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[Prescription and Medicines] Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium) modified: Zhi Caozhong (Honey-fried Licorice Root, *Glycyrrhizae Radix et Rhizoma*) 5g, Huangqin (Scutellaria Root, *Scutellariae Radix*) 10g, Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*) 12 pieces, Ganjiang (Dried Ginger Rhizome, *Zingiberis Rhizoma Recens* dried), Jiangxia (Ginger-processed Pinellia Tuber, *Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine*) 10g, Chuanlian (Coptis Rhizome, *Coptidis Rhizoma*) 4g, Shengshaishen (Freshly Sun-dried Ginseng Root, *Panacis Quinquefolii Radix*) 5g, Dahuang (Rhubarb Root and Rhizome, *Rhei Radix et Rhizoma*) 3g, Gongyingying (Dandelion Herb, *Taraxaci Herba*) 15g.

In recent years, domestic scholars have conducted in vitro antibacterial tests against Helicobacter pylori on 53 commonly used Chinese medicinal herbs and their compound prescriptions for the clinical treatment of stomach diseases. They found that Dahuang (Rhubarb Root and Rhizome, *Rhei Radix et Rhizoma*), Huanglian (Coptis Rhizome, *Coptidis Rhizoma*), Wumei (Mume Fruit, *Pruni Mume Fructus*), Danshen (Salvia Root and Rhizome, *Salviae Miltiorrhizae Radix et Rhizoma*), and Sanqi (Notoginseng Root and Rhizome, *Notoginseng Radix et Rhizoma*) have strong inhibitory effects on Helicobacter pylori; Dahuang can reduce gastric juice secretion, lower gastric free acid and pepsin activity, clear Helicobacter pylori, alleviate inflammation, improve local microcirculation, and facilitate ulcer healing. The main component of Huanglian is berberine, which has a broad antibacterial spectrum, the highest inhibitory effect on Helicobacter pylori, and antispasmodic effects on acetylcholine. Sanqi not only has strong bactericidal effects but also accelerates the pathological reversal of atrophic intestinal metaplasia or hyperplastic tissues by improving gastric mucosal microcirculation. Additionally, pharmacological studies confirm that Gongyingying (Dandelion Herb, *Taraxaci Herba*), Baihuasheshecao (Hedyotis Diffusa Herb, *Hedyotidis Diffusae Herba*), Banzhilian (Scutellaria Barbata Herb, *Scutellariae Barbatae Herba*), Lianqiao (Forsythia Fruit, *Forsythiae Fructus*), Xuchangqing (Cynanchum Paniculatum Root, *Cynanchi Paniculati Radix*), and Ezhu (Curcuma Rhizome, *Curcumae Rhizoma*) have the effect of killing Helicobacter pylori.

Epigastric pain is mostly a chronic disease, often caused by emotional injury and irregular diet. In clinical practice, it often presents as a complex interweaving of cold, heat, deficiency, and excess. Therefore, detailed syndrome differentiation is necessary for effective treatment of epigastric pain. The treatment of precancerous lesions of gastric cancer with Chinese medicine varies according to the individual, the disease, and the syndrome. It is formulated under the guidance of the holistic concept and syndrome differentiation, fully embodying the principle of "preventing disease before it arises, treating cancer early if present."

