(1) Early symptoms: Abdominal distension, discomfort and indigestion may appear at the earliest stage, and then there will be changes in defecation habits, such as increased defecation times, diarrhea or constipation, abdominal pain before defecation, etc. There will be mucus stool or mucus purulent bloody stool in the future.
(2) Poisoning symptoms: Due to tumor ulceration, blood loss and toxin absorption, patients often have anemia, low fever, fatigue, emaciation and edema, especially anemia and emaciation.
(3) Intestinal obstruction: It is a symptom of incomplete or complete low intestinal obstruction, such as abdominal distension, abdominal pain (abdominal distension or colic), constipation or constipation. Physical examination showed abdominal bulge, intestinal type, local tenderness, and strong bowel sounds could be heard.
(4) Abdominal mass: it is a tumor or mass that infiltrates and adheres to the greater omentum and surrounding tissues. Hard, irregular shape, part can move with the intestine to a certain extent. There are many infiltrations in advanced tumors, and the masses can be fixed.
(5) Late manifestations: there are signs of liver metastasis such as jaundice, ascites and edema, and there are also manifestations of distant spread and metastasis of tumors such as cachexia, anterior rectal recess and supraclavicular lymph node enlargement.
Most patients with colon cancer are over middle age, with a median age of 45, and about 5% patients are under 30. The clinical manifestations of colon cancer vary with the size, location and pathological type of the lesion. Many patients with early colon cancer may be asymptomatic clinically, but with the development of the disease course and the enlargement of the focus, a series of common symptoms of colon cancer may occur, such as increased stool frequency, bloody stool with mucus, abdominal pain, diarrhea or constipation, intestinal obstruction, general fatigue, weight loss, anemia and so on. The whole colon is divided into two parts: the right colon and the left colon, with the middle part of the transverse colon as the boundary. The clinical manifestations of these two cancers do have their own characteristics, which are described as follows:
(1) Right colon cancer The right colon cavity is thick, and the intestinal feces are liquid. Most of the cancers in this section of the intestine are ulcerated or cauliflower-like cancers protruding into the intestinal cavity, and there are few annular strictures, so obstruction does not often occur. However, these cancers often fester and bleed, with secondary infection and toxin absorption. Abdominal pain, sudden change, abdominal mass, anemia, emaciation or cachexia may appear clinically. China Medical Health Network
1. Abdominal discomfort About 75% patients have abdominal discomfort or dull pain, which is intermittent at first, then persistent, often located in the right lower abdomen, much like the attack of chronic appendicitis. If the tumor is located in the liver curvature and the stool is dry, colic can also occur, which should be differentiated from chronic cholecystitis. About 50% patients have anorexia, fullness, belching, nausea and vomiting.
2. In the early stage of stool change, the stool is thin, there is pus and blood, and the number of defecation increases, which is related to the formation of cancer and ulcer. When the tumor volume increases and affects the passage of feces, diarrhea and constipation may occur alternately. The amount of bleeding is very small. With the peristalsis of the colon, it is fully mixed with feces, which is not easy to see with naked eyes, but occult blood test is often positive.
3. Abdominal masses can be found in more than half of patients. This lump may be the cancer itself, or it may be a lump formed by infiltration and adhesion outside the intestine. The former has regular shape and clear outline; The latter is not very regular. Masses are generally hard in texture, and once infected, their activities are limited and they are tender.
4. Anemia and cachexia About 30% of patients suffer from anemia, weight loss, limb weakness and even systemic cachexia due to continuous bleeding from cancer ulcers.
(2) Left colon cancer The intestinal cavity of the left colon is thin, and the feces in the intestine become dry and hard because of absorbing water. Left colon cancer is mostly invasive and often causes annular stenosis, so the clinical manifestations are mainly acute and chronic intestinal obstruction. The mass is small in size, with little bleeding and no toxin absorption, so anemia, emaciation, cachexia and other phenomena are rare and it is not easy to touch the mass.
