1.Pathogenesis and Treatment Approach of Cancer-Related Anorexia-Cachexia Syndrome Based on the Concept of "Blood Exhaustion" in The Inner Canon of Yellow Emperor (《黄帝内经》)
Jinbiao ZHU ; Mengyun YUAN ; Lu BAI ; Duorui NIE ; Mianhua WU ; Yingjie YAN ; Dawei DING
Journal of Traditional Chinese Medicine 2026;67(5):575-579
Based on the concept of "blood exhaustion" from The Inner Canon of Yellow Emperor (《黄帝内经》), a three-stage syndrome differentiation and treatment strategy for cancer-related anorexia-cachexia syndrome is proposeed. In the cancer-induced anorexia stage, the pathogenesis is characterized by cancer consuming the spleen and stomach, leading to stagnation of transportation and transformation in the middle jiao (焦). Treatment should focus on strengthening the spleen, promoting appetite, dispersing accumulation, and aiding digestion, with modified Zisheng Pills (资生丸) in Extensive Notes on Medicine from Xian Xing Studio (《先醒斋医学广笔记》) or Zisheng Decoction (资生汤) in Records of Chinese Medicine with Reference to Western Medicine (《医学衷中参西录》). In the pre-cachectic stage of malnutrition, the pathogenesis involves insufficient nourishment of blood and qi with essence depletion hindering production. Treatment should focus on nourishing blood and harmonizing ying (营), warming yang and supplementing qi, and modified Huangqi Jianzhong Decoction (黄芪建中汤) can be used. In the cachectic stage, the pathogenesis involves blood deficiency and essence exhaustion, with blood stasis obstructing the collaterals. The therapeutic approach should focus on tonifying deficiency and replenishing essence, unblocking collaterals, and removing stasis, and modified Buzhong Yiqi Decoction (补中益气汤) and Zuo Gui Beverage (左归饮) are suggested.
2.Exploring the Pathogenesis and Syndrome Treatment of Brain Tumor Based on the"Deficient Qi and Kenang"Theory
Yi JI ; Lingyan ZHU ; Xueping XIA ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(7):969-973
Professor Wu Mianhua,a renowned national traditional Chinese medicine(TCM)practitioner,proposed the"deficient qi and Kenang"theory based on the doctrines of"deficient qi"and"Kenang".This theory is applied to the pathogenesis analysis and clinical syndrome differentiation and treatment of brain tumors.It posits that the fundamental pathogenesis of brain tumors involves orig-inal qi deficiency,internal generation of deficient qi,intermingling of phlegm and blood stasis,and conglomeration of toxins into nest-like foci.The treatment strategy emphasizes reinforcing healthy qi,regulating qi,resolving phlegm,dispelling stasis,attacking toxins,dispersing nodules,and adjusting treatment according to disease stages.In the early stage,it is to support healthy qi and regulate qi to remove qi deficiency;in the middle stage,it is to dissipate phlegm and expel blood stasis to resolve pathological nests;in the late stage,it is to attack toxins and resolve masses to break up nest sac.Throughout the treatment,strictly adhere to the principle of"rein-forcing healthy qi without retaining pathogens,and breaking accumulations without impairing healthy qi".
3.Exploring the Pathogenesis and Syndrome Treatment of Radiation-Induced Skin Injury Based on the"Fire-Toxin Pathogenesis"Theory
Yan WU ; Yi JI ; Jinbiao ZHU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1641-1646
Radiation-induced skin injury is a common complication in tumor radiotherapy,which seriously affects patients'quality of life and treatment continuity.Based on the theory of"fire-toxin pathogenesis",Professor Wu Mianhua,a renowned national tradi-tional Chinese medicine(TCM)practitioner,holds that its core pathogenesis is"external attack by fire-toxin,damage to yin and con-sumption qi,and blood stasis obstructing the skin and muscles".The course of the disease presents a dynamic evolution of acute stage(blazing heat-toxin),subacute stage(yin deficiency and blood stasis),and chronic stage(deficiency of both qi and yin).In terms of treat-ment,the principles of"syndrome differentiation by stages and simultaneous treatment of root cause and symptoms"are adopted:clear-ing heat and resolving toxin,cooling blood and reducing swelling in the acute stage;nourishing yin and moistening dryness,clearing heat and dissolving stasis in the subacute stage;and benefiting qi and nourishing yin,dissipating stasis and unblocking collaterals in the chronic stage.Emphasis is laid on the combination of internal and external treatment as well as the integration of prevention and treatment.This paper systematically sorts out Professor Wu Mianhua's academic thoughts on exploring the pathogenesis and syndrome treatment of radiation-induced skin injury using the"fire-toxin pathogenesis"theory,and attaches analysis of proven cases,so as to provide theoretical and practical references for clinical practice.
