方药：甘草泻心汤加减：炙草5克 黄芩10克 大枣十二枚 干姜5克 姜夏10克 川连4克生晒参5克 大黄3克 蒲公英15克
近年来，国内学者对临床治疗胃病的常用53味中药及其复方，分别对幽门螺杆菌作抑菌试验，发现大黄、黄连、乌梅、丹参、三七对幽门螺杆菌有较强的抑菌作用；大黄能减少胃液分泌，降低胃游离酸及胃蛋白酶活性，有清除幽门螺杆菌作用，减轻炎症程度，改善局部微循环，有利于溃疡愈合。黄连主要成分为小蘖碱，抗菌谱较广，对幽门螺杆菌抑菌最高，并且对乙酰胆碱有解痉作用。三七不仅杀菌作用较强，且能通过改善胃粘膜微循环，而加速萎缩性肠化生或增生组织病理逆转。此外，蒲公英、白花蛇舌草、半支莲、连翘、徐长卿、莪术等药理证实有杀灭幽门螺杆菌作用。
胃脘痛大多是久病，常因七情损伤，饮食不节而成，临证又多以寒热虚实错综交织出现，因此治疗胃脘痛必详细辨证方可取效。中医药对胃癌前病变的治疗因人、因病、因证而异，是在整体观念和辨证论治的精神指导下制定的，充分体现了"无癌早防，有癌早治"的治未病原则。
2．胃癌的中医治疗
胃癌是发生于胃部上皮组织的恶性肿瘤，流行病学调查业已证实我国是胃癌发病率和死亡率最高的国家之一，约占消化道癌肿死亡人数的一半，每年新发生的胃癌患者约20万，发病率亦居各种恶性肿瘤之前列。能手术切除的占确诊病例的50%，手术切除病例的5年生存率大约20%左右。中医典籍中无胃癌之病名，按临床表现分析，属于祖国医学"噎膈""反胃""伏梁""胃脘病""癥瘕""积聚"等病症范畴。例如当癌瘤引起贲门狭窄，导致进行性吞咽困难与"噎膈"的进食噎塞不利，甚至食入即吐的症状非常相似，当癌瘤引起幽门狭窄或完全梗塞时，其临床表现与汉代张仲景所说"胃反"，《扁鹊心书》所说的'翻胃'基本相同。《灵枢-四时气》篇云："饮食不下，膈塞不通，邪在胃脘。"《素问-至真要大论》篇曰"胃脘当心而痛，上支两胁，甚则呕吐，膈咽不通。"《金匮要略-呕吐哕下利》曰；"朝食暮吐，暮食朝吐，宿谷不化，名曰'胃反'。"《外台秘要-癥癖等一切病》篇云："心腹积聚久癥癖，块大如杯碗，黄疸，宿食朝起呕变，支满上气，时时腹胀，心下坚结，上来抢心，傍攻两胁，彻背连胸"以上描述，指明了本病的病变部位和主要临床表现。对病因病理，则认为与饮食不当，情志抑郁或久病不愈有关。如《圣惠方-治反胃呕哕诸方》云："夫反胃者┉则有因饮酒过伤脾胃，劳乏所致┉则有因忧悒蓄怒，肠结胃翻所致，则有宿滞癖痼，积聚冷痰，久不全除，致成兹疾"。对某些可能成为胃癌的前期病变也早有所警惕。如《证治汇补-吞酸》篇说："吞酸，小疾也，然可暂而不可久，久而不愈为噎膈反胃之渐也。"对胃癌的防治，《医贯-噎膈论》指出："必外避六淫，内节七情，饮食自养，滋血生津，以润肠胃┉气清血和，则脾气健运而食消传化矣。"综上所述：祖国医学对胃癌的病因病理，治疗及预防有着广泛而深入的研究。
胃癌的病因病机
胃为水谷之海，百物聚集之地，又为多气多血之乡，人赖胃气而生，饮食药饵，先伤于胃，物聚类杂，最易壅塞，胃癌之生系饮食失节，忧思过度，脾胃受损，运化失常，气结痰凝，瘀毒互结而成，若先天不足则更有易感性。
1、情志因素
