1First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China; 2 Department of Nutrition, the Cancer Hospital of the University of Chinese Academy of Science, Hangzhou, Zhejiang 310022, China; 3 Department of Integrated Traditional Chinese and Western Medicine, the Cancer Hospital of the University of Chinese Academy of Science, Hangzhou, Zhejiang 310022, China; 4 Department of Oncology, First Affiliated Hospital of Zhejiang Traditional Medical University, Hangzhou, Zhejiang 310003, China; 5 Key Laboratory of Traditional Chinese Medicine Oncology, the Cancer Hospital of the University of Chinese Academy of Science, Hangzhou, Zhejiang 310022, China
Abstract:The incidence of malnutrition in patients with malignant tumor is extremely high, especially in patients with gastrointestinal malignancy, which seriously affects the treatment and prognosis of cancer patients. Tumor nutrition therapy as another treatment method in addition to surgery, radio-chemotherapy, targeted therapy, immunotherapy should be used throughout the whole process of tumor treatment. Studies have shown that tumor nutrition therapy can not only shorten the length of hospitalization, increase the effective of anti-tumor therapy, reduce the adverse reactions caused by anti-tumor therapy, improve the quality of life, but also increase the overall survival of patients. Therefore, tumor nutrition therapy plays an irreplaceable role in the whole process of anti-tumor treatment. Traditional Chinese medicine(TCM) and Western medicine, as the two major medical systems in China, play an important role in the prevention and treatment of diseases. TCM believes that malnutrition is considered the category of “consumptive disease”. According to the theories in TCM of “reinforcing the vital energy and consolidating the constitution” and “reinforcing in deficiency condition”, TCM has certain curative effect in the prevention and treatment of tumor malnutrition. Based on the current research pattern of clinical interdisciplinary penetration, this paper comprehensively analyzes the tumor nutrition therapy from the perspective of TCM and Western medicine and lay a foundation for proposing a new model of tumor nutrition management in patients with gastrointestinal malignancy.
1陈海滔,2陆怡,3徐超,4郭勇,3,5姚庆华. 消化道肿瘤营养的中西医全程管理新模式探索[J]. 肿瘤代谢与营养电子杂志, 2019, 6(3): 370-375.
1CHEN Hai-tao, 2LU Yi, 3XU Chao, 4GUO Yong, 3,5YAO Qing-hua. Exploration of a new mode of whole-process management of nutrition of gastrointestinal malignancy in Chinese and Western medicine. Electron J Metab Nutr Cancer, 2019, 6(3): 370-375.
1.Bozzetti F, Arends J, Lundholm K, et al. ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr. 2009;28(4):445-454.
2.应丽美, 陈芳芳, 陈艺丹, 等. 国内肿瘤患者的营养风险及营养不良研究现状分析. 肿瘤代谢与营养电子杂志. 2017;4(2):226-231.
3.Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36(5):1187-1196.
4.Baldwin C. Nutritional support for malnourished patients with cancer. Curr Opin Support Palliat Care.2011;5(1):29-36.
5.Garla P, Waitzberg DL, Tesser A. Nutritional therapy in gastrointestinal cancers. Gastroenterol Clin North Am. 2018;47(1):231-242.
6.Jarvinen T, Ilonen I, Kauppi J, et al. Loss of skeletal muscle mass during neoadjuvant treatments correlates with worse prognosis in esophageal cancer: a retrospective cohort study. World J Surg Oncol.2018;16(1):27.
7.Kasahara R, Kawahara T, Ohtake S, et al. A low psoas muscle index before treatment can predict a poorer prognosis in advanced bladder cancer patients who receive gemcitabine and nedaplatin therapy. Biomed Res Int. 2017;2017:7981549.
8.Mir O, Coriat R, Blanchet B, et al. Sarcopenia predicts early dose-limiting toxicities and pharmacokinetics of sorafenib in patients with hepatocellular carcinoma. PLoS One. 2012;7(5):e37563.
9.Poziomyck AK, Fruchtenicht AV, Kabke GB, et al. Reliability of nutritional assessment in patients with gastrointestinal tumors. Rev Col Bras Cir.2016;43(3):189-197.
10.Xie FL, Wang YQ, Peng LF, et al. Beneficial effect of educational and nutritional intervention on the nutritional status and compliance of gastric cancer patients undergoing chemotherapy: a randomized trial. Nutr Cancer.2017;69(5):762-771.
11.Yang C W, Lin H H, Hsieh T Y, et al. Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study. BMC Palliat Care. 2015;14:58.
12.Martindale RG, Mcclave SA, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine and American society for parenteral and enteral nutrition: executive summary. Crit Care Med.2009;37(5):1757-1761.
13.Klute K A, Brouwer J, Jhawer M, et al. Chemotherapy dose intensity predicted by baseline nutrition assessment in gastrointestinal malignancies: a multicentre analysis. Eur J Cancer. 2016;63:189-200.