4.Clinical Study of Xuefu Zhuyu Decoction in the Prevention and Treatment of Radiation-Induced Lung Fi-brosis in Esophageal Cancer Patients with Blood Stasis Type Underwent Concurrent Chemoradiotherapy
Yijun WANG ; Lejun CHEN ; Jing YAN ; Teng HUANG ; Juan HAN ; Qiuyun YU ; Dahai YU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1657-1665
OBJECTIVE To observe the clinical efficacy of Xuefu Zhuyu Decoction(XFZY)in the prevention and treatment of radiation-induced lung fibrosis(RILF)in esophageal cancer patients with blood stasis type underwent concurrent chemoradiotherapy(CRT).METHODS A total of 130 esophageal cancer patients with blood stasis type who treated with concurrent CRT were randomly divided into an experimental group and a control group,with 65 cases in each group.No patients dropped out during the study period.Patients in both groups received CRT and standardized symptomatic treatment was given according to the condition if radiation-induced lung injury occurred during treatment.On the basis of the treatment of the control group,the patients in the experimental group received XFZY from the beginning day until 30 days after the completion of CRT.The TCM syndrome score of the two groups were compared before and after treatment.The incidence of acute radiation pneumonia(RP)and chronic RILF and changes in pulmo-nary function indicators[forced expiratory volume in the first second as a percentage of predicted value(FEV1%pred),forced vital ca-pacity(FVC),FVC as a percentage of predicted value(FVC%pred),FEV1/FVC ratio,and carbon monoxide diffusing capacity as a per-centage of predicted value(DLCO%pred)]and serum cytokine levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and transforming growth factor β1(TGF-β1)]were compared at 6 months and 12 months after the completion of CRT.The occurrence of adverse reaction during treatment was recorded.RESULTS The total score of TCM syndrome of the two groups was significantly improved and the experimental group was better than that of the control group(P<0.01)after treatment.The efficacy of TCM syndrome was better in the experimental group than that of the control group(P<0.01).There was no statistically significant difference in the incidence rate of acute RP between the two groups(P>0.05)at 6 months after the completion of CRT.The levels of lung function indicators FEV1%pred,FVC%pred,and DLCO%pred in the experimental group were higher than those in the control group(P<0.05),and the levels of various cytokines in the experimental group were lower than those in the control group(P<0.05).The incidence rate of chronic RILF in the experimental group was significantly lower than that of the control group(P<0.05)at 12 months after the completion of CRT.The DLCO%pred level in the experimental group was higher than that in the control group(P<0.01),and the levels of cytokines HIF-1α,VEGF,and TGF-β1 were lower than those in the control group(P<0.05,P<0.01).There was no serious adverse event observed in either group of patients during the treat-ment.CONCLUSION XFZY can effectively prevent and treat RILF in esophageal cancer patients with blood stasis type underwent CRT,reducing the loss to lung function caused by radiotherapy,and its mechanism may be related to downregulating the levels of cyto-kines of HIF-1α,VEGF,and TGF-β1.
5.Exploring the Pathogenesis and Syndrome Treatment of Radiation-Induced Skin Injury Based on the"Fire-Toxin Pathogenesis"Theory
Yan WU ; Yi JI ; Jinbiao ZHU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1641-1646
Radiation-induced skin injury is a common complication in tumor radiotherapy,which seriously affects patients'quality of life and treatment continuity.Based on the theory of"fire-toxin pathogenesis",Professor Wu Mianhua,a renowned national tradi-tional Chinese medicine(TCM)practitioner,holds that its core pathogenesis is"external attack by fire-toxin,damage to yin and con-sumption qi,and blood stasis obstructing the skin and muscles".The course of the disease presents a dynamic evolution of acute stage(blazing heat-toxin),subacute stage(yin deficiency and blood stasis),and chronic stage(deficiency of both qi and yin).In terms of treat-ment,the principles of"syndrome differentiation by stages and simultaneous treatment of root cause and symptoms"are adopted:clear-ing heat and resolving toxin,cooling blood and reducing swelling in the acute stage;nourishing yin and moistening dryness,clearing heat and dissolving stasis in the subacute stage;and benefiting qi and nourishing yin,dissipating stasis and unblocking collaterals in the chronic stage.Emphasis is laid on the combination of internal and external treatment as well as the integration of prevention and treatment.This paper systematically sorts out Professor Wu Mianhua's academic thoughts on exploring the pathogenesis and syndrome treatment of radiation-induced skin injury using the"fire-toxin pathogenesis"theory,and attaches analysis of proven cases,so as to provide theoretical and practical references for clinical practice.
