In the advanced stage of breast cancer, it is particularly important to distinguish between the virtual and the real, the yin and the yang. The development of breast cancer is based on the deficiency of positive qi and the imbalance of chong ren, and the interrelationship of qi stagnation and phlegm stasis is its superficial phenomenon. Under the influence of pathological factors, this process gradually accumulates and undergoes qualitative changes, which eventually leads to the endogenous cancer toxicity. This endogenous poison, like a cunning thief, often flows along the meridians, causing damage to the internal organs. The deficiency of righteous qi provides an opportunity for the flow of cancer toxin, and the internal resistance of phlegm and stasis is not only the cause of tumor formation, but also the key factor for the spread of cancer toxin. In this complex pathological process, the deficiency of positive qi is mainly related to the spleen and kidney, especially the importance of spleen, stomach, qi and blood. The spleen and stomach are the source of qi and blood biochemistry. When the spleen and stomach are weak, the metaplasia of qi and blood will appear to be stretched, and the middle qi will be insufficient, and phlegm and stasis will take the opportunity to breed. These endogenous phlegm turbidity and blood stasis further block the meridian qi and blood, aggravating the situation of phlegm and stasis intermingling. Over time, these pathological factors accumulate and eventually metamorphosis into cancer. Cancer toxins flow along the meridians, resulting in stagnation of qi and blood, which further aggravates the formation of phlegm and stasis, forming a vicious circle. Clinically, patients with multiple metastases of breast cancer often show phlegm stasis such as purple and dark tongue, white or yellow greasy, and bruising of the veins under the tongue. From the perspective of systemic symptoms, pale or yellowish complexion, fatigue, low voice, weak breath, loose stool, clear and long urine, pale tongue, thin and weak pulse, etc., are mostly illusory; On the other hand, the face is red and red, the chest is tight and irritable, the voice is high and the breath is rough, the phlegm and saliva are abundant, the constipation knot or the lower is urgent, the tongue coating is thick and greasy, and the pulse is large, etc., are mostly true. From the perspective of local symptoms, the cancer is broken and ulcerated, the color is red and tight, the blood is dripping, the smell is unbearable, or the pain is severe, etc., which are mostly positive signs; However, the cancer is broken and ulcerated, the skin color is purple or dark or the skin color remains unchanged, and the ulcer surface is deeply sunken, etc., which are mostly negative syndromes. These changes in the virtual and real yin and yang provide us with an important basis for identifying the condition of breast cancer. 
In the process of multiple metastasis of breast cancer, according to the pathological characteristics of phlegm and stasis, spleen strengthening has become the core strategy. However, spleen strengthening is not static, but needs to be flexibly adjusted according to the patient's physical and physical conditions. For weak patients, strengthening the spleen and replenishing deficiency is the primary task, by supplementing righteous qi, enhancing the patient's resistance, and laying the foundation for subsequent expectoration and stasis**. When faced with the situation of the existence of evil, phlegm and stasis have become the key. At this time, the cancer is full of poison, but the righteousness still exists, indicating that the patient still has a glimmer of life. Therefore, the goal is to open the way out of phlegm and stasis, so that the evil qi can be expelled. In clinical practice, we often use perilla seeds, white mustard seeds, coria seeds, sulforaphane seeds and other medicinal materials to expel phlegm and reduce qi, and dissipate knots. At the same time, combined with astragalus, ginseng, atractylodes, poria cocos, yam and other drugs that strengthen the spleen and invigorate qi, in order to achieve the purpose of transporting phlegm and dampness. The significance of this strategy is multifaceted. First of all, by cleansing the phlegm and turbidity, we can remove the phlegm and dampness from the body, thereby reducing the patient's symptoms. The spleen is the source of phlegm, and the lungs are the phlegm storage organs, which helps to transport water valleys and prevent phlegm dampness. At the same time, perilla seeds, white mustard seeds and other medicinal materials can warm the lungs and improve qi, eliminate