Leukemia, a malignant disease of the blood system of unknown cause, has no specific drugs at home and abroad that can completely cure it. Countless medical researchers have come and gone, but it remains a difficult problem that modern medicine has not completely solved. In the mid- to late 1950s, many Chinese medicine practitioners, such as Prof. Yan Dexin, a master of Chinese medicine, were actively involved in the research of hematological diseases, making painstaking efforts and innovative attempts. This initiative has positive social significance and is a historical memory not to be forgotten, but due to the scarcity of relevant information, there are fewer retrospective studies in this area. The State Administration of Traditional Chinese Medicine, the famous Chinese medicine inheritance model of key research laboratory and the sea of Yan's internal medicine school of traditional Chinese medicine inheritance research base work to start, through some of the historical documents and materials to start suitcases to revisit, analyze and organize, with a view to restore the original appearance of this historical fact.
In the mid to late 1950s, the incidence of blood diseases in the Shanghai area increased, aplastic anemia, leukemia and so on, due to the lack of effective means of treatment, each unit has launched a medical research on blood diseases, for which the Shanghai Municipal *** specially set up the city's blood disease group. In 1959, the railroad hospital was assigned to the Shanghai Railway Medical College Hospital, the following year, the extension of the Middle Road, No. 301, the new hospital building fell into the inpatient department. In order to implement the spirit of the national key research on major diseases, the hospital set up a hematology group, Professor Yan Dexin joined the hematology group of the Affiliated Hospital of Shanghai Railway Medical College, and put into the work of combining traditional Chinese and Western medicine in the treatment of acute and chronic leukemia.
Mechanism study
Since there is no record of "leukemia" in ancient medical books, Prof. Yan Dexin and the members of the group combined the patients' signs and symptomatic changes in the treatment, and referred to the descriptions of the same and similar clinical symptoms as those of leukemia in the ancient literature of traditional Chinese medicine, and analyzed the understanding of leukemia in traditional Chinese medicine in a more detailed way. Acute leukemia is similar to "Warm Evil" (heat oppressing the camp blood), "Acute Labor", "Hot Labor" and "Blood Disease", etc. The treatment of chronic leukemia is scattered in "Deficiency", "Mass in the abdomen" and "Accumulation", etc. The treatment of chronic leukemia is also similar to that of leukemia. As for those with enlarged lymph nodes all over the body, they are similar to galls, tumors and phlegm nuclei, while green tumors are similar to malignant nuclei. The etiology of the disease is related to kidney deficiency, and although other organs may be involved, it is mainly due to kidney deficiency, which is caused by deficiency rather than disease; however, according to the theory of modern medicine, it is believed that there is no symptom or sign with characteristic, so the diagnosis mainly relies on the blood and bone marrow image examination. This understanding was published in July 1963 in the Shanghai Journal of Traditional Chinese Medicine in the "treatment of leukemia clinical experience" article.
After sorting out the symptoms and treatments of acute and chronic leukemia in the ancient Chinese medicine books, Prof. Yan Dexin began to treat leukemia with Chinese medicine, and summarized its pathogenesis and characteristics in the process of treatment, and formed the understanding of the etiology and mechanism of leukemia, and in June 1965, together with Chen Shunru, a member of the group, published an article entitled "Exploration of the Pathogenesis of Leukemia" in Harbin Chinese Medicine Magazine, which concluded that the pathogenesis of leukemia is general. He believed that the pathogenesis of leukemia was mainly based on renal deficiency, in which, except for yin and yang deficiency, yin deficiency, phlegm-heat and warmth-heat types belonged to renal yin deficiency, and yang deficiency and blood stasis types belonged to renal yang deficiency, and that, on the basis of which, due to the different physical conditions of each individual, different pathologies arose and different organs were involved. As a result, the symptoms specific to each type appear respectively. For example, in the Yin Deficiency type, due to the deficiency of kidney yin, water does not contain wood, leading to hyperactivity of liver yang, and the lack of water and fire leads to inflammation of the heart, and on the other hand, the heart and liver organs can interact with each other, so that this type mainly manifests the symptoms of the kidneys, liver, and heart organs. Another example is the phlegm-heat type, which also originates from the deficiency of kidney yin, on the one hand, because water does not contain wood, resulting in liver yang hyperactivity, liver yang hyperactivity, wood and fire can be penalized by gold, resulting in lung yin deficiency. On the other hand, the kidney is water, the lung is gold, gold and water for the mother and child organs, and can affect each other, and make the lungs, the kidney two organs of the disease aggravated.