2. Traditional Chinese Medicine Treatment of Gastric Cancer

Gastric cancer is a malignant tumor occurring in the epithelial tissue of the stomach. Epidemiological surveys have confirmed that China is one of the countries with the highest incidence and mortality rates of gastric cancer, accounting for about half of the deaths from digestive tract cancers. Approximately 200,000 new cases occur annually, and the incidence ranks among the top of all malignant tumors. About 50% of diagnosed cases are eligible for surgical resection, and the 5-year survival rate for surgically resected cases is approximately 20%. There is no specific disease name for gastric cancer in traditional Chinese medicine classics. Based on clinical manifestations, it belongs to the categories of "Yige" (Dysphagia and Food Impaction), "Fanwei" (Regurgitation), "Fuliang" (Abdominal Mass), "Weiwanybing" (Epigastric Disease), "Zhengjia" (Fixed Masses), and "Jiju" (Accumulations) in traditional Chinese medicine. For example, when a tumor causes stenosis of the cardia, leading to progressive dysphagia, it is very similar to the symptoms of food impaction and immediate vomiting after eating seen in "Yige". When a tumor causes stenosis or complete obstruction of the pylorus, its clinical manifestations are basically the same as the "Weifan" described by Zhang Zhongjing in the Han Dynasty and the "Fangwei" described in "Bianque Xinshu". The chapter "Sixty-four Qi" in *Ling Shu* states: "Food and drink cannot go down, the chest and throat are blocked, the pathogen is in the epigastrium." The chapter "To Be Great and Necessary" in *Su Wen* says: "Pain in the epigastrium corresponding to the heart, radiating to both hypochondria, severe cases may have vomiting, blockage of the chest and throat." *Jin Gui Yao Lue - Vomiting, Hiccups, Diarrhea* states: "Morning food vomited in the evening, evening food vomited in the morning, undigested food remains, this is called 'Weifan'." The chapter "All Diseases of Abdominal Masses" in *Wai Tai Mi Yao* states: "Long-standing abdominal masses and fixed lumps, large as cups or bowls, jaundice, regurgitation of overnight food in the morning, fullness and rising qi, frequent abdominal distension, hardness below the heart, rushing up to the heart, attacking both hypochondria, extending to the back and chest." The above descriptions point out the site of lesion and main clinical manifestations of this disease. Regarding etiology and pathology, it is considered related to improper diet, emotional depression, or chronic illness that does not heal. As stated in "Formulas for Treating Regurgitation, Vomiting, and Hiccups" in *Sheng Hui Fang*: "As for Weifan... some are caused by excessive drinking damaging the spleen and stomach, and fatigue... some are caused by sorrow, frustration, and anger, leading to intestinal knotting and stomach turning... some are caused by retained stagnation,癖 masses, cold phlegm, which are not completely eliminated over time, resulting in this disease." Early vigilance was also paid to certain conditions that could become precancerous lesions of gastric cancer. As stated in the chapter "Acid Regurgitation" in *Zheng Zhi Hui Bu*: "Acid regurgitation is a minor ailment, but it can be temporary and not long-lasting; if it persists and does not heal, it becomes a precursor to Yige and Weifan." Regarding the prevention and treatment of gastric cancer, *Yi Guan - Discussion on Yige* points out: "One must avoid external six evils, regulate internal seven emotions, nourish oneself through diet, nourish blood and generate fluids to moisten the intestines and stomach... If qi is clear and blood is harmonious, then spleen qi will transport and transform efficiently, and food will be digested and transmitted." In summary: Traditional Chinese medicine has extensive and in-depth research on the etiology, pathology, treatment, and prevention of gastric cancer.

Etiology and Pathogenesis of Gastric Cancer

The stomach is the sea of water and grain, the place where all things gather, and also a region abundant in qi and blood. Humans rely on stomach qi for life. Diet and medication first injure the stomach; when substances accumulate and mix, they easily cause blockage. The occurrence of gastric cancer is due to irregular diet and excessive worry/thought, leading to damage to the spleen and stomach, dysfunction of transportation and transformation, accumulation of qi and condensation of phlegm, and mutual binding of stasis and toxin. If there is congenital insufficiency, susceptibility is even greater.