6.Application of Anti-tumor Compatibility Structure of Chinese Medicine
Lanpin CHEN ; Feng TAN ; Xiaoman WEI ; Junyi WANG ; Liu LI ; Mianhua WU ; Haibo CHENG ; Dongdong SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):198-208
Malignant tumors are one of the major diseases that endanger human life and health. Chinese medicine has unique advantages in clinical anti-tumor treatment. However, how to translate the anti-tumor effects of Chinese medicine into clinical practice is the core issue that must be addressed in the process of treating malignant tumors with traditional Chinese medicine (TCM). Unlike modern chemical drugs, the compatibility application of Chinese medicine is the key factor that determines whether Chinese medicine can achieve optimal anti-tumor efficacy and realize the goal of "enhancing efficacy and reducing toxicity". The formulation structure based on this compatibility is the basic form for the safe, efficient, and rational clinical use of anti-tumor Chinese medicine, and it mainly includes three categories: herb pairs, tri-herbal combinations, and compound compatibility. Although herb pairs have the characteristics of a simple structure and strong targeting (enhancing efficacy and reducing toxicity), they often have a single effect and cannot fully address the complex pathogenesis of tumors. As a result, herb pairs are rarely used alone in practice. Compared to herb pairs, tri-herbal combinations broaden the application scope of herbs in clinical treatment, but their therapeutic range remains limited. The traditional "sovereign, minister, assistant, and guide" compound prescription, which includes herb pairs and tri-herbal combinations, improves the efficacy of herbs in treating serious diseases, hypochondriasis, chronic diseases, and miscellaneous disorders. However, due to the limitations of its historical background, it has not been integrated with modern clinical practice and modern pharmacological research, which restricts the development of compound compatibility theory. With the emergence of modern medical technology, it has been combined with traditional compatibility theory of Chinese medicine to create an innovative modern compatibility theory. This includes the "aid medicine" theory derived from modern Chinese medicine pharmacology, which compensates for the inability of the "sovereign, minister, assistant, and guide" theory to accurately apply medicine. Additionally, the "state-targeted treatment based on syndrome differentiation" theory, developed from pharmacology and modern medicine, addresses the deficiency in disease cognition in the "sovereign, minister, assistant, and guide" theory. Under the guidance of these compatibility forms and theories, clinical anti-tumor Chinese medicine can exert its maximum anti-tumor efficacy, which is of great significance for the application of Chinese medicine in clinical tumor treatment.
7.Prevention and Treatment Principles of Virus-Associated Malignant Tumors under the Guidance of the"Cancer Toxin"Pathogenesis Theory
Hongli ZHOU ; Luyu CHEN ; Yuanyuan QIN ; Wenting LI ; Hongguang ZHOU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(11):1414-1428
The development of malignant tumors is influenced by multiple factors,including genetics,environment,lifestyle,and pathogen infection.Viral infection plays a significant role in tumor development and progression.This article integrates the common pathways of seven oncogenic viruses(HPV,EBV,HBV,HCV,KSHV,HTLV-1,and HIV)based on the theory of cancer toxin pathomechanism.The findings reveal that cancer toxin formation is influenced by both internal factors(healthy qi deficiency,viscus dysfunction,and qi,blood,and body fluid stagnation)and external factors(viral infection,environmental factors,and the six exogenous pathogens),driving tumor development,metastasis,and recurrence.Viral infection not only provides the material foundation for cancer toxin but also accelerates its maturation and spread through chronic inflammation and immune imbalance,forming a complex pathogen-esis of"viral toxicity-endogenous cancer toxin",which translates into a three-stage strategy of"prevention,treatment,and post-recovery prevention".This article systematically discusses the pathogenesis of major cancer toxins and their associated tumors.Inte-grating the cancer toxin theory,the article explores preventive and therapeutic strategies for virus-associated malignancies,providing a theoretical basis and practical reference for the integrated prevention and treatment of tumors using traditional Chinese and Western medicine.