中医历来十分重视情志与疾病的关系，认为"百病生于气也，怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，炅则气泄，惊则气乱，劳则气耗，思则气结┉。"《内经》指出胃癌是"暴忧之病"忧思伤脾，脾伤则气结，气结则津液不能输布，聚而成痰；恼怒伤肝，肝伤则气郁，气郁则血流不畅，积而成瘀，痰瘀互结，壅塞腔道，阻隔胃气，引起进食噎塞难下；肝气郁滞，常可横逆犯胃侮脾，以致肝胃不和，气郁日久，则可气郁化火伤阴，损伤脉络，症见胃痛，吐血，便血等胃癌症状。忧思郁怒不仅可以致病，而且往往使病情加剧，许多胃癌患者，一旦查证是胃癌，立即忧心忡忡，食欲明显减退，全身无力，悲观失望，削弱了求生意志和自身防御，抗癌能力，这些都说明肿瘤的发生与精神情志密切相关。
2、饮食因素
饮食劳逸是人类生存和保持健康的必要条件，饮食要节制，劳逸要适情，否则会影响人体生理功能，导致气机紊乱或正气损伤，中医早就认识到饮食劳伤，可导致胃癌的发生。若恣食膏梁厚味，辛辣炙煿之品，影响脾胃运化功能。脾主湿，脾虚不能运化水湿，湿蕴于内，积久不散，津液不化，津枯凝集痰浊积而为肿物，《医碥·反胃噎膈》也认为噎膈的成因为"酒客多噎膈，饮热酒者尤多，以热伤津液，咽管干涩，食不得入也。"上海消化道病研究所研究发现，胃癌区及癌旁区细胞内维生素A、E、B12、及维他命胡萝卜素含量显著低于非癌的胃标本对应区细胞中的含量，这表明胃癌的发生与维生素的缺乏有重要关系，这种关系在癌前期已在细胞内部发生。因而养成良好的饮食习惯，从食物中摄取充足的维生素及胡萝卜素，不要长期食用腌菜，干咸鱼，熏制品，不吃污染霉变食品。对防范胃癌的发生是重要的。
3、先天因素
先天因素即遗传因素，胃癌有否遗传？胃癌多见于一些家庭，与遗传有一定关系。它的发生率在患者的亲族中比对照人群要高四倍；而A型血胃癌发病率高于其它血型的人，说明胃癌是受多因素性基因影响的。有先天素体不足，长期存在慢性胃疾。在此基础上复因情志失调，饮食失节，发生胃癌的危险性就会增加。
胃癌的临床治疗
中医对胃癌的治疗有中医治疗及综合治疗。
中医治疗
面对大批未能手术根治或术后复发，转移及不能忍受化疗的中晚期患者，有相当部份中医师从中医整体观出发，不是把缩小肿块作为唯一目标，而注重扶正与袪邪相结合，调整机体平衡，使患者减轻痛苦，延长寿命。有为数不少的患者，由于长期服用中药，尽管癌症发展已经相当广泛，但自觉症状仍不甚明显，生存质量较高，可见重视整体是中医治疗肿瘤的特点；改善生存质量，减轻患者痛苦，延长患者寿命及延缓肿瘤的发展，正是中医的长处。临证时应根据病程长短，邪正盛衰，伴有症状，辨明虚实的主次。胃癌早期多属肝经气郁，脾胃阳虚证型；中期多见湿浊内生，血瘀痰凝证型；晚期则多见胃热津伤，气血双亏，瘀毒内阻。
主证：胃脘胀满，时时作痛，串及两胁，口苦心烦，嗳气陈腐，饮食少进或呕吐反胃，大便干结，舌苔薄黄或薄白，脉弦细。
方药：逍遥散加减：柴胡12克 郁金12克 杭白芍12克 砂仁3克后下 玫瑰花6克 姜夏12克 川连3克 炒三仙各10克 全瓜蒌20克代赭石先煎12克 藤梨根30克
主证：胃脘胀满隐痛，喜温喜按，或朝食暮吐，暮食朝吐，或食入经久仍复吐出，时呕清水，面色晄白无华，神疲肢凉，便溏，或完谷不化，舌淡胖边有齿痕，苔白滑润，脉沉缓或沉细濡。
