Chronic constipation is a common disease in tumor patients, mainly manifested as reduced frequency of defecation, difficulty in defecation or incomplete feeling, or dry and difficult to relieve stool. The Yellow Emperor’s Classic of Internal Medicine refers to constipation as “difficulty in defecation”, and the Treatise on Typhoid is divided into “Yang knot”, “Yin knot”, and “Spleen about”. In later times, there were also theories of “wind, qi, cold, heat, damp constipation” and “wind-heat dryness”, etc. Only in the Qing Dynasty, in the “Source of Miscellaneous Diseases Rhinoceros Turbidity”, was the name “constipation” first seen. Constipation” the name of the disease. Although constipation is generally not life-threatening, it can increase the patient’s mental burden, add anxiety and tension, and may induce or aggravate other diseases (such as hypertension, coronary heart disease, heart failure, etc.), thus affecting the patient’s quality of life. At present, the diagnosis of chronic constipation, according to the clinical manifestations, generally take the diagnostic criteria of Rome II, that is, in the past 12 months, continuous (not necessarily continuous), at least 12 weeks with 2 or more of the following symptoms: (1) lumpy or hard defecation; (2) defecation with effort, difficulty; (3) defecation with a sense of incompleteness; (4) defecation with anorectal obstruction (5) Need to use manual assistance for defecation; (6) Defecation <3 times/week. The degree of chronic constipation is generally divided into three degrees. Mild refers to mild symptoms, does not affect life, can be improved by general treatment, no medication or less medication; severe refers to constipation symptoms persist, the patient is unusually painful, seriously affect life, can not stop medication or treatment is ineffective; moderate between the two. The process of defecation is roughly divided into three steps: (1) the gradual formation of feces and advancement to the rectum; (2) stimulation of the rectal mucosa after the feces fills the rectum, generating the desire to defecate and causing the defecation reflex; (3) defecation action under the regulation of the cerebral cortex and the low-level centers in the lumbosacral crestal medulla, through rectal contraction, anal sphincter relaxation, abdominal muscle and diaphragm contraction and feces will be expelled. The constipation occurs through contraction of the rectum, release of the anal sphincter, and contraction of the abdominal muscles and diaphragm. For tumor patients, especially in advanced cases, constipation is a common symptom, which is mainly seen in the following cases according to the etiology: Simple constipation (1) eating too little or too fine a diet with insufficient fiber content, which reduces the stimulation of colonic motility; (2) disturbance of bowel habits due to the change of life pattern, surrounding environment and mental tension; (3) disturbance of bowel habits due to the change of life pattern, surrounding environment and mental tension; (4) disturbance of bowel habits due to the change of life pattern. (2) disturbance of defecation habits due to life pattern, change of surrounding environment and mental stress; (3) prolonged bed rest, reduced activity and slowed intestinal peristalsis; (4) chronic wasting, malnutrition or senile weakness, etc., resulting in muscle atrophy or muscle weakness and making defecation difficult. Secondary constipation (1) intestinal stenosis or obstruction caused by intestinal tumors; (2) intestinal compression by extraintestinal tumors; (3) constipation caused by compression of the cremaster, lumbar plexus, and sacral plexus nerves by primary or metastatic tumors; (4) secretory lesions, such as hyperparathyroidism or hypothyroidism when the intestinal muscle power is reduced; (5) metabolic disorders, such as hypokalemia and hypercalcemia; (6) intestinal irritability syndrome, the pathogenesis of which is unknown. The pathogenesis is still unclear, constipation is one of the main clinical manifestations, which is caused by the impaired movement of the smooth muscle of the gastrointestinal tract. Medical constipation (1) laxative abuse. Long-term overdose of laxatives (commonly stimulant laxatives) can cause damage to the intestinal mucosa, colonic smooth muscle atrophy and nerve damage, while making the intestine less sensitive to laxatives, forming dependence and tolerance to laxatives, which can eventually