1. Abdominal colic is the main manifestation of cancerous intestinal obstruction. Obstruction can be sudden, with abdominal cramps, accompanied by abdominal distension, intestinal peristalsis, constipation and blocked exhaust; Chronic intestinal obstruction is characterized by abdominal distension discomfort, paroxysmal abdominal pain, hyperactivity of bowel sounds, constipation, bloody feces and mucus, and sometimes partial intestinal obstruction lasts for several months before it turns into complete intestinal obstruction.
2. Half of the patients with difficulty in defecation have this symptom. With the progress of the disease, constipation becomes more and more serious. If the location of cancer is low, there may be a feeling of poor defecation and urgency.
3. Feces with blood or mucus Because the feces of the left colon are gradually forming, blood and mucus are not mixed with feces, and blood and mucus can be seen with naked eyes in the feces of about 25% patients.
Colon cancer metastasis
1. The distant metastasis of colon cancer is mainly the liver, and about 50% patients will have liver metastasis before or after operation. The data also showed that about 30% patients had occult liver metastasis that could not be found by preoperative B-ultrasound or CT. Resection of liver metastasis of colorectal cancer is safe and a possible treatment to improve the long-term survival rate of patients with metastasis. But only a small part (10%-20%) was suitable for surgical resection, and 70% of them recurred after operation.
2. Lymphatic metastasis of colon cancer. Lymphatic metastasis generally spreads from near to far in the following order, but there are also disorderly spanning metastasis.
(1) The colonic lymph nodes are located on the fat side of the intestinal wall.
(2) Paracolonic lymph nodes are located in the mesentery adjacent to the colon wall.
(3) Mesangial vascular lymph nodes are located beside the blood vessels in the middle of the mesocolon, also called intermediate lymph nodes.
(4) Mesangial root lymph nodes are located at the mesenteric root. & ltBR & gt& ltBR & gt After cancer invades the muscle layer of intestinal wall, the possibility of lymphatic metastasis increases. If the subserous lymphatic vessels are invaded, the probability of lymphatic metastasis is greater.
3. Hematogenous metastasis generally means that cancer cells or tumor thrombus first reach the liver along the portal vein system, and then reach other tissues and organs such as lung, brain and bone. Hematogenous metastasis is usually caused by cancer invading capillaries and venules, but it can also be caused by pressing the tumor during physical examination, squeezing the tumor during operation, and even strong peristalsis during obstruction.
4. Invasion of implant cancer can directly invade surrounding tissues and organs. Cancer cells shed in the intestinal cavity, which can be planted on mucous membranes elsewhere, shed in the abdominal cavity, or planted on the peritoneum. Metastasis is nodular or millet-shaped, white or grayish white and hard. Spreading to the whole abdominal cavity can cause cancerous peritonitis and ascites.
Colon cancer is one of the common malignant tumors, and its incidence ranks fourth to sixth among malignant tumors. Recently, its incidence has been on the rise. The 5-year survival rate after radical resection is about 50%. Postoperative recurrence and metastasis are important causes of death. At present, the accepted treatment of colon cancer is a comprehensive treatment based on surgery, supplemented by chemotherapy, immunotherapy, traditional Chinese medicine and other supportive treatments.
First, surgical treatment.
The treatment of colon cancer first emphasizes surgical resection, preoperative chemotherapy, radiotherapy and other comprehensive treatments to improve the surgical resection rate, reduce postoperative recurrence rate and improve survival rate. The principles of surgical treatment are: (1) radical treatment as far as possible; (2) Try to protect pelvic autonomic nerve, preserve patients' sexual function, urination function and defecation function, and improve the quality of life.
1. Preoperative preparation In addition to routine preoperative preparation, intestinal preparation must be made for colon surgery, including ① bowel cleansing: eating a small amount or no residue two days before operation; Take laxatives 1 ~ 2 days before operation, and take them a few days in advance if you have constipation or incomplete intestinal obstruction; According to the difficulty of defecation, clean enema can be carried out one or several days before operation. ② Intestinal disinfection: kill pathogenic bacteria in the intestine, especially common anaerobic bacteria such as Bacteroides fragilis and gram-negative aerobic bacteria. The former is mainly metronidazole, and the latter can be sulfonamides, neomycin, erythromycin, kanamycin, etc. Adequate intestinal preparation can reduce intraoperative pollution and infection, which is conducive to healing.