phlegm and reduce qi, so that qi can be lowered without phlegm being reversed. Secondly, by cultivating righteousness, we can strengthen patients' resistance and improve their quality of life. The flow of cancer poison is based on the deficiency of righteous qi, so the key to cultivating and intercepting the flow is the best. Ginseng, astragalus and other drugs can strengthen the spleen and invigorate qi, so that the water valley can be lucky, and the essence and qi can be raised. In this way, it can not only cultivate righteous qi, but also make the lifting and lowering appropriate, and maintain the balance of the body. Finally, by harmonizing the five organs, we can reduce the damage to the five organs caused by the flow of cancer toxins. The lungs face the hundred veins, the main joints, and the main body of all qi, so it is very important to reduce qi and dissolve phlegm to protect the function of the lungs. At the same time, the spleen is the source of qi and blood biochemistry, and strengthening the spleen and invigorating qi can also soothe the five organs and improve the overall health level of patients. To sum up, when the phlegm and stasis of multiple metastases of breast cancer are intertwined, it is important to strengthen the spleen and adjust the strategy according to the virtual and real world, which is the key to ensure the best effect. Through the multi-faceted effects of cleansing phlegm and turbidity, cultivating righteous qi and peace and five internal organs, we can provide patients with better solutions, improve their quality of life, and prolong their lifespan. When the deficiency and poison are flourishing, it is particularly important to strengthen the spleen and replenish the deficiency. The disease is getting worse and worse, the cancer poison is deep into the bone marrow, the righteousness is getting weaker and weaker, and the difficulty is increasing. At this time, if the blood is forcibly broken and the phlegm is cleansed, not only will it not be beneficial to the condition, but it may further deplete the righteous qi and accelerate the depletion of Yuanyang. Cancer is deeply toxic and often leads to damage to all five organs, but if the five organs are supplemented, it lacks focus and is difficult to achieve significant curative effects. As stated in "Su Wen: The Biography of Specimen Disease": "The one in parallel is even alone." "The spleen and stomach play a central role in the rise and fall of the body's qi, the decay of water valleys, the metaplasia of qi and blood, the subtlety of cloth transmission, and the nourishment of viscera. Therefore, in the case of advanced breast cancer, we adopt the strategy of "taking the middle focus alone" and pay attention to regulating the spleen and stomach. In clinical practice, we commonly use Codonopsis, Astragalus, Atractylodes macrocephalus and other qi and spleen, sand kernels, fried malt, fried rice sprouts, betel nut, wood fragrance, sulforaphane seeds, red yeast rice, Shenqu, etc., and stomach qi to eliminate appetite, Poria cocos, Atractylodes, tangerine peel, coix seed, white lentils and other spleen and dampness. If the patient has poor stool, reuse Atractylodes macrocephalus and add citrus aurantium, citrus aurantium, and magnolia bark to laxative. If insomnia is also seen, add sour jujube seeds, acacia flowers, and shou wu vine to nourish the heart and calm the nerves. For those who have bone marrow suppression caused by chemotherapy and are deficient in sperm and blood, we add the flesh and blood products of Guilu Erxian Tang on the basis of strengthening the spleen and invigorating qi and blood such as Gui Spleen Decoction and Angelica Tonifying Blood Decoction to nourish the kidneys and improve sperm and marrow. In the process of medication, we emphasize peace and avoid the use of harsh drugs to avoid further damage to righteousness. For metastatic breast cancer, more attention should be paid to the protection of righteousness. There are two aspects of medication peace: one is to avoid attacking too violently, and often use the self-simulated Liuzi Yangqin decoction to remove phlegm and regulate qi, and take its characteristics of dissolving phlegm without being warm and dry, and reducing qi without breaking qi. It should be used with caution for bitter cold and poisonous drugs such as gansui and coriander, so as not to aggravate the condition. As pointed out in "Jingyue Quanshu - Cradle Carbuncle Milk Rock": "If the accumulation grows over time, the rock color is red and the water is out, and the deep hole is difficult to treat, but the use of medicine such as Qiangui Spleen Decoction can prolong the