow urine ,constipation,red tongue with little or no coating ,and thready and rapid pulse .
Therapeutic Methods : To nurish yin,clear away heat,remove toxic substance and diminish stagnation .


Deficiency of Lung Qi and Spleen Qi Syndrome

Chief Manifestations : Shortness of breath ,cough with abundant white sputum,lassitude,feeling of oppression in the chest ,poor appetite ,abdominal distension ,loose stools ,sweating on exertion,pale tongue with teeth marks on lateral sides ,white and greasy tongue coating,and thready or soft-superficial and smooth pulse .
Therapeutic Methods : To replenish qi ,invigorate the spleen,regulate it and resole phlegm


 Accumulation of Phlegm-Dampness in the Lung
Chief Manifestations : Shortness of breath ,wheezing sound in the throat ,cough with difficult expectoration of sticky sputum,distending pain in the chest and hypochondriac region ,pale tongue with white and greasy or yellow and greasy coating ,wiry and smooth and raid pulse .
Therapeutic Methods : To resolve phlegm,eliminate turbidity,remove toxic substance and clear the lung .


Stagnation of Qi and Blood Stasis

Chief Manifestations : Stabbing pain and oppression in the chest ,shortness of breath ,rough cough with darkish blood in sputum,purplish lips,crimson tongue with ecchymotic spots on its surface ,thin yellow tongue coating ,and thready and unsmooth or wiry and thready pulse .
Therapeutic Methods : To promote the circulation of qi and blood ,resolve phlegm and soften hard masses .


Deficiency of Qi and Yin

Chief Manifestations : Dull pain in the chest and back ,cough with low sound ,lassitude,dysphoria wth feverish sensation in the chest ,palms and soles ,spontaneous sweating ,night sweating,red tongue with little coatings ,and deep,thready and rapid pulse .
Therapeutic Methods : To resplenish qi,nourish yin,clear away lung heat and remove toxic substance .


Deficiency of Yin and Yang

Chief Manifestations : Pale complexiojn ,cough with little sputum,feeling of oppression in the chest ,shortness of breath,dyspnea on exertion,sweating ,tinnitus,lumbago and weal legs,aversion to cold ,cold limbs,pale tongue with thin and white coating ,and deep and thready pulse .
Therapeutic Methods : To invigorate the lung and kidney,and regulate both yin and yang .

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