方药：理中汤加减：人参10克 白术12克 茯苓12克姜夏10克 高良姜8克炙草6克 生芪30克肉桂后下5克 米仁30克
3、痰湿凝结型
主证：脘腹疼痛，胸闷不舒，肢懈乏力，呕吐痰涎量多，舌黯淡，苔滑腻，脉细而濡。
方药，开郁二陈汤加减：瓜蒌皮12克 姜夏12克 茯苓12克 苍术12克 白术12克 夏枯草30克 牡蛎30克先煎 川朴10克
4、胃热伤阴型
主证：胃脘灼痛，嘈杂不安，食后加重，口干且苦，五心烦热，大便秘结，舌红无苔，脉细数。
方药：玉女煎合增液汤加减：石斛15克 元参20克 知母10克 生地10克 天花粉12克 南沙参15克半支莲30克 蛇舌草30克
主证：胃脘灼热刺痛，食后痛剧，脘胀拒按，心下触及痞块，肌肤枯燥甲错，或有呕血便血，舌紫暗或见瘀斑，脉沉弦，细涩或弦数。
方药：失笑散加味：生蒲黄10克 五灵脂10克 制元胡10克 当归12克 半支莲30克 蜂房12克屯梨根30克 守宫3枚苦参30克
6、气血双亏型
主证：胃癌晚期，高度贫血，形体消瘦，面目虚肿无华，神疲乏力，心悸气短，头晕目眩，虚烦不寐，自汗盗汗，畏寒身冷，纳少乏味，上腹包块明显，舌淡胖苔少，脉虚细无力。
方药：十全大补汤加减：黄芪30克 何首乌15克 人参10克 白术12克 茯苓12克 当归12克仙灵脾12克 杭白芍12克 炙甘草5克 炒三仙各10克 浮小麦30克牡蛎 30克先入
综合治疗
应用中医药来调整胃癌患者内在抗肿瘤能力，治疗手术的并发症，减轻放、化疗的毒副反应，是提高疗效的有效手段，可贯穿治疗过程中的始终。
1、中医对手术治疗的配合
中医配合手术有术前治疗及术后治疗。术前治疗的目的在于调整阴阳气血、脏腑功能，最大限度地恢复正气，使之能顺利接受手术。治疗的原则是补养气血，健脾和胃，滋补肝肾，常用方药有四君子汤、八珍汤、保元汤、十全大补汤、六味地黄汤等。这些扶正药物能增加病人免疫功能，增强患者周围血中的白细胞总数及T淋巴细胞活性。笔者临床上常嘱胃癌病人术前服用别直参一支，确有减少手术疼痛。手术疤痕愈合好，术后体力恢复快的效果。
术后治疗主要是手术所造成的一些并发症。如低热、盗汗、食欲差、肠胃功能障碍。治法上应进行八纲辨证，区分轻重缓急，辨证论治如下：
低热：方药用太子参10克 南北沙参各10克 地骨皮10克 银柴胡10克 知母10克 川石斛15克 元参10克 生地12克 生草3克西洋参5克
盗汗：方药用牡蛎先入30克 龙骨先入30克 炙芪30克 碧桃干10克 糯稻根15克 穭豆衣12克 杭白芍12克 萸肉12克 仙鹤草30克
食欲差：方药用党参12克 茯苓12克 冬术12克 甘草3克 炒六曲12克 沉香曲12克 炒二芽各10克 红枣20克 平地木12克 香附10克
泄泻：方药用川朴10克冬术12克 炒诃子肉10克 龙骨30克 玉果炭10克 制附片5克石榴皮10克 生芪30克 茯苓10克 炒鸡金10克 炮姜6克
胃肠粘连：方药用乌药12克 枳壳12克 红屯30克 银花屯各15克 蒲公英30克 半支连30克杭白芍10克 黄连5克 黄柏10克 丹皮10克 制大黄10克
2、中医对放疗的的配合