1. Emotional Factors

Traditional Chinese medicine has always attached great importance to the relationship between emotions and disease, believing that "all diseases arise from qi; anger causes qi to rise, joy causes qi to slacken, grief causes qi to dissipate, fear causes qi to sink, cold causes qi to contract, heat causes qi to escape, shock causes qi to become chaotic, labor causes qi to be depleted, and thought causes qi to knot." *Nei Jing* points out that gastric cancer is a disease of "sudden and severe worry." Worry and thought injure the spleen; when the spleen is injured, qi knots, and body fluids cannot be distributed, gathering to form phlegm; anger injures the liver; when the liver is injured, qi stagnates, and blood flow is unsmooth, accumulating to form stasis. Phlegm and stasis bind mutually, blocking the cavity and obstructing stomach qi, causing difficulty in swallowing food; liver qi stagnation often rebels against the stomach and insults the spleen, resulting in disharmony between the liver and stomach. Prolonged qi stagnation can transform into fire, injuring yin and damaging collaterals, presenting with symptoms such as epigastric pain, hematemesis, and melena, which are symptoms of gastric cancer. Worry, thought, depression, and anger not only cause disease but often exacerbate the condition. Many gastric cancer patients, once diagnosed, become deeply worried, appetite significantly decreases, the whole body feels weak, and they lose hope, weakening their will to live and self-defense/anti-cancer capabilities. All these indicate that the occurrence of tumors is closely related to mental and emotional factors.

2. Dietary Factors

Diet and moderation in work and rest are necessary conditions for human survival and health maintenance. Diet should be regulated, and work/rest should be appropriate; otherwise, it will affect human physiological functions, leading to qi mechanism disorder or righteous qi damage. Traditional Chinese medicine has long recognized that dietary and labor injuries can lead to the occurrence of gastric cancer. If one indulges in rich, greasy, spicy, and roasted foods, it affects the transportation and transformation function of the spleen and stomach. The spleen governs dampness; spleen deficiency fails to transport and transform water and dampness, dampness accumulates internally, persists for a long time, body fluids fail to transform, dryness congeals into turbid phlegm, accumulating to form a mass. *Yi Bie · Fanwei Yige* also believes that the cause of Yige is "wine drinkers often suffer from Yige, especially those who drink hot wine, because heat injures body fluids, the throat becomes dry and rough, and food cannot enter." Research by the Shanghai Digestive Disease Institute found that the intracellular content of vitamins A, E, B12, and vitamin carotene in cells in the gastric cancer area and adjacent areas was significantly lower than in the corresponding cells of non-cancerous gastric specimens. This indicates that the occurrence of gastric cancer is closely related to vitamin deficiency, a relationship that occurs internally at the cellular level during the precancerous stage. Therefore, developing good dietary habits, obtaining sufficient vitamins and carotenes from food, avoiding long-term consumption of pickled vegetables, dried salted fish, and smoked products, and not eating contaminated or moldy foods are important for preventing gastric cancer.

3. Congenital Factors

Congenital factors refer to genetic factors. Is gastric cancer hereditary? Gastric cancer is more common in some families and is related to genetics. Its incidence rate in the relatives of patients is four times higher than in the control population; and the incidence rate of gastric cancer in people with blood type A is higher than in people with other blood types, indicating that gastric cancer is influenced by multifactorial genes. Those with congenital constitutional insufficiency and long-standing chronic stomach diseases, compounded by emotional imbalance and irregular diet, have an increased risk of developing gastric cancer.

Clinical Treatment of Gastric Cancer

The treatment of gastric cancer in traditional Chinese medicine includes Chinese medicine treatment and comprehensive treatment.