Clinical research
In Chinese medicine, the clinical manifestations of various types of leukemia or different stages of similar leukemia are different. Professor Yan Dexin initially categorized the clinical manifestations of leukemia into six types, namely, Yin deficiency, Yang deficiency, Yin-Yang deficiency, Phlegm-heat, Blood stasis, and Warm-heat. Prof. Yan Dexin experienced that when treating this disease, the estimation of the patient's positive qi should be highly vigilant, and the urgency is to treat the symptoms, treating the symptoms so as to reduce the consumption of positive qi, and the clinical use of medicines, often combined with the symptomatic treatment of tonic medicines, which can make the patient's symptoms disappear quickly and tend to relieve, or the combination of western medicine against leukemia and traditional Chinese medicine to replenish the deficiency, which all have certain clinical significance. In order to effectively control leukemia, Prof. Yan Dexin constantly seeks and screens for effective medicines on traditional prescriptions, especially those with multiple effects. The treatment of anemia with Chinese medicine can be divided into three categories: nourishing yin, tonifying yang, and tonifying both yin and yang. Yin nourishing and spleen and kidney warming (yang tonifying) medicines generally have the effect of raising red blood cells and hematocrit. When yin nourishing drugs are effective, there is also the possibility of *** leukocyte increase, generally the yin and yang tonic effect is the best. Yin nourishing drugs such as Shouwu, raw and ripe ground, Agaricus, wolfberry, Angelica sinensis, white peony, bamboo, yellow essence, cornelian cherry, etc. are used more. Yang deficiency type to Cangzhu, white atractylodes, yam, antlers, lemongrass, ginseng leaves, Morinda citrifolia, bone marrow, Cistanche, etc. with the more appropriate hand, the other for the cattle bone marrow and placenta decoction, the efficacy of the treatment is also good. For the treatment of leukopenia of various types of leukemia, it should be divided into two categories of cold or hot to deal with separately: hot to shouwu, dijianpi, cold to adenosine, gui, antler, etc. More applications. Especially for those whose white blood cells have dropped below 1000, the curative effect of American ginseng is more remarkable, and often can turn the danger into safety. Others, such as ginseng and powdered ginseng, also have a certain degree of efficacy. Thrombocytopenia, sometimes the single use of forsythia, jujube is effective. In the compound prescription with gum, especially the turtle deer two fairy gum or deer gum, has a certain effect.
Although the integrated treatment of leukemia in Chinese and Western medicine has achieved some efficacy, but there is still a large gap from the ideal effect, Professor Yan Dexin began to think about finding drugs in traditional Chinese medicine, he chose andrographis paniculata (made of arsenic), a choice for the modern treatment of leukemia to make a useful exploration.
Traditional Chinese medicine has a thousand-year history of using harsh medicines. Generally speaking, the use of peaceful medicines for ordinary illnesses does not require harsh medicines, but when a serious illness occurs, it is not the case that ordinary medicines can't be used. Prof. Yan Dexin told that his use of andrographis to treat leukemia was influenced by his father, Yan Yilu. During his medical practice, Yan Yilu often used two parts of Xionghuang mixed with Poria to treat malaria and other intractable fevers. Yan Yilu explained that the use of Xionghuang to treat fevers was based on the idea of "fighting poison with poison" in the Chinese medicine philosophy of treatment. Inspired by his father's thinking, Prof. Yan Dexin used the TCM thinking of analogy to apply Xionghuang to a patient with leukemia who had been repeatedly treated for high fever. The use of andrographis is a kind of risky move, the courage to be big and small heart, the patient took the drug, Professor Yan Dexin day and night with the patient, eating and living in the hospital room, and do not go home at night, to observe the patient's reaction to the drug. Two days later, a miracle occurred, the patient's body temperature returned to normal, white blood cells dropped to normal levels, and then took Ziyin Solidifying Soup, the symptoms improved, and transferred to the hospital to continue recuperation treatment. Then, he used andrographis powder in other patients in the ward, also proved that andrographis treatment of various types of acute leukemia, can reduce white blood cells, red blood cells, platelets have no effect, combined with chemotherapy can play a synergistic effect, can also be used as a maintenance of remission period of the drug. Later, in addition to Xionghuang, he also studied the waist Huang, experience toxicity than Xionghuang to be a little smoother, for the hot come too fierce leukemia with waist Huang, come calm leukemia with Xionghuang. As soon as these two medicines were used, the number of white blood cells dropped significantly. In the specific use of the process, he will be andrographis preparations, made into 0.5g / capsule, in the relevant literature use 55 as the number of andrographis.