years, and if it is misused to attack, it will be in danger." "The second is to be cautious about the use of toxic drugs, for the strong warm tonic drugs such as aconite, etc., because they can consume yin blood, and have great toxicity, improper use may aggravate the condition. However, it is not completely forbidden to use toxic drugs, such as insect drugs have the effect of searching for wind and cleansing phlegm, clearing channels and stopping spasms, and are often effective for phlegm poison flowing, numbness of limbs caused by internal movement of wind and phlegm, and convulsions. In clinical application, we take its ability to attack poison and disperse condensation, and it is often used for multiple metastasis of tumors, but it must be accompanied by drugs such as atractylodes, poria, and licorice to strengthen the spleen and invigorate qi, so as to cultivate and replenish the middle earth and prevent the consumption of righteous qi. For patients with advanced breast cancer, external treatment is equally important. Patients are often accompanied by symptoms such as local ulceration and bleeding of the breast, and obvious pain. For those with more local ulcers and exudation, on the basis of modern medical system and TCM syndrome differentiation and treatment, we add a wet compress of Coptis chinensis liquid to detoxify and build muscles, reduce swelling and relieve pain, and collect dampness and sores. If it is accompanied by bleeding, peach blossom powder is added to stop bleeding; For those with infection, local redness and swelling, apply external medicine such as Jinhuangsan to clear heat and detoxify. Modern studies have shown that Coptis chinensis has activities such as antibacterial, reducing the expression of inflammatory factors, and promoting the proliferation of human vascular endothelial cells, which may be one of the mechanisms of its detoxification and muscle building, swelling and pain relief. Through both internal and external treatment, we strive to provide patients with a more comprehensive and effective ** solution.
Attaching importance to daily adjustment, doctor-patient joint decision-making and palliative care occupy an indispensable position in the process of breast cancer. There are many levels to daily photography, and emotional photography is one of them. Liver stagnation is an important part of the pathogenesis of breast cancer, and emotional regulation is particularly important for patients who have been ill for a long time and are depressed. As stated in the "Medical Sect Jinjian: Surgical Volume": "If the recurrence is caused by sudden anger, the blood is spilled, the roots are swollen and stronger, and the five organs are declining, that is, success or failure, and there is no salvation; If the patient can clear his mind and recuperate, he can be treated. "Clinically, verbal counseling combined with Xiaoyaosan, Bupleurum Shugansan and other prescriptions can help to soothe the liver and regulate qi and promote patients. In addition, guided slimming is also an effective method of adjustment. Through simple guiding actions, such as the self-created "Women's Health Guidance", patients can easily dredge the meridians, regulate the internal organs, and regulate yin and yang at home. Foot bath health care is also valued, especially for patients with advanced breast cancer, foot bathing can not only warm the five organs, strengthen the spleen and kidneys, but also relieve fatigue and promote sleep. In metastatic breast cancer, the goal of TCM is not only to alleviate symptoms, but more importantly, to improve the quality of life of patients, prolong survival, and achieve the coexistence of human tumors. For elderly patients who are frail and have many underlying diseases, joint decision-making and palliative care between doctors and patients are particularly important. Doctors need to abandon the traditional paternalistic decision-making model, fully communicate with patients, and comprehensively consider the patient's economy, wishes and values, and formulate the most suitable plan for the patient. When choosing the rescue methods of modern medicine, it is more necessary to fully evaluate the patient's benefit-risk ratio to avoid increasing the patient's pain and family financial burden. For pain caused by local ulceration and metastasis, the physician should provide adequate analgesia**. On the basis of topical application of Coptis chinensis liquid, Jinlingzisan should be taken internally, and if necessary, the pain should be relieved according to the three-step analgesic method to ensure that the patient can comfortably pass the ** period. **10,000 Fans Incentive Plan