lead to severe constipation; (2) toxic side effects of chemotherapeutic drugs, such as vincristine, onychotoxin, etc.; (3) opioid painkillers, which can make the sensitivity of defecation reflex stimulation (3) opioid analgesics, which can reduce the sensitivity of bowel reflex stimulation and weaken intestinal peristalsis, causing constipation; (4) 5-HT3 receptor antagonist antiemetic drugs; (5) other drugs, such as bismuth, acid suppressants, antidepressants, anticholinergic drugs, etc.; (6) postoperative complications, such as intestinal adhesions, scar stenosis; (7) radiation enteritis. According to Chinese medicine, constipation is caused by the malfunction of the large intestine in transmitting and transforming dregs, mostly due to heat in the intestinal tract, or lack of fluid and yin and blood, loss of intestinal moistening and conduction, or due to cold condensation and qi deficiency resulting in intestinal qi obstruction. It can be divided into heat accumulation in the spleen and stomach, yin-cold accumulation, and qi stagnation; deficiency lies in the loss of moisture in the intestine and weakness in propulsion, including qi deficiency, blood deficiency, yin deficiency, and yang deficiency. 3.Treatment of combined constipation in tumor patients The diagnosis of constipation in tumor patients is not difficult, but to clarify the cause of constipation, in addition to careful medical history, symptoms and comprehensive physical examination, if necessary, should be supplemented by stool routine, endoscopy, gastrointestinal X-ray, CT, MRI and other auxiliary examinations. Timely and reasonable treatment is necessary to reduce the patient's pain. In addition to etiological treatment, the following measures can be taken appropriately. (2) Encourage patients to increase their activities within the limits of their condition, such as walking, jogging, regular turning, etc., and to develop the habit of regular bowel movements, avoiding strong efforts to squat for a long time; (3) Encourage patients to eat more fiber-rich foods, such as vegetables (wild rice, leek, spinach (3) encourage patients to eat more fiber-rich foods, such as vegetables (wild rice, leek, spinach, celery, loofah, lotus root, etc.), fruits (persimmons, grapes, apricots, pears, apples, bananas, tomatoes, etc. contain more fiber), mixed grains, appropriate consumption of some lubricating foods (such as black sesame, walnuts), and increase water intake; (4) can be supplemented with abdominal massage (starting from the right lower abdomen up, to the left, and then down clockwise, 2 to 3 times a day, 20 to 30 times each time) (5) Reduce the application of medications that may cause constipation; (6) Apply laxative medications to predictable constipation at the right time to prevent constipation. Application of gastrointestinal motility drugs. Such as mosapride, cisapride, etc. The new generation of 5-HT receptor agonist tegaserod was approved by FDA in August 2004 for the treatment of chronic constipation. These drugs act on the 5-HT receptors of the motor neurons of the muscular plexus of the intestinal wall and increase the release of acetylcholine, which can shorten the intestinal transmission time and enhance gastrointestinal motility and contractility. However, cisapride and other drugs exist to cause tachycardia, Q-T interval prolongation syndrome, and even induce fatal arrhythmias, especially in its combination with macrolide antibiotics, imidazoles or antidepressants affect its metabolism, can make the blood concentration increase, should not be combined, the drug is now withdrawn from the market in some countries. Use of laxatives (1) lubricating laxatives mineral oil such as paraffin oil, glycerin. Not absorbed after oral intake, can lubricate the intestinal tract, wrapped in fecal mass outside, so that it is easy to pass through the intestine. It is suitable for patients with dry stools, or old and frail patients with weakened bowel movement, but long-term use will affect the absorption of carotene and vitamin A and D. (2) Softening laxatives such as sodium octobutyl sulfonate. It is a basic non-absorbable surfactant, which can soften the water and fat in the stool by easy mixing. Suitable for the short course of treatment for patients with weak bowel movements. The drug should not be used in combination with paraffin oil, because it can promote the absorption of paraffin oil and produce adverse reactions. (3) volumetric