目前对胃癌的放疗只应用术前及术中，中医配合治疗的作用，在於减轻放疗副反应，维护患者的正气，使之顺利手术，放疗的常见症状会出现恶心，食欲差，严重时可有呕吐、放疗后期尚可发生腹痛腹泻，血象下降，免疫功能下降等，根据病症可用以下方药治疗。
恶心、呕吐：方药用姜夏10克 代赭石先入12克姜竹茹12克 公丁香3枚 沉香5克 旋复花包煎12克白芍10克 砂仁后下3克
食欲差可参照术后治疗中的相同方药，适当增补一些健脾理气药，血象的免疫功能下降可用黄芪建中汤及八珍汤、十全大补汤，症状严重尚可用人参5克 河车粉10克灵芝12克 仙鹤草30克 冬虫夏草之类药物增补。
3、中医对化疗的配合
治疗胃癌的化疗药品均有不同程度的毒副作用，主要表现在骨髓造血功能的抑制、消化道胃肠反应、免疫功能下降等。有的病人会出现心脏、肾脏、肝脏以及神经组织的损害，因毒副作用迫使相当一部份患者中断治疗或不能接受化疗，中医药对防治化疗所产生的毒副作用起着积极的治疗效果。运用健脾补气，滋补肝肾的中药可以防止白细胞下降，提高巨噬细胞功能，使血浆皮质醇含量上升，对不能接受及中断化疗的患者使之疗程顺利进行。化疗的毒副反应并发症，临床表现是很复杂的，归纳起来有以下四大方面
（1）全身反应
表现为头昏，乏力，汗出，食欲减退，神疲寐劣。中医辨证多为气血两虚，肝肾不足，药用补气养血，滋补肝肾，方药用四君子汤、四物汤、补中益气汤、八珍汤、十全大补汤、六味地黄汤加减
（2）骨髓抑制
【处方药物】甘草泻心汤加减：炙甘草5克，黄芩10克，大枣十二枚，干姜5克，姜半夏10克，川黄连4克，生晒参5克，大黄3克，蒲公英15克。
近年来，国内学者对临床治疗胃病常用的53味中药及其复方分别进行了幽门螺杆菌抑菌试验，发现大黄、黄连、乌梅、丹参、三七对幽门螺杆菌具有较强的抑菌作用；大黄能减少胃液分泌，降低胃游离酸及胃蛋白酶活性，具有清除幽门螺杆菌的作用，减轻炎症程度，改善局部微循环，有利于溃疡愈合。黄连主要成分为小檗碱，抗菌谱较广，对幽门螺杆菌的抑菌效果最高，并且对乙酰胆碱有解痉作用。三七不仅杀菌作用较强，且能通过改善胃黏膜微循环，加速萎缩性肠化生或增生组织病理的逆转。此外，药理证实蒲公英、白花蛇舌草、半枝莲、连翘、徐长卿、莪术等具有杀灭幽门螺杆菌的作用。
胃脘痛大多属于久病，常因七情内伤、饮食不节所致，临证时又多表现为寒热虚实错综交织，因此治疗胃脘痛必须详细辨证才能取得疗效。中医药对胃癌前病变的治疗因人而异、因病而异、因证而异，是在整体观念和辨证论治的精神指导下制定的，充分体现了“无癌早防，有癌早治”的治未病原则。
2．胃癌的中医治疗
胃癌是发生于胃部上皮组织的恶性肿瘤，流行病学调查已证实我国是胃癌发病率和死亡率最高的国家之一，约占消化道癌肿死亡人数的一半，每年新发胃癌患者约20万，发病率亦居各种恶性肿瘤前列。能手术切除的占确诊病例的50%，手术切除病例的5年生存率大约为20%左右。中医典籍中无胃癌这一病名，按临床表现分析，属于祖国医学“噎膈”、“反胃”、“伏梁”、“胃脘病”、“癥瘕”、“积聚”等病症范畴。例如，当癌瘤引起贲门狭窄，导致进行性吞咽困难，与“噎膈”的进食噎塞不利，甚至食入即吐的症状非常相似；当癌瘤引起幽门狭窄或完全梗塞时，其临床表现与汉代张仲景所说的“胃反”，《扁鹊心书》所说的“翻胃”基本相同。