Chinese Medicine Treatment

Facing a large number of mid-to-late-stage patients who cannot undergo radical surgery, or who have postoperative recurrence/metastasis, or cannot tolerate chemotherapy, a considerable number of TCM practitioners start from the holistic view of TCM. Instead of making shrinking the tumor mass the only goal, they focus on combining supporting healthy qi (Fu Zheng) and eliminating pathogenic factors (Qu Xie), adjusting bodily balance, alleviating patient suffering, and prolonging life. For many patients, despite the extensive development of cancer, self-perceived symptoms remain not very obvious, and quality of life is high due to long-term use of Chinese herbal medicine. This shows that emphasizing the holistic approach is a characteristic of TCM tumor treatment; improving quality of life, alleviating patient suffering, prolonging life, and delaying tumor development are precisely the strengths of TCM. In clinical practice, one should distinguish the primary and secondary aspects of deficiency and excess based on the duration of the disease, the balance of pathogenic and righteous qi, and accompanying symptoms. Early gastric cancer mostly belongs to the syndromes of liver meridian qi stagnation and spleen-stomach yang deficiency; mid-stage often sees endogenous damp-turbidity and blood stasis-phlegm condensation syndromes; late-stage often sees stomach heat injuring yin, dual deficiency of qi and blood, and internal obstruction by stasis and toxin.

1. Liver-Stomach Disharmony Syndrome

Main Symptoms: Epigastric distension and fullness, intermittent pain radiating to both hypochondria, bitter taste in the mouth, irritability, foul belching, reduced food intake or vomiting/regurgitation, dry stool, thin yellow or thin white tongue coating, wiry and fine pulse.

Treatment Method: Soothe the liver and harmonize the stomach, descend rebellious qi and relieve pain, eliminate tumors.

Prescription: Xiaoyao San (Free and Easy Wanderer Powder) modified: Chaihu (Bupleurum Root, *Bupleuri Radix*) 12g, Yujin (Turmeric Tuber, *Curcumae Longae Rhizoma*) 12g, Hang Baishao (White Peony Root, *Paeoniae Radix Alba*) 12g, Sharen (Amomum Fruit, *Amomi Fructus*) 3g added later, Meiguihua (Rose Flower, *Rosa Rugosae Flos*) 6g, Jiangxia (Ginger-processed Pinellia Tuber, *Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine*) 12g, Chuanlian (Coptis Rhizome, *Coptidis Rhizoma*) 3g, Chao Sanxian (Stir-fried Three Immortals: Shenqu, Maiya, Shaoyao) 10g each, Quan Gualou (Whole Trichosanthes Fruit, *Trichosanthis Fructus*) 20g, Daizheshi (Magnetite, *Hematitum*) 12g decocted first, Tengligen (Actinidia Vine Root, *Actinidiae Volubilis Radix*) 30g.

2. Spleen-Stomach Deficiency-Cold Syndrome

Main Symptoms: Epigastric distension and dull pain, preference for warmth and pressure, or morning food vomited in the evening, evening food vomited in the morning, or food vomited long after ingestion, occasional vomiting of clear fluid, pale and lusterless complexion, mental fatigue and cold limbs, loose stools, or undigested food in stool, pale and swollen tongue with teeth marks, white slippery and moist tongue coating, deep slow or deep fine and soggy pulse.

Treatment Method: Warm the middle and dispel cold, strengthen the spleen and harmonize the stomach.

Prescription: Lizhong Tang (Regulate the Middle Decoction) modified: Renshen (Ginseng Root, *Panacis Ginseng Radix*) 10g, Baizhu (Atractylodes Macrocephala Rhizome, *Atractylodis Macrocephalae Rhizoma*) 12g, Fuling (Poria, *Poria*) 12g, Jiangxia (Ginger-processed Pinellia Tuber, *Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine*) 10g, Gaoliangjiang (Galangal Rhizome, *Alpiniae Officinarum Rhizoma*) 8g, Zhi Caozhong (Honey-fried Licorice Root, *Glycyrrhizae Radix et Rhizoma*) 6g, Sheng Huangqi (Astragalus Root, *Astragali Radix*) 30g, Rougui (Cinnamon Bark, *Cinnamomi Cortex*) 5g added later, Yiyiren (Coix Seed, *Coicis Semen*) 30g.

3. Phlegm-Dampness Condensation Syndrome

Main Symptoms: Abdominal pain, chest tightness and discomfort, limb weakness and fatigue, copious vomiting of phlegm-saliva, dark-purple tongue, slippery and greasy tongue coating, fine and soggy pulse.