At present, some hospitals at home and abroad adopt the method of total intestinal lavage for intestinal preparation. The method is to drip or orally take a special irrigation solution (containing a certain concentration of electrolyte and intestinal disinfectant to maintain a certain osmotic pressure), the dosage is 4 ~ 8 liters, and squat on the defecation device. Can achieve the purpose of cleaning intestinal tract and disinfection at the same time.
2. Surgical methods
(1) Right hemicolectomy is suitable for cecal cancer, ascending colon cancer and hepatic carcinoma of colon. Excision range: ileum terminal 15 ~ 20 cm, right half of cecum, ascending colon, transverse colon, mesentery and lymph nodes. Most of the lymph nodes in the transverse colon and the right gastroepiploic artery group still need to be removed for liver cancer. After resection, the colon is anastomosed end-to-end or end-to-side (colon closure).
Right hemicolectomy with preservation of middle colonic artery
Resection of right colon cancer
(2) Left hemicolectomy is suitable for carcinoma of descending colon and splenic flexure of colon. Scope of resection: left hemitransverse colon, descending colon, part or all of sigmoid colon and its mesentery and lymph nodes. End-to-end anastomosis after resection of colon or colon and rectum.
Excision of left colon cancer
(3) Transverse colectomy is suitable for transverse colon cancer. Scope of resection: transverse colon and its hepatic curvature and splenic curvature. After resection, end-to-end anastomosis of ascending and descending colon was performed. If the anastomotic tension is too high, right hemicolectomy can be added for ileocolic anastomosis.
(4) Radical resection of sigmoid colon cancer According to the specific part of the cancer, except for resection of sigmoid colon, or resection of descending colon or part of rectum. Colon-colon or colorectal anastomosis.
Resection of sigmoid colon cancer
(5) Surgical principles for patients with intestinal obstruction If the intestinal contents are significantly reduced after preoperative preparation, one-stage resection and anastomosis can be performed if the patient's conditions permit, but protective measures should be taken during the operation to minimize pollution. If the intestine is full and the patient's condition is poor, colostomy near the tumor can be performed first, and then the second-stage radical resection can be performed after the patient's condition improves.
(6) Surgical principles: Radical surgery cannot be performed when the tumor is widely invaded locally, or it cannot be removed after being fixed with surrounding tissues and organs. If the intestine has been obstructed or may be about to be obstructed, short-circuit surgery between the distal and proximal ends of the tumor can be used, and colostomy can also be performed. If there is distant organ metastasis, local tumor is still allowed to be removed, and local palliative resection can be used to alleviate symptoms such as obstruction, chronic blood loss, infection and poisoning.
3. Matters needing attention in operation
(1) After laparotomy, the exploration of the tumor should be light and should not be squeezed.
(2) During resection, the blood vessels at the root of tumor mesangium should be blocked first to prevent the blood from being transferred. And separated from the mesenteric root to the intestine.
(3) Blocking the intestine with a cloth belt at the position where the intestine is to be cut, so as to reduce the implantation and metastasis of cancer cells in the intestine. Some people advocate injecting anticancer drugs into the blocked intestine, usually 5- fluorouracil 30 mg/kg body weight, diluting with 50 ml normal saline, and separating the intestine after 30 minutes.
(4) When it adheres to the surrounding tissues, it can be removed as much as possible.
(5) Before abdominal closure, the abdominal cavity should be fully flushed to reduce cancer cell implantation and abdominal infection.
Second, chemotherapy.
About half of colon cancer patients have metastasis and recurrence after operation. Except for some early patients, patients with advanced colon cancer and patients after surgical resection need chemotherapy. Chemotherapy is another important treatment measure for colon cancer after comprehensive treatment and relay operation.
1. Chemotherapy for colon cancer is mainly based on 5-FU, and tetrahydrofolate (LV) as a regulator can enhance the efficacy of effector 5-FU.