During the study period, Prof. Yan Dexin treated 8 cases of chronic leukemia with andrographis alone; 7 cases of chronic leukemia with andrographis and maryland; 4 cases of acute leukemia with andrographis alone; and 7 cases of acute leukemia with the combination of andrographis and 6-MP, observing the blood counts of the patients, the bone marrow smears of some of the patients, and the patients' clinical manifestations before and after treatment. Results in the blood changes found that andrographis has a certain inhibitory effect on the total number of leukocytes, generally sensitive people in 1~3 days began to decline. However, when combined with 6-MP or Maliran, it can produce synergistic effect, accelerate the efficacy of each other, and shorten the number of days for the beginning of decline. In the change of bone marrow image, the bone marrow image of leukemia patients before and after obtaining the treatment are seen to have different degrees of relief. In the clinical manifestation of chronic leukemia with andrographis alone treatment group 8 cases, all for complete remission, acute leukemia with andrographis alone treatment group 4 cases in 2 cases of complete remission, 2 cases of partial remission. In the chronic leukemia andrographis plus malignant combination treatment group, among 7 cases, there were 5 cases of complete remission and 2 cases of partial remission. Acute leukemia andrographis plus 6-MP combined group in 7 cases, complete remission in 2 cases, partial remission in 4 cases, no effect in 1 case. Yan Dexin, Yu Huaiqin, Chen Shunru et al. summarized its clinical observation effect in October 1964, published in the "Harbin Chinese medicine" magazine, "the preliminary observation of the efficacy of the Chinese traditional medicine "55 powder" treatment of leukemia", that through the clinical efficacy of the discovery of andrographis has a certain inhibitory effect on white blood cell abnormally high, while the red blood cells, platelets have no obvious effect, and that the cause may be through certain enzyme It is believed that the cause may be through the action of certain enzymes and reduce oxidation and sugar metabolism, inhibit the oxygen consumption of erythrocytes and the decomposition of proteins, can dilate the capillaries, strengthen the peripheral blood circulation, promote the anabolic process of tissues and organs, and promote the absorption of the, and in the thesis clearly indicated that the Chinese traditional medicine "55 Powder" is a compound of arsenic and sulphur. The article was exchanged in 1963 at the hematology symposium in Suzhou, Hangzhou and Shanghai and in 1964 at the National Hematology Conference, and this clinical report has played a certain reference value for the modern treatment of leukemia in the future.
In addition, the application of No. 55 homemade powder added to Jinhuang San paste for external application or as a tourniquet penetration of leukocyte infiltration caused by local swelling and pain and subcutaneous nodules, etc., the effect is quite good; ultrashort-wave hyperthermia applied to the lymph node swelling and local inflammation; the use of "elimination of plaque powder" external treatment of chronic granulocytic leukemia, etc., are one of the methods of comprehensive treatment of various types of methods. For example, a patient surnamed Zou was hospitalized for more than nine months, only using "6-MP" for 16 days, and all the rest were treated with traditional Chinese medicines, and he was able to obtain full remission of his blood picture and clinical condition, and he survived for more than one year. In cases of chronic leukemia, complete hematologic and clinical remission can be achieved without using "Maryland" as the only therapeutic drug. Among the cases of acute leukemia treated, there were three cases with a survival rate of more than one year, and there were also cases of chronic leukemia with a survival rate of more than seven years. From 1962 to 1964, the group led by Prof. Yan Dexin published many influential papers, such as "Identification and Treatment of Leukemia", "Comprehensive Treatment of Leukemia", "Trial Exploration of the Pathogenesis of Leukemia", "Evidence and Treatment of Leukemia", "Clinical Experiences in the Treatment of Leukemia", "Introduction to the Comprehensive Treatment of Leukemia", and "External Treatment of Spleen Enlargement in Chronic Leukemia". Harbin Chinese Medicine" "Journal of Traditional Chinese Medicine" and national hematology conference exchange published, laid the general idea of Chinese medicine on the diagnosis and treatment of leukemia.
However, the ensuing 10-year political storm interrupted Professor Yan's research in the field of leukemia, but the scientific exploration of leukemia diagnosis and treatment in China continued. Nine years after the publication of the article "Preliminary Observations on the Efficacy of Chinese Medicine "55 Powder" in the Treatment of Leukemia", Prof. Zhang Tingdong used the compound arsenic "Cancer Spirit" (composed of arsenic, light powder, toadstool and other medicines) to treat leukemia effectively, and published the article "Preliminary Clinical Observations on Cancer Spirit Injection in the Treatment of 6 Cases of Leukemia" in 1973, and then successively published many articles. In 1996, Prof. Zhang Peng and others reported for the first time the treatment of leukemia with "Arsenic trioxide injection" extracted from a single drug arsenic, and in 1996, academicians Wang Zhenyi and Chen Zhu carried out research on the molecular mechanism of the role of arsenic trioxide in the treatment of leukemia, and then a number of experts conducted preclinical experimental studies and Ⅱ and Ⅲ clinical trials, making a significant contribution to the arsenic preparations for the treatment of acute and chronic leukemia therapy.