《灵枢·四时气》篇云：“饮食不下，膈塞不通，邪在胃脘。”《素问·至真要大论》篇曰：“胃脘当心而痛，上支两胁，甚则呕吐，膈咽不通。”《金匮要略·呕吐哕下利》曰：“朝食暮吐，暮食朝吐，宿谷不化，名曰‘胃反’。”《外台秘要·癥癖等一切病》篇云：“心腹积聚久癥癖，块大如杯碗，黄疸，宿食朝起呕变，支满上气，时时腹胀，心下坚结，上来抢心，傍攻两胁，彻背连胸”。以上描述指明了本病的病变部位和主要临床表现。对于病因病理，则认为与饮食不当、情志抑郁或久病不愈有关。如《圣惠方·治反胃呕哕诸方》云：“夫反胃者……则有因饮酒过伤脾胃，劳乏所致……则有因忧悒蓄怒，肠结胃翻所致，则有宿滞癖痼，积聚冷痰，久不全除，致成兹疾”。对某些可能成为胃癌的前期病变也早有所警惕。如《证治汇补·吞酸》篇说：“吞酸，小疾也，然可暂而不可久，久而不愈为噎膈反胃之渐也。”对胃癌的防治，《医贯·噎膈论》指出：“必外避六淫，内节七情，饮食自养，滋血生津，以润肠胃……气清血和，则脾气健运而食消传化矣。”综上所述：祖国医学对胃癌的病因病理、治疗及预防有着广泛而深入的研究。
胃癌的病因病机
胃为水谷之海，百物聚集之地，又为多气多血之乡，人赖胃气而生，饮食药饵先伤于胃，物聚类杂，最易壅塞，胃癌的发生系饮食失节、忧思过度，导致脾胃受损，运化失常，气结痰凝，瘀毒互结而成，若先天不足则更有易感性。
1、情志因素
中医历来十分重视情志与疾病的关系，认为“百病生于气也，怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，炅则气泄，惊则气乱，劳则气耗，思则气结……”。《内经》指出胃癌是“暴忧之病”，忧思伤脾，脾伤则气结，气结则津液不能输布，聚而成痰；恼怒伤肝，肝伤则气郁，气郁则血流不畅，积而成瘀，痰瘀互结，壅塞腔道，阻隔胃气，引起进食噎塞难下；肝气郁滞，常可横逆犯胃侮脾，以致肝胃不和，气郁日久，则可气郁化火伤阴，损伤脉络，症见胃痛、吐血、便血等胃癌症状。忧思郁怒不仅可以致病，而且往往使病情加剧，许多胃癌患者一旦查证是胃癌，立即忧心忡忡，食欲明显减退，全身无力，悲观失望，削弱了求生意志和自身防御、抗癌能力，这些都说明肿瘤的发生与精神情志密切相关。
2、饮食因素
饮食劳逸是人类生存和保持健康的必要条件，饮食要节制，劳逸要适情，否则会影响人体生理功能，导致气机紊乱或正气损伤，中医早就认识到饮食劳伤可导致胃癌的发生。若恣食膏粱厚味、辛辣炙煿之品，影响脾胃运化功能。脾主湿，脾虚不能运化水湿，湿蕴于内，积久不散，津液不化，津枯凝集痰浊积而为肿物，《医碥·反胃噎膈》也认为噎膈的成因为“酒客多噎膈，饮热酒者尤多，以热伤津液，咽管干涩，食不得入也。”上海消化道病研究所研究发现，胃癌区及癌旁区细胞内维生素A、E、B12及维他命胡萝卜素含量显著低于非癌的胃标本对应区细胞中的含量，这表明胃癌的发生与维生素的缺乏有重要关系，这种关系在癌前期已在细胞内部发生。因而养成良好的饮食习惯，从食物中摄取充足的维生素及胡萝卜素，不要长期食用腌菜、干咸鱼、熏制品，不吃污染霉变食品，对防范胃癌的发生是重要的。
3、先天因素
