Differential diagnosis of endometrial cancer in TCM

Endometrial cancer is similar to the descriptions of "uterine bleeding", "five-color bands" and "accumulation of symptoms" in traditional Chinese medicine books. It is caused by dysfunction of the spleen, liver and viscera, damp-heat and stasis, accumulation of toxicity in the uterus, or stagnation of liver qi, stagnation of qi and blood stasis, and obstruction of meridians, which accumulate in the abdomen over time. Traditional Chinese medicine divides endometrial cancer into four types: blood heat type, qi deficiency type, blood stasis type and kidney deficiency type, and treats them symptomatically. The treatment methods are as follows:

1. Blood heat type

Main symptoms: Patients with this type of endometrial cancer may experience sudden heavy vaginal bleeding or continuous bleeding, chest and flank distension, irritability, red tongue with thin yellow coating, and rapid and stringy pulse.

Treatment principle: Calm the liver and clear away heat, assist in stopping bleeding.

Prescription: Danzhi Xiaoyao Powder with modifications.

Bupleurum, Atractylodes, Chinese Angelica, White Peony Root, Poria, Menthus Flavour, Cortex Moutan, Gardenia, Motherwort, Sanguisorba Officinalis, and Licorice.

2. Qi deficiency type

Main symptoms: sudden metrorrhagia or dripping blood, light color and clear texture, pale complexion, limb fatigue, shortness of breath and laziness to speak, pale tongue or with teeth marks on the edges of the tongue, thin and moist tongue coating, slow and weak pulse.

Treatment principle: tonify Qi and strengthen the spleen, consolidate and stop bleeding.

Prescription: Yiyuan Decoction with modifications.

Ginseng, Astragalus, roasted licorice, Atractylodes macrocephala, Cimicifuga heracleifolia, Mugwort leaf, donkey-hide gelatin (melted).

3. Blood stasis type:

Main symptoms: intermittent bleeding, continuous bleeding, or sudden heavy flow with blood clots, pain in the lower abdomen that resists pressure. Dark purple tongue, or with spots on the edges, thin fur, deep and astringent pulse or stringy and thin pulse.

Treatment principle: Promote blood circulation and remove blood stasis, regulate qi and relieve pain.

Prescription: Xuefu Zhuyu Decoction with modifications.

Peach kernel, safflower, angelica, raw rehmannia, chuanxiong, red peony root, bupleurum, corydalis, myrrh, and licorice.

4. Kidney deficiency type

Main symptoms: Vaginal bleeding of varying amounts, bright red in color, dizziness, tinnitus, palpitations, fever in the five parts of the body, red cheekbones, soreness of the waist and knees, red tongue with little coating, and a thready pulse.

Treatment principle: Nourish yin and kidney, consolidate Chong and stop bleeding.

Prescription: Zuogui Pills with modifications.

Rehmannia glutinosa, Chinese yam, Cornus officinalis, Cuscuta australis, Lycium barbarum, antler glue, (melted), Ligustrum lucidum, Eclipta prostrata, Agrimoniae, Sanguisorba officinalis charcoal, and palm charcoal.