laxatives also known as bulking agents, such as methylcellulose, glucomannan, psyllium. Rich in polysaccharides or cellulose, can expand into a lubricious gel, promote intestinal peristalsis, so that the intestinal contents easy to pass. Suitable for those who eat less residue diet, no systemic effects, can be applied for a long time, while drinking more water. (4) osmotic laxatives such as magnesium sulfate, sodium sulfate, sorbitol, lactulose, polyethylene glycol. By increasing the osmotic concentration of stool, thus increasing the water content in the stool and stimulating intestinal peristalsis. Lactulose is especially suitable for patients with hepatic encephalopathy; magnesium sulfate, sodium sulfate laxative effect is strong, often can produce watery diarrhea; renal impairment patients can not take magnesium salts, because the accumulation of magnesium in the kidney will cause toxic reactions. ⑤ stimulating laxatives such as senna, castor oil, rhubarb, fruit guide, stool stop. By stimulating the synthesis and release of inflammatory mediators in the intestinal tract to cause fluid accumulation in the intestinal lumen and diarrhea. It is suitable for people with weak bowel motility, but long-term use of these laxatives must be avoided. The long-term use of these laxatives and the need to gradually increase the dose in order to ensure normal defecation may cause loss of intestinal motility, and the laxative effect of these laxatives may cause colic, abdominal tension and watery stools, and loss of large amounts of water and electrolytes. Other (1) enema Available warm water, warm saline, soapy water or 123 enema (50% magnesium sulfate 30ml, glycerin 60ml, water 90ml). (2) rectal suppositories such as glycerin suppositories, cecropia. The above 2 types of drugs are mainly suitable for the temporary treatment measures of fecal mass constipation, embedded in the rectum and sigmoid colon. (3) methylnaltrexone and alvimopan are peripheral opioid receptor antagonists that do not cross the blood-brain barrier and are effective for opioid-induced constipation. (4) Microecological preparations Containing bifidobacteria, lactobacilli, enterococci and other normal beneficial intestinal flora, it is a kind of intestinal microecological regulator, directly supplementing the normal physiological flora and improving the intestinal microecological environment, but care should be taken to avoid simultaneous use with antibiotics. 4, Chinese medicine evidence-based treatment (1) actual heat constipation constipation of dry heat can be referred to the three Cheng Qi Tang or Hou Pu San Wu Tang. The large Cheng Qi Tang attacks the actual heat and cleanses the dry knots; the stomach-regulating Cheng Qi Tang diarrhea heat and stomach, moisten the dryness and soften the firmness; the small Cheng Qi Tang diarrhea and swept down the accumulation, eliminating the plankton and eliminating the fullness; the thick Park San Wu Tang regulates the Qi and eliminates the fullness, eliminates the plankton and diarrhea heat to remove the actuality. (2) Spleen constipation with heat in the stomach, deficiency of spleen yin, intestinal dryness without moistening, dregs from the constipation of the spleen can be used with Ma Zi Ren Wan, in which Hou Pu, Citrus aurantium and Rhubarb clear the stomach heat, Ma Zi Ren nourishes yin and moistens the intestines, Paeonia lactiflora nourishes spleen yin and almonds moisten the intestines, so that the stomach heat is drained and the spleen fluid is restored. (3) Damp-heat constipation Damp-heat stagnation, easy to trap the spleen and block the Qi and cause constipation, can be Xiao Chai Hu Tang each to solve the less Yang, pass down the inner reality. (4) Watery drink constipation Watery drink is a yin evil, easily blocking qi, resulting in constipation due to abnormal lift. The formula is based on Hou Pu Da Huang Tang and Da Shen Che Tang to remove heat and drink to break the knot. (5) Deficiency constipation is especially common in tumor patients, with Yang deficiency and cold constipation. The Chinese herbal medicine should emphasize the diagnosis and treatment. Constipation is closely related to tumor and should be given clinical attention. It can be caused by a variety of reasons and is therefore an individualized and comprehensive treatment process. We should correctly identify the evidence and reasonably administer treatment, and try to improve the quality of life of tumor patients.