先天因素即遗传因素，胃癌是否有遗传？胃癌多见于一些家庭，与遗传有一定关系。它的发生率在患者的亲族中比对照人群要高四倍；而A型血胃癌发病率高于其它血型的人，说明胃癌是受多因素性基因影响的。有先天素体不足，长期存在慢性胃疾，在此基础上复因情志失调、饮食失节，发生胃癌的危险性就会增加。
胃癌的临床治疗
中医对胃癌的治疗包括中医治疗和综合治疗。
中医治疗
面对大批未能手术根治或术后复发、转移及不能忍受化疗的中晚期患者，有相当部分中医师从中医整体观出发，不是把缩小肿块作为唯一目标，而注重扶正与祛邪相结合，调整机体平衡，使患者减轻痛苦，延长寿命。有为数不少的患者，由于长期服用中药，尽管癌症发展已经相当广泛，但自觉症状仍不甚明显，生存质量较高，可见重视整体是中医治疗肿瘤的特点；改善生存质量，减轻患者痛苦，延长患者寿命及延缓肿瘤的发展，正是中医的长处。临证时应根据病程长短、邪正盛衰、伴有症状，辨明虚实的主次。胃癌早期多属肝经气郁、脾胃阳虚证型；中期多见湿浊内生、血瘀痰凝证型；晚期则多见胃热津伤、气血双亏、瘀毒内阻。
主证：胃脘胀满，时时作痛，串及两胁，口苦心烦，嗳气陈腐，饮食少进或呕吐反胃，大便干结，舌苔薄黄或薄白，脉弦细。
方药：逍遥散加减：柴胡12克，郁金12克，杭白芍12克，砂仁3克后下，玫瑰花6克，姜半夏12克，川黄连3克，炒三仙各10克，全瓜蒌20克，代赭石先煎12克，藤梨根30克。
主证：胃脘胀满隐痛，喜温喜按，或朝食暮吐，暮食朝吐，或食入经久仍复吐出，时呕清水，面色晄白无华，神疲肢凉，便溏，或完谷不化，舌淡胖边有齿痕，苔白滑润，脉沉缓或沉细濡。
方药：理中汤加减：人参10克，白术12克，茯苓12克，姜半夏10克，高良姜8克，炙甘草6克，生黄芪30克，肉桂后下5克，米仁30克。
3、痰湿凝结型
主证：脘腹疼痛，胸闷不舒，肢懈乏力，呕吐痰涎量多，舌黯淡，苔滑腻，脉细而濡。
方药：开郁二陈汤加减：瓜蒌皮12克，姜半夏12克，茯苓12克，苍术12克，白术12克，夏枯草30克，牡蛎30克先煎，川朴10克。
4、胃热伤阴型
主证：胃脘灼痛，嘈杂不安，食后加重，口干且苦，五心烦热，大便秘结，舌红无苔，脉细数。
方药：玉女煎合增液汤加减：石斛15克，元参20克，知母10克，生地10克，天花粉12克，南沙参15克，半枝莲30克，白花蛇舌草30克。
主证：胃脘灼热刺痛，食后痛剧，脘胀拒按，心下触及痞块，肌肤枯燥甲错，或有呕血便血，舌紫暗或见瘀斑，脉沉弦，细涩或弦数。
方药：失笑散加味：生蒲黄10克，五灵脂10克，制元胡10克，当归12克，半枝莲30克，蜂房12克，藤梨根30克，守宫3枚，苦参30克。
6、气血双亏型
主证：胃癌晚期，高度贫血，形体消瘦，面目虚肿无华，神疲乏力，心悸气短，头晕目眩，虚烦不寐，自汗盗汗，畏寒身冷，纳少乏味，上腹包块明显，舌淡胖苔少，脉虚细无力。
方药：十全大补汤加减：黄芪30克，何首乌15克，人参10克，白术12克，茯苓12克，当归12克，仙灵脾12克，杭白芍12克，炙甘草5克，炒三仙各10克，浮小麦30克，牡蛎30克先入。
综合治疗
应用中医药来调整胃癌患者内在抗肿瘤能力，治疗手术的并发症，减轻放、化疗的毒副反应，是提高疗效的有效手段，可贯穿治疗过程中的始终。