Treatment Method: Resolve phlegm and dissipate nodules, warm and transform the middle jiao.

Prescription: Kaiyu Erchen Tang (Open Depression and Two Olds Decoction) modified: Gualoupi (Trichosanthes Peel, *Trichosanthis Pericarpium*) 12g, Jiangxia (Ginger-processed Pinellia Tuber, *Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine*) 12g, Fuling (Poria, *Poria*) 12g, Cangzhu (Atractylodes Lancea Rhizome, *Atractylodis Lanceae Rhizoma*) 12g, Baizhu (Atractylodes Macrocephala Rhizome, *Atractylodis Macrocephalae Rhizoma*) 12g, Xiakucao (Prunella Spike, *Prunellae Spica*) 30g, Muli (Oyster Shell, *Concha Ostreae*) 30g decocted first, Chunghou (Magnolia Bark, *Magnoliae Officinalis Cortex*) 10g.

4. Stomach Heat Injuring Yin Syndrome

Main Symptoms: Burning pain in the epigastrium, stomach discomfort and hunger without desire to eat, worsening after meals, dry and bitter mouth, five-palm heat, constipation, red tongue with no coating, fine and rapid pulse.

Treatment Method: Nourish yin and benefit the stomach, clear heat and detoxify.

Prescription: Yunu Jian (Jade Woman Decoction) combined with Zengye Tang (Increase Fluids Decoction) modified: Shihu (Dendrobium Stem, *Dendrobii Caulis*) 15g, Yuan Shen (Scrophularia Root, *Scrophulariae Radix*) 20g, Zhimu (Anemarrhena Rhizome, *Anemarrhenae Rhizoma*) 10g, Shengdi (Rehmannia Root, *Rehmanniae Radix*) 10g, Tianhuafen (Trichosanthes Root, *Trichosanthis Radix*) 12g, Nan Shashen (Glehnia Root, *Glehniae Radix*) 15g, Banzhilian (Scutellaria Barbata Herb, *Scutellariae Barbatae Herba*) 30g, Sheyeshecao (Hedyotis Diffusa Herb, *Hedyotidis Diffusae Herba*) 30g.

5. Stasis-Toxin Internal Binding Syndrome

Main Symptoms: Burning and stabbing pain in the epigastrium, severe pain after eating, abdominal distension and refusal to press, palpable mass below the heart, dry and scaly skin, or hematemesis and melena, purple-dark tongue or ecchymosis, deep wiry, fine choppy, or wiry-rapid pulse.

Treatment Method: Clear heat and detoxify, invigorate blood and resolve stasis, eliminate tumors.

Prescription: Shixiao San (Laughing Apart Powder) plus modifications: Sheng Puhuang (Pollen Typhae) 10g, Wulingzhi (Trogopterus Dung, *Excrementum Trogopterori*) 10g, Zhi Yuanhu (Processed Corydalis Rhizome, *Corydzalis Rhizoma*) 10g, Danggui (Angelica Sinensis Root, *Angelicae Sinensis Radix*) 12g, Banzhilian (Scutellaria Barbata Herb, *Scutellariae Barbatae Herba*) 30g, Fengfang (Honeycomb, *Cera Cerapis*) 12g, Tengligen (Actinidia Vine Root, *Actinidiae Volubilis Radix*) 30g, Shougong (Gecko, *Gekko*) 3 pieces, Kushen (Sophora Root, *Sophorae Flavescentis Radix*) 30g.

6. Dual Deficiency of Qi and Blood Syndrome

Main Symptoms: Late-stage gastric cancer, severe anemia, emaciation, puffy and lusterless face and eyes, mental fatigue and weakness, palpitations and shortness of breath, dizziness and blurred vision, empty irritability and insomnia, spontaneous and night sweats, aversion to cold and cold body, poor appetite and lack of taste, obvious upper abdominal mass, pale and swollen tongue with little coating, deficient, fine, and powerless pulse.

