Research Article

Hong Kong Chinese Medicine Clinical Practice Guideline for Cancer Palliative Care: Pain, Constipation, and Insomnia

Table 7

Herbal treatment on cancer insomnia.

PatternPathogenesis and treatment principleRecipe and ingredient herbsGrading and level

Liver-qi stagnationPathogenesis: Liver failing in free coursing, qi movement stagnation
Principle: Soothe the liver and release the stagnation
Modified Chai Hu Shu Gan San:
Chai Hu (Bupleuri Radix), Bai Shao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium Viride), Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Zhi Qiao (Aurantii Fructus), Gan Cao (Glycyrrhizae Radix Et Rhizoma)
Grading of recommendation: C§
 Level of evidence: IV

Liver depression and spleen deficiencyPathogenesis: Liver depression and blood deficiency, spleen-stomach weakness
Principle: Harmonize the liver and spleen, Soothe the liver and release the stagnation
Modified Xiao Yao San:
Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Bo He (Menthae Haplocalycis Herba), Fu Ling (Poria), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus)
Grading of recommendation: C§
 Level of evidence: IV

Qi and blood deficiencyPathogenesis: Dual deficiency of qi and blood
Principle: Tonify qi and replenish blood
Modified Ba Zhen Tang:
Huang Qi (Astragali Radix), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Dang Shen (Codonopsis Radix), Yu Jin (Curcumae Radix), Mu Xiang (Aucklandiae Radix), Suan Zao Ren (Ziziphispinosaesemen), Yuan Zhi (Polygalae Radix), Zhi Gan Cao (Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle)
Grading of recommendation: B§
 Level of evidence: IIa [17, 18]

Qi and yin deficiencyPathogenesis: Dryness damaging the lung and stomach, fluid-humor depletion
Principle: Tonify the lung and stomach, engender fluid and moisten dryness
Modified Si Jun Zi Tang plus Sha Can Mai Dong Tang:
Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bei Sha Shen (Glehniae Radix), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Gua Lou Pi (Trichosanthis Pericarpium), Shi Shang Bai (Selaginella Doederleinii Hieron.), Shi Jian Chuan (Salvia Chinensia Benth.), Bai Hua She She Cao (Spreading Hedyotis Herb), Chan Pi (Bufo Melanostictus Schneider), Xia Ku Cao (Prunellae Spica), Mu Li (Ostreae Concha)
Grading of recommendation: B§
 Level of evidence: IIa [19]

Heart and spleen deficiencyPathogenesis: Heart blood deficiency, spleen qi deficiency
Principle: Tonify qi and fortify the spleen, nourish the heart to tranquilize
Modified Ren Shen Gui Pi Tang:
Ren Shen (Ginseng Radix Et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Yuan Zhi (Polygalae Radix), Suan Zao Ren (Ziziphispinosaesemen), Fu Shen (Tuckahoe With Pine), Mu Xiang (Aucklandiae Radix), Long Yan Rou (Longan Arillus), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus), Gan Cao (Glycyrrhizae Radix Et Rhizoma)
Grading of recommendation: C§
 Level of evidence: IV