[Diagnosis and treatment strategies for middle and advanced lung cancer based on theory of "middle Jiao deficiency and blood stasis"].

Based on the theory of "middle Jiao deficiency and blood stasis", this article systematically elucidates the evolutionary patterns of etiology and pathogenesis and the corresponding system of syndrome differentiation and treatment for middle and advanced lung cancer. This theory proposes that "middle Jiao deficiency"(impairment of the spleen and stomach in middle Jiao) is not only the origin of lung cancer but also the foundation of its disease progression. When the middle Jiao is deficient, the generation of Qi and blood is insufficient, leading to depletion of Yang Qi, internal emotional constraint, and stagnation of latent pathogens; these three factors interact as both cause and effect and jointly give rise to key pathological products such as phlegm turbidity, blood stasis, and toxic pathogens. These pathogenic factors intertwine and accumulate, obstructing the lung collaterals and ultimately forming the intractable condition of "blood stasis". At the therapeutic level, primary emphasis is placed on the principle of careful assessment of Yin and Yang, establishing fortifying the middle earth to safeguard the lung metal as the fundamental treatment strategy. In clinical practice, deviations in Yin-Yang balance and patterns of deficiency and excess should be carefully differentiated. In cases characterized predominantly by middle Jiao deficiency with Yang depletion, treatment focuses on strengthening the spleen, regulating the lung, warming Yang, and transforming Qi, with Jianpi Xiaotan Decoction selected and modified according to the presentation. In cases marked mainly by depletion of Yin essence, the therapeutic strategy emphasizes nourishing the stomach, replenishing essence, enriching Yin, and moistening the lung, using Maimendong Decoction combined with Baihe Gujin Decoction with appropriate modifications. When the syndrome of "blood stasis" has already formed, treatment should employ methods of activating blood to dissipate masses, transforming stasis, and dredging collaterals; classical formulas such as Zeqi Decoction, Dahuang Zhechong Pills, or Didang Decoction combined with Wuwei Xiaodu Decoction may be selected according to the clinical presentation to collectively eliminate phlegm turbidity, resolve blood stasis, detoxify pathogenic factors, and prevent disease transmission and progression. A representative case is cited to demonstrate the specific clinical application and favorable therapeutic outcomes of this theory in the treatment of advanced lung squamous cell carcinoma, reflecting the core academic concept of reinforcing healthy Qi while eliminating pathogenic factors and integrating attack with supplementation. This theoretical system establishes a complete clinical pathway encompassing principles, methods, formulas, and drugs, providing important guidance for the TCM-based syndrome differentiation and treatment of middle and advanced lung cancer. It holds significant value in alleviating symptoms, improving quality of life, and controlling disease progression, and also offers new perspectives and approaches for the prevention and treatment of malignant tumors within TCM.