Treatment Method: Tonify and nourish qi and blood, strengthen the spleen and benefit the kidney.

Prescription: Shiquan Dabu Tang (Ten Ingredients Great Supplement Decoction) modified: Huangqi (Astragalus Root, *Astragali Radix*) 30g, Heshouwu (Polygonum Multiflorum Root, *Polygoni Multiflori Radix*) 15g, Renshen (Ginseng Root, *Panacis Ginseng Radix*) 10g, Baizhu (Atractylodes Macrocephala Rhizome, *Atractylodis Macrocephalae Rhizoma*) 12g, Fuling (Poria, *Poria*) 12g, Danggui (Angelica Sinensis Root, *Angelicae Sinensis Radix*) 12g, Xianlingpi (Acanthopanax Bark, *Acanthopanacis Cortex*) 12g, Hang Baishao (White Peony Root, *Paeoniae Radix Alba*) 12g, Zhi Gancao (Honey-fried Licorice Root, *Glycyrrhizae Radix et Rhizoma*) 5g, Chao Sanxian (Stir-fried Three Immortals: Shenqu, Maiya, Shaoyao) 10g each, Xiaomai (Floating Wheat, *Tritici Levis Fructus*) 30g, Muli (Oyster Shell, *Concha Ostreae*) 30g added first.

Comprehensive Treatment

Applying traditional Chinese medicine to adjust the intrinsic anti-tumor ability of gastric cancer patients, treat surgical complications, and alleviate the toxic and side effects of radiotherapy and chemotherapy is an effective means to improve curative effects and can run throughout the entire treatment process.

1. TCM Cooperation with Surgical Treatment

TCM cooperation with surgery includes preoperative and postoperative treatment. The purpose of preoperative treatment is to adjust yin and yang, qi and blood, and zang-fu functions, maximizing the recovery of righteous qi so that the patient can smoothly undergo surgery. The treatment principles are tonifying qi and blood, strengthening the spleen and harmonizing the stomach, and nourishing the liver and kidney. Common prescriptions include Sijunzi Tang (Four Gentlemen Decoction), Bazhen Tang (Eight Treasures Decoction), Baoyuan Tang (Preserve Origin Decoction), Shiquan Dabu Tang (Ten Ingredients Great Supplement Decoction), and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). These supportive drugs can increase patient immune function and enhance the total white blood cell count and T-lymphocyte activity in peripheral blood. In clinical practice, I often advise gastric cancer patients to take one piece of Biezhi Shen (Korean Ginseng, *Panacis Ginseng Radix Rubra*) before surgery, which indeed reduces surgical pain, improves scar healing, and accelerates postoperative physical recovery.

Postoperative treatment mainly addresses complications caused by surgery, such as low-grade fever, night sweats, poor appetite, and gastrointestinal dysfunction. The treatment method should involve Eight Principles syndrome differentiation, distinguishing severity and urgency, and treating according to syndrome differentiation as follows:

Low-grade fever: Prescription uses Taizishen (Pseudostellaria Root, *Pseudostellariae Radix*) 10g, Nan/Shabei Sha Shen (Glehnia/Glabrous Foxglove Root, *Glehniae Radix / Digitalopsis Glabrae Radix*) 10g each, Digupi (Groundcherry Root Bark, *Lycii Cortex*) 10g, Yinchaihu (Silverroot, *Cistanches Herba* - Note: Usually Cistanche, but here likely refers to *Boreau's Silverroot* or similar heat-clearing herb, context suggests clearing deficiency heat), Zhimu (Anemarrhena Rhizome, *Anemarrhenae Rhizoma*) 10g, Chuan Shihu (Dendrobium Stem, *Dendrobii Caulis*) 15g, Yuan Shen (Scrophularia Root, *Scrophulariae Radix*) 10g, Shengdi (Rehmannia Root, *Rehmanniae Radix*) 12g, Sheng Cao (Raw Licorice Root, *Glycyrrhizae Radix et Rhizoma*) 3g, Xiyangshen (American Ginseng Root, *Panacis Quinquefolii Radix*) 5g.

