Loss of appetite is one of the common clinical symptoms, and many diseases can cause loss of appetite. However, because of the lack of characteristic significance of loss of appetite to the diagnosis of tumor, the harm brought by loss of appetite to tumor patients is not easy to be paid attention to, and there are few studies in this area, and there are few textbook discussions and journal papers. Research on loss of appetite in tumor patients and effective treatment are beneficial to improve the quality of life and prolong the survival time of advanced tumor patients.
I. Causes
Most of the tumors in various parts of the body can cause loss of appetite in the late stage of the disease, but it is mostly seen in the tumors of digestive system, such as gastric cancer, pancreatic cancer, liver cancer, gallbladder cancer and so on. As the normal tissues of these organs are replaced by tumor tissues or eroded by tumor tissues, the function of normal secretion that promotes appetite is disrupted, thus triggering loss of appetite. Tumors in other parts of the body, such as lung cancer, breast cancer, etc., can cause loss of appetite when they reach the malignant stage or systemic metastasis stage, or because of cancer pain. In Chinese medicine, it is included in the category of “anorexia” and “fullness”, and it is mainly due to deficiency of spleen and stomach qi, but also due to phlegm and dampness and liver depression and qi stagnation.
Clinical manifestations
Loss of appetite caused by tumor is caused by tumor, especially digestive system tumor, such as gastric cancer, small intestine tumor, pancreatic cancer, etc. In the early stage of the disease, while nausea, vomiting and weakness appear, mild loss of appetite can appear, which is manifested as a reduced desire to eat and a reduced amount of food, but can still barely eat, and the loss of appetite can be improved by taking some appetizer or digestive aid. As the disease progresses or worsens, the degree of loss of appetite will gradually worsen, the desire to eat is very low, and the amount of food eaten is significantly reduced compared with the previous one.
Some other non-digestive system tumors can have no obvious effect on appetite in the early stage of the disease, but as the tumor progresses, recurs or metastasizes, loss of appetite will occur. The following conditions can aggravate loss of appetite: tumor metastasis to the digestive system, such as some tumors commonly metastasize to the liver. In addition, cancer pain caused by tumor metastasis to bones and nerves, or insomnia and malignancy can aggravate the phenomenon of loss of appetite, at this time, general appetizing and digestive drugs can hardly be effective. According to traditional Chinese medicine, this disease is caused by the dysfunction of spleen and stomach, and the loss of appetite can be clinically classified into the following types: 1.
1, spleen and stomach qi deficiency: loss of appetite, epigastric discomfort, tiredness and weakness, sometimes light and sometimes heavy.
2, liver depression and qi stagnation: loss of appetite, distention and fullness of the abdomen and stomach, good sighing.
3, phlegm-dampness internal obstruction: distention and fullness of the abdomen, loss of appetite, nausea and vomiting.
Third, diagnosis and differential diagnosis
Loss of appetite and poor appetite, loss of appetite, anorexia are about the same meaning, and the general ones cause the decrease of eating quantity. If there is a history of tumor and the patient has loss of appetite, most of this loss of appetite can be considered to be caused by tumor. If the loss of appetite lasts for a longer period of time, the general treatment effect is not good and the physical condition deteriorates, it is necessary to consider whether the patient is suffering from tumor, especially malignant tumor of digestive system. Through medical history investigation, physical examination and necessary auxiliary examination, sometimes the type of cancer suffered can be found out.
Since there are more diseases that cause loss of appetite, there are some diseases that need to be distinguished from tumors. Note that some benign diseases of digestive system can cause loss of appetite, such as hepatitis, liver cirrhosis, gastritis, etc.; some endocrine diseases, such as hypothyroidism, etc.; some metabolic disorders, drug poisoning, etc., and anorexia nervosa, etc.
IV. Chinese and Western medicine treatment
There are not many Chinese and Western medical treatments for tumor-induced loss of appetite, and the efficacy is not ideal. Since loss of appetite is a manifestation of advanced tumor, it is very difficult to treat advanced tumor in terms of removing the cause, and it is not easy to remove the tumor completely, but the effective treatment of tumor complications, such as pain relief and improvement of sleep, may improve the loss of appetite.
Symptomatic treatment for loss of appetite is also a common method. On the one hand, the application of appetizing and digestive drugs, and on the other hand, the preparation of delicious meals with the cooperation of nutritional physicians can sometimes receive some effects.
Chinese medicine treatment
1, spleen and stomach qi deficiency: hunger and lack of desire to eat, the epigastric discomfort, fullness and uncomfortable, sometimes light, sometimes heavy, like warmth and like to press, body fatigue, shortness of breath, lazy speech, loose stools, light tongue, white coating, sunken weak pulse.
Treatment: Strengthening the spleen qi and regulating stomach qi.
Radix: Xiang Sha Liu Jun Zi Tang with Bao He Wan plus reduction. In the formula, Radix et Rhizoma Ginseng benefits Qi and tonifies the middle; Atractylodes Macrocephala, Poria, Pericarpium Citri Reticulatae, Radix et Rhizoma Glycyrrhiza Glabra strengthen the spleen and dry dampness; Muxiang and Sharen regulate Qi; Hawthorn, Shen Qu and Malt dispel food and induce stagnation. Qi stagnation is obvious with the addition of aromatic herbs, Citrus aurantium, Yuanhu to increase the effectiveness of Qi and pain relief.
2, liver depression and stagnation of Qi: distension and fullness in the abdomen and stomach, dullness, belching and good breath, irritability, aggravated by emotional discomfort, thin white fur, string pulse.
Treatment: Relieve liver stagnation, regulate qi and eliminate stagnation.
Radicals: Chai Hu Dredging Liver San plus or minus. In this formula, Sihuanxiong Ligusticum regulates the Qi in Blood, Xiangxiang Hu regulates the Blood in Qi, Qing Pi and Chen Pi regulate Liver and Qi, and Yu Jin is added to clear the Liver and relieve depression. For severe pain, it is advisable to add Yuan Hu and Chuan Neem to regulate Qi and Blood to relieve pain; for Qi stagnation and heat, add Gardenia and Dan Pi to regulate Qi and diarrhea heat.
3, phlegm-damp internal obstruction: fullness of the chest and epigastric, hunger, nausea and vomiting, dizziness, heavy body and limbs, light mouth, no thirst, fat tongue, white thick and greasy moss, sunken and slippery pulse.
Treatment: Eliminate dampness, resolve phlegm, regulate Qi and broaden the middle.
Radicals: combining Pinghu San with Er Chen Tang, plus or minus. Chen Pi and Hou Pu regulate qi and remove dampness; Cang Zhu, Fu Ling and Han Xia strengthen spleen and dry dampness; licorice, jujube and ginger benefit qi and regulate camp. The formula can be supplemented with Neijin, malt, and Shenqu to eliminate stagnation; for obvious spleen deficiency, add white lentils, yam, and lotus seeds to strengthen the spleen and benefit the qi.