1、中医对手术治疗的配合
中医配合手术有术前治疗及术后治疗。术前治疗的目的在于调整阴阳气血、脏腑功能，最大限度地恢复正气，使之能顺利接受手术。治疗的原则是补养气血，健脾和胃，滋补肝肾，常用方药有四君子汤、八珍汤、保元汤、十全大补汤、六味地黄汤等。这些扶正药物能增加病人免疫功能，增强患者周围血中的白细胞总数及T淋巴细胞活性。笔者临床上常嘱胃癌病人术前服用别直参一支，确有减少手术疼痛、手术疤痕愈合好、术后体力恢复快的效果。
术后治疗主要是手术所造成的一些并发症。如低热、盗汗、食欲差、肠胃功能障碍。治法上应进行八纲辨证，区分轻重缓急，辨证论治如下：
低热：方药用太子参10克，南北沙参各10克，地骨皮10克，银柴胡10克，知母10克，川石斛15克，元参10克，生地12克，生甘草3克，西洋参5克。
盗汗：方药用牡蛎先入30克，龙骨先入30克，炙黄芪30克，碧桃干10克，糯稻根15克，穭豆衣12克，杭白芍12克，山萸肉12克，仙鹤草30克。
食欲差：方药用党参12克，茯苓12克，冬术12克，甘草3克，炒六曲12克，沉香曲12克，炒二芽各10克，红枣20克，平地木12克，香附10克。
泄泻：方药用川朴10克，冬术12克，炒诃子肉10克，龙骨30克，玉果炭10克，制附片5克，石榴皮10克，生黄芪30克，茯苓10克，炒鸡金10克，炮姜6克。
胃肠粘连：方药用乌药12克，枳壳12克，红藤30克，金银花藤各15克，蒲公英30克，半枝莲30克，杭白芍10克，黄连5克，黄柏10克，丹皮10克，制大黄10克。
2、中医对放疗的配合
目前对胃癌的放疗只应用于术前及术中，中医配合治疗的作用在于减轻放疗副反应，维护患者的正气，使之顺利手术，放疗的常见症状会出现恶心、食欲差，严重时可有呕吐、放疗后期尚可发生腹痛腹泻、血象下降、免疫功能下降等，根据病症可用以下方药治疗。
恶心、呕吐：方药用姜半夏10克，代赭石先入12克，姜竹茹12克，公丁香3枚，沉香5克，旋覆花包煎12克，白芍10克，砂仁后下3克。
食欲差可参照术后治疗中的相同方药，适当增补一些健脾理气药，血象的免疫功能下降可用黄芪建中汤及八珍汤、十全大补汤，症状严重尚可用人参5克，河车粉10克，灵芝12克，仙鹤草30克，冬虫夏草之类药物增补。
3、中医对化疗的配合
治疗胃癌的化疗药品均有不同程度的毒副作用，主要表现在骨髓造血功能的抑制、消化道胃肠反应、免疫功能下降等。有的病人会出现心脏、肾脏、肝脏以及神经组织的损害，因毒副作用迫使相当一部分患者中断治疗或不能接受化疗，中医药对防治化疗所产生的毒副作用起着积极的治疗效果。运用健脾补气，滋补肝肾的中药可以防止白细胞下降，提高巨噬细胞功能，使血浆皮质醇含量上升，对不能接受及中断化疗的患者使之疗程顺利进行。化疗的毒副反应并发症，临床表现是很复杂的，归纳起来有以下四大方面
（1）全身反应
表现为头昏，乏力，汗出，食欲减退，神疲寐劣。中医辨证多为气血两虚，肝肾不足，药用补气养血，滋补肝肾，方药用四君子汤、四物汤、补中益气汤、八珍汤、十全大补汤、六味地黄汤加减。
（2）骨髓抑制
[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