The efficacy of (1)5-FU/LV regimen combined with 5-FU/LV has been confirmed by most studies, and it is the standard treatment regimen in the world at this stage.
Lv: 200 mg/m2, from grade one to grade five;
5-Fu: 500 mg/m2, from the first day to the fifth day;
Huachansu oral liquid (Chinese patent medicine) can reduce chemotherapy reaction, protect liver and kidney function, improve immunity, improve appetite and increase white blood cells. ): 10-20ml/ time, three times a day.
(2)FOLFOX4 regimen is the safest and most effective chemotherapy regimen for advanced colon cancer, and it is also the best choice for postoperative adjuvant chemotherapy for stage ⅲ colon cancer.
Oxaliplatin: 150mg/m2, the first day;
Lv: 200 mg/m2, from grade one to grade five;
5-Fu: 500 mg/m2, from the first day to the fifth day;
Huachansu oral liquid: 10-20ml/ time, three times a day.
Systemic intravenous chemotherapy can be used before, during and after operation: (1) preoperative chemotherapy is also called neoadjuvant chemotherapy, which aims to prevent distant metastasis, reduce tumor volume and facilitate resection. However, due to the short time, different tumor patients have different chemosensitivity, and postoperative adjuvant chemotherapy is still needed. (2) Postoperative chemotherapy, mainly 5-FU/LV combined chemotherapy (/kloc-0 repeated for 5 days after each month, at least 6 cycles), has become the standard postoperative treatment for stage III colon cancer.
2. Oral chemotherapy Oral chemotherapy drugs for colon cancer mainly refer to the precursor of fluoropyrimidine, which is converted into 5- fluorouracil through 1 or multiple metabolism after absorption, and plays an anti-cancer role. Oral chemotherapy has the advantages of high curative effect, few adverse reactions, convenient administration, outpatient treatment, and is suitable for elderly cancer patients and family chemotherapy, which has become a new trend in adjuvant treatment of colon cancer. In recent years, low-dose long-term maintenance chemotherapy has been introduced into the treatment of colon cancer, and oral chemotherapy has been further promoted.
Third, radiotherapy.
Although surgical resection is the main method to treat colorectal cancer, the local recurrence rate after simple operation is high, and most of the local recurrence occurs in the pelvic cavity, so the tumor invading the soft tissue around the rectum cannot be completely removed by surgery. Therefore, pelvic radiotherapy is the only effective method to remove the deposition of these cancer cells. However, patients with colon cancer have no significant effect on preoperative and postoperative radiotherapy. Radiotherapy is only suitable for patients with colon cancer during operation.
(1) radiotherapy scheme for colon cancer
1. Radical radiotherapy: The complete killing of tumor cells by radiotherapy is only suitable for a few early patients and patients with particularly sensitive cell types.
2. Symptomatic radiotherapy: aiming at relieving symptoms. It is suitable for palliative treatment such as relieving pain, stopping bleeding, reducing secretion, shrinking tumor and controlling tumor.
3. Comprehensive treatment of radiotherapy and surgery, and comprehensive application of surgery and radiotherapy in a planned way.
(2) Radiotherapy for colon cancer
1. preoperative radiotherapy: preoperative radiotherapy has the following advantages: ① the activity of cancer cells is weakened, making it difficult for disseminated or residual cancer cells to survive in surgery. ② For huge and fixed cancers that are difficult to resect, preoperative radiotherapy can shrink the tumor and improve the resection rate. ③ Radiobiological studies show that cancer cells are more sensitive to radiation before operation than after operation when blood supply or oxygen supply is reduced.
Preoperative radiotherapy should strictly control the dose, and the moderate dose (3500 ~ 4500 cgy) is appropriate, which will not increase the surgical complications, but also improve the surgical effect.
2. postoperative radiotherapy: postoperative radiotherapy has the following advantages: ① according to the surgical findings, after the primary tumor is removed, the possible residual parts of the tumor are marked and located, so that the irradiation parts may be more accurate, the irradiation is selective and the effect is better. ② After resection of primary tumor, the tumor load is obviously reduced, which is beneficial to improve the radiation effect of residual cancer.