Night Sweats: Prescription uses Muli (Oyster Shell, *Concha Ostreae*) 30g added first, Longgu (Fossilized Bone, *Os Draconis*) 30g added first, Zhi Huangqi (Honey-fried Astragalus Root, *Astragali Radix*) 30g, Bitaogan (Peach Twig Knot, *Persicae Ramulus Nodus*) 10g, Nuodaogen (Glutinous Rice Root, *Oryzae Sativae Radix*) 15g, Ru Douyi (Sojae Semen Preparatum) 12g, Hang Baishao (White Peony Root, *Paeoniae Radix Alba*) 12g, Yurou (Cornus Fruit, *Corni Fructus*) 12g, Xianhecao (Agrimony Herb, *Agrimoniae Herba*) 30g.

Poor Appetite: Prescription uses Dangshen (Codonopsis Root, *Codonopsis Radix*) 12g, Fuling (Poria, *Poria*) 12g, Dongzhu (Winter Atractylodes Rhizome, *Atractylodis Rhizoma*) 12g, Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) 3g, Chao Liuqu (Stir-fried Medicated Leaven, *Massa Medicata Fermentata*) 12g, Chenxiangqu (Agarwood Medicated Leaven, *Aquilariae Massa Medicata*) 12g, Chao Erya (Stir-fried Two Sprouts: Maiya, Shiyiya) 10g each, Hongzao (Jujube Fruit, *Ziziphi Jujubae Fructus*) 20g, Pingdimu (Actinidia Vine Root, *Actinidiae Volubilis Radix*) 12g, Xiangfu (Cyperus Rhizome, *Cyperi Rhizoma*) 10g.

Diarrhea: Prescription uses Chunghou (Magnolia Bark, *Magnoliae Officinalis Cortex*) 10g, Dongzhu (Winter Atractylodes Rhizome, *Atractylodis Rhizoma*) 12g, Chao Hezirou (Stir-fried Areca Nut Flesh, *Arecae Pericarpium*) 10g, Longgu (Fossilized Bone, *Os Draconis*) 30g, Yuguo Tan (Charred Nutmeg, *Myristicae Semen Carbonisatum*) 10g, Zhi Fupian (Processed Aconite Lateral Root, *Aconiti Lateralis Radix Praeparata*) 5g, Shiliupi (Pomegranate Peel, *Punicae Granati Cortex*) 10g, Sheng Huangqi (Astragalus Root, *Astragali Radix*) 30g, Fuling (Poria, *Poria*) 10g, Chao Jinji (Stir-fried Chicken Gizzard Membrane, *Gigeria Galli Endochilii Periostracum*) 10g, Paojiang (Roasted Ginger Rhizome, *Zingiberis Rhizoma Praeparatum*) 6g.

Gastrointestinal Adhesions: Prescription uses Wuyao (Lindera Root, *Linderae Radix*) 12g, Zhiqiao (Bitter Orange Fruit, *Citri Reticulatae Viridis Fructus*) 12g, Hongteng (Sargentodoxa Vine, *Sargentodoxae Caulis et Folium*) 30g, Jinyintahateng (Honeysuckle Stem, *Lonicerae Japonicae Caulis*) 15g each, Gongyingying (Dandelion Herb, *Taraxaci Herba*) 30g, Banzhilian (Scutellaria Barbata Herb, *Scutellariae Barbatae Herba*) 30g, Hang Baishao (White Peony Root, *Paeoniae Radix Alba*) 10g, Huanglian (Coptis Rhizome, *Coptidis Rhizoma*) 5g, Huangbai (Phellodendron Bark, *Phellodendri Chinensis Cortex*) 10g, Danpi (Moutan Cortex, *Paeoniae Moutan Cortex*) 10g, Zhi Dahuang (Processed Rhubarb Root and Rhizome, *Rhei Radix et Rhizoma*) 10g.