14.王辉, 花宝金, 孙桂芝. 中医药防治恶性肿瘤营养不良的研究进展. 中华中医药学刊. 2012;30(7):1492-1494.
15.Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48.
16.蒋聪, 杨浩, 陈伟, 等. 住院病人的营养不良风险筛查. 肠外与肠内营养. 2016;23(3):158-161.
17.秦环龙, 贾震易. 术前营养筛查工具及其临床意义. 中国实用外科杂志. 2012;32(2):112-115.
18.石汉平, 赵青川, 王昆华, 等. 营养不良的三级诊断. 肿瘤代谢与营养电子杂志. 2015;2(2):31-36.
19.吉琳琳, 侯栋梁, 宋丽楠, 等. 营养风险筛查2002、营养不良通用筛查工具和患者主观整体评估在住院肿瘤患者中应用和比较. 营养学报. 2017;39(3):242-246.
20.石汉平. 肿瘤营养疗法. 中国肿瘤临床.2014;41(18):1141-1144.
21.石汉平, 许红霞, 李苏宜, 等. 营养不良的五阶梯治疗. 肿瘤代谢与营养电子杂志. 2015;2(1):29-33.
22.中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会肿瘤康复与姑息治疗专业委员会, 等. 肿瘤营养治疗通则. 肿瘤代谢与营养电子杂志. 2016;3(1):28-33.
23.Hebuterne X, Lemarie E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38(2):196-204.
24.Caillet P, Liuu E, Raynaud SA, et al. Association between cachexia, chemotherapy and outcomes in older cancer patients: a systematic review. Clin Nutr. 2017;36(6):1473-1482.
25.王萧萧, 舒静娜, 林胜友. 化疗对大肠癌中医证候影响的研究. 中华中医药学刊.2013;31(1):33-35.
26.朱为康, 李雁, 候风刚, 等. 胃癌患者化疗前后中医证候临床观察. 中华中医药学刊.2012;30(5):1180-1182.
27.杨丽, 王彩霞. 脾主运化的源流及发展. 中华中医药杂志. 2016;31(5):1773-1777.
28.Xie F L, Wang Y Q, Peng L F, et al. Beneficial effect of educational and nutritional intervention on the nutritional status and compliance of gastric cancer patients undergoing chemotherapy: a randomized trial. Nutr Cancer. 2017;69(5):762-771.
29.Furness K, Silvers MA, Savva J, et al. Long-term follow-up of the potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial. Support Care Cancer.2017;25(11):3587-3593.
30.Zhang Z, Zhu Y, Ling Y, et al. Comparative effects of different enteral feeding methods in head and neck cancer patients receiving radiotherapy or chemoradiotherapy: a network meta-analysis. Onco Targets Ther. 2016;9:2897-2909.
31.李洁, 李荣, 刘婷, 等. 浅析肠内营养制剂的合理应用. 世界最新医学信息文摘.2016;16(76):239-240.
32.夏羽菡, 王雯倩. 肠内营养制剂中特殊医学用途配方食品的管理和临床应用概述. 中国药师. 2017;20(10):1842-1845.
33.Murphy RA, Yeung E, Mazurak VC, et al. Influence of eicosapentaenoic acid supplementation on lean body mass in cancer cachexia. Br J Cancer. 2011;105(10):1469-1473.
34.Shirai Y, Okugawa Y, Hishida A, et al. Fish oil-enriched nutrition combined with systemic chemotherapy for gastrointestinal cancer patients with cancer cachexia. Sci Rep. 2017;7(1):4826.
35.Papanikolopoulou A, Syrigos K N, Drakoulis N. The role of glutamine supplementation in thoracic and upper aerodigestive malignancies. Nutr Cancer. 2015;67(2):231-237.
36.董万斌, 闰玉洁, 赵增喜, 等. 温针灸联合肠内营养治疗术后胃瘫综合征的临床疗效观察. 环球中医药. 2017;10(9):1134-1136.
37.陈小平. 穴位贴敷对改善晚期肿瘤患者营养状况的临床研究. 中医临床研究. 2017;9(17):110-112.
38.周月芬, 吴敏华, 陈旭烽, 等. 参麦注射液对肿瘤化疗患者血常规和CD4/CD8比例的影响. 中国临床药理学与治疗学.2011;16(12):1410-1413.
39.张玉, 潘宇, 杨亚平, 等. 平胃散及中药外敷治疗晚期肿瘤不全性肠梗阻的临床疗效. 中国老年学杂志. 2018;38(14):3370-3372.
40.彭健. 中药治疗恶性肠梗阻的系统评价及Meta分析. 北京中医药大学. 2018.
41.梁超, 郑丽平, 张宇静. 中药保留灌肠联合艾灸治疗癌性肠梗阻临床观察. 山西中医.2017;33(12):49-50.