3. Intraoperative radiotherapy: during the operation, large doses of β -rays were used for the suspected residual cancer and the parts that could not be completely removed.
(3) Contraindications of radiotherapy for colon cancer
1. Severe emaciation and anemia.
2. Patients with severe center of gravity instability and renal insufficiency who cannot be relieved after treatment.
3. Severe infection or septicemia.
4. Patients who can't tolerate re-radiotherapy locally.
5. When the white blood cell count is lower than 3× 109/L, the platelet count is lower than 80× 109/L, and the hemoglobin is lower than 80g/L, radiotherapy is generally suspended.
Complications of radiotherapy
1. The perineal incision healing was slightly delayed in patients undergoing preoperative radiotherapy.
2. Abdominal pain, nausea, vomiting, diarrhea and other symptoms.
3. Simple anal inflammation (1% ~ 2%), local perineal scar, poor healing or sclerosis with pain (2%), incomplete intestinal obstruction (1%).
4. Urinary incontinence (0.5% ~ 1%), cystitis and hematuria (1.5%), etc.
5. pancytopenia.
(5) Adjuvant treatment of radiotherapy
1. Patients with nausea and vomiting should be treated with metoclopramide and other drugs, and those with intractable vomiting should be treated with sufuning.
2. Leukopenia, give drugs to improve white blood cells. Such as vitamin B4, leixuesheng and leukemia.
3. cinobufotalin oral liquid 10-20ml/ time, three times a day, is a Chinese patent medicine, which has the functions of relieving radiotherapy reaction, protecting liver and kidney function, enhancing immunity, improving appetite and increasing white blood cells.
4. Those who react to the skin should apply talcum powder to the perineum in the first reaction, and apply gentian violet liquid or skin-relaxing ointment in the second reaction.
Fourth, Chinese medicine treatment.
Traditional Chinese medicine can regulate the body's immunity, restore and enhance the immune system function of postoperative patients, and has synergistic attenuation effect with chemotherapy, especially the protective effect on digestive tract reaction and hematopoietic inhibition caused by chemotherapy, so it has been paid more and more attention not only in China but also in some developed countries in the world. For postoperative patients with colon cancer, Chinese medicine generally adopts the methods of invigorating qi and spleen, clearing away heat and detoxifying. According to the results of syndrome differentiation, it can also be combined with the method of dredging collaterals and dispersing stagnation. The specific medication varies from person to person, and individualized treatment is carried out according to different stages of illness, different constitutions and different syndromes.
(1) Chinese patent medicines
1. cinobufotalin injection: cinobufotalin 20ml+5% glucose 500ml, once a day, can be used alone or in combination with radiotherapy and chemotherapy.
2. cinobufotalin oral liquid: 10 ~ 20ml/ time, taken orally three times a day, combined with radiotherapy and chemotherapy, has the functions of alleviating the side effects of radiotherapy and chemotherapy, maintaining liver and kidney functions and protecting bone marrow. For advanced patients who cannot tolerate radiotherapy and chemotherapy, it can also be used alone.
(2) Treatment based on syndrome differentiation.
1. damp-heat accumulation type; Pulsatilla soup.
Pulsatilla 30g Cortex Fraxini 15g Rhizoma Coptidis 3g Cortex Phellodendri 9g Caulis Sargentodoxae 15g Herba Patriniae 15g Radix Sophorae Flavescentis 15g Herba Portulacae 15g Flos Hibisci 12g Radix Actinidiae 30g.
2. Stasis toxin internal resistance type: Gexia Zhuyu decoction is modified.
Peach kernel 9g safflower 9g Radix Paeoniae Rubra 9g Radix Angelicae Sinensis 9g Rhizoma Chuanxiong 6g Oletum 9g Rhizoma Cyperi 9g Rhizoma Corydalis 15g Rhizoma Curcumae 15g Manicure 9g Rhizoma Smilacis Glabrae 30g
3. Spleen deficiency and qi stagnation type: Xiangsha Liujunzi decoction.
Radix Aucklandiae 6g Fructus