8.Clinical Study of Xuefu Zhuyu Decoction in the Prevention and Treatment of Radiation-Induced Lung Fi-brosis in Esophageal Cancer Patients with Blood Stasis Type Underwent Concurrent Chemoradiotherapy
Yijun WANG ; Lejun CHEN ; Jing YAN ; Teng HUANG ; Juan HAN ; Qiuyun YU ; Dahai YU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1657-1665
OBJECTIVE To observe the clinical efficacy of Xuefu Zhuyu Decoction(XFZY)in the prevention and treatment of radiation-induced lung fibrosis(RILF)in esophageal cancer patients with blood stasis type underwent concurrent chemoradiotherapy(CRT).METHODS A total of 130 esophageal cancer patients with blood stasis type who treated with concurrent CRT were randomly divided into an experimental group and a control group,with 65 cases in each group.No patients dropped out during the study period.Patients in both groups received CRT and standardized symptomatic treatment was given according to the condition if radiation-induced lung injury occurred during treatment.On the basis of the treatment of the control group,the patients in the experimental group received XFZY from the beginning day until 30 days after the completion of CRT.The TCM syndrome score of the two groups were compared before and after treatment.The incidence of acute radiation pneumonia(RP)and chronic RILF and changes in pulmo-nary function indicators[forced expiratory volume in the first second as a percentage of predicted value(FEV1%pred),forced vital ca-pacity(FVC),FVC as a percentage of predicted value(FVC%pred),FEV1/FVC ratio,and carbon monoxide diffusing capacity as a per-centage of predicted value(DLCO%pred)]and serum cytokine levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and transforming growth factor β1(TGF-β1)]were compared at 6 months and 12 months after the completion of CRT.The occurrence of adverse reaction during treatment was recorded.RESULTS The total score of TCM syndrome of the two groups was significantly improved and the experimental group was better than that of the control group(P<0.01)after treatment.The efficacy of TCM syndrome was better in the experimental group than that of the control group(P<0.01).There was no statistically significant difference in the incidence rate of acute RP between the two groups(P>0.05)at 6 months after the completion of CRT.The levels of lung function indicators FEV1%pred,FVC%pred,and DLCO%pred in the experimental group were higher than those in the control group(P<0.05),and the levels of various cytokines in the experimental group were lower than those in the control group(P<0.05).The incidence rate of chronic RILF in the experimental group was significantly lower than that of the control group(P<0.05)at 12 months after the completion of CRT.The DLCO%pred level in the experimental group was higher than that in the control group(P<0.01),and the levels of cytokines HIF-1α,VEGF,and TGF-β1 were lower than those in the control group(P<0.05,P<0.01).There was no serious adverse event observed in either group of patients during the treat-ment.CONCLUSION XFZY can effectively prevent and treat RILF in esophageal cancer patients with blood stasis type underwent CRT,reducing the loss to lung function caused by radiotherapy,and its mechanism may be related to downregulating the levels of cyto-kines of HIF-1α,VEGF,and TGF-β1.
9.Exploring the Pathogenesis and Syndrome Treatment of Brain Tumor Based on the"Deficient Qi and Kenang"Theory
Yi JI ; Lingyan ZHU ; Xueping XIA ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(7):969-973
Professor Wu Mianhua,a renowned national traditional Chinese medicine(TCM)practitioner,proposed the"deficient qi and Kenang"theory based on the doctrines of"deficient qi"and"Kenang".This theory is applied to the pathogenesis analysis and clinical syndrome differentiation and treatment of brain tumors.It posits that the fundamental pathogenesis of brain tumors involves orig-inal qi deficiency,internal generation of deficient qi,intermingling of phlegm and blood stasis,and conglomeration of toxins into nest-like foci.The treatment strategy emphasizes reinforcing healthy qi,regulating qi,resolving phlegm,dispelling stasis,attacking toxins,dispersing nodules,and adjusting treatment according to disease stages.In the early stage,it is to support healthy qi and regulate qi to remove qi deficiency;in the middle stage,it is to dissipate phlegm and expel blood stasis to resolve pathological nests;in the late stage,it is to attack toxins and resolve masses to break up nest sac.Throughout the treatment,strictly adhere to the principle of"rein-forcing healthy qi without retaining pathogens,and breaking accumulations without impairing healthy qi".
10.Prevention and Treatment Principles of Virus-Associated Malignant Tumors under the Guidance of the"Cancer Toxin"Pathogenesis Theory
Hongli ZHOU ; Luyu CHEN ; Yuanyuan QIN ; Wenting LI ; Hongguang ZHOU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(11):1414-1428
The development of malignant tumors is influenced by multiple factors,including genetics,environment,lifestyle,and pathogen infection.Viral infection plays a significant role in tumor development and progression.This article integrates the common pathways of seven oncogenic viruses(HPV,EBV,HBV,HCV,KSHV,HTLV-1,and HIV)based on the theory of cancer toxin pathomechanism.The findings reveal that cancer toxin formation is influenced by both internal factors(healthy qi deficiency,viscus dysfunction,and qi,blood,and body fluid stagnation)and external factors(viral infection,environmental factors,and the six exogenous pathogens),driving tumor development,metastasis,and recurrence.Viral infection not only provides the material foundation for cancer toxin but also accelerates its maturation and spread through chronic inflammation and immune imbalance,forming a complex pathogen-esis of"viral toxicity-endogenous cancer toxin",which translates into a three-stage strategy of"prevention,treatment,and post-recovery prevention".This article systematically discusses the pathogenesis of major cancer toxins and their associated tumors.Inte-grating the cancer toxin theory,the article explores preventive and therapeutic strategies for virus-associated malignancies,providing a theoretical basis and practical reference for the integrated prevention and treatment of tumors using traditional Chinese and Western medicine.

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