2. TCM Cooperation with Radiotherapy

Currently, radiotherapy for gastric cancer is only applied preoperatively and intraoperatively. The role of TCM cooperative treatment lies in alleviating radiotherapy side effects, maintaining the patient's righteous qi, and enabling smooth surgery. Common symptoms of radiotherapy include nausea and poor appetite; severe cases may have vomiting. In the late stage of radiotherapy, abdominal pain, diarrhea, decreased blood counts, and decreased immune function may occur. The following prescriptions can be used for treatment based on symptoms.

Nausea and Vomiting: Prescription uses Jiangxia (Ginger-processed Pinellia Tuber, *Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine*) 10g, Daizheshi (Magnetite, *Hematitum*) 12g added first, Jiang Zhuru (Ginger-processed Bamboo Shavings, *Bambusae Caulis in Taeniam Praeparatus*) 12g, Gong Dingxiang (Clove, *Caryophylli Flos*) 3 pieces, Chenxiang (Agarwood, *Aquilariae Lignum Resinatum*) 5g, Xuanfuhua (Inula Flower, *Inulae Flos*) 12g wrapped decocted, Baishao (White Peony Root, *Paeoniae Radix Alba*) 10g, Sharen (Amomum Fruit, *Amomi Fructus*) 3g added later.

Poor appetite can refer to the same prescriptions as in postoperative treatment, appropriately adding spleen-strengthening and qi-regulating herbs. Decreased blood counts and immune function can be treated with Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) combined with Bazhen Tang (Eight Treasures Decoction) or Shiquan Dabu Tang (Ten Ingredients Great Supplement Decoction). For severe symptoms, Renshen (Ginseng Root, *Panacis Ginseng Radix*) 5g, Heche Fen (Placenta Powder, *Placenta Humana*) 10g, Lingzhi (Ganoderma, *Ganodermatis Spora* or *Ganodermatis Lucidi Fructus*), Xianhecao (Agrimony Herb, *Agrimoniae Herba*) 30g, Dongchong Xiacao (Cordyceps, *Cordyceps Sinensis*) and other herbs can be added.

3. TCM Cooperation with Chemotherapy

Chemotherapeutic drugs for treating gastric cancer all have varying degrees of toxic and side effects, mainly manifested as inhibition of bone marrow hematopoietic function, gastrointestinal reactions, and decreased immune function. Some patients may experience damage to the heart, kidneys, liver, and nervous tissue. Due to toxic side effects, a considerable number of patients interrupt treatment or cannot accept chemotherapy. Traditional Chinese medicine plays an active therapeutic role in preventing and treating the toxic side effects produced by chemotherapy. Using Chinese herbs to strengthen the spleen and replenish qi, and nourish the liver and kidney can prevent the decline of white blood cells, improve macrophage function, raise plasma cortisol levels, and ensure the smooth progress of the treatment course for patients who cannot accept or have interrupted chemotherapy. The clinical manifestations of chemotherapeutic toxic side effect complications are very complex. Summarized, they fall into the following four major aspects:

(1) Systemic Reactions

Manifested as dizziness, fatigue, sweating, reduced appetite, mental fatigue, and poor sleep. TCM syndrome differentiation is mostly dual deficiency of qi and blood, and liver-kidney insufficiency. Medicinals used for replenishing qi and nourishing blood, and nourishing the liver and kidney include Sijunzi Tang (Four Gentlemen Decoction), Siwu Tang (Four Substances Decoction), Buzhong Yiqi Tang (Center-Boosting Qi-Enriching Decoction), Bazhen Tang (Eight Treasures Decoction), Shiquan Dabu Tang (Ten Ingredients Great Supplement Decoction), and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) modified.

(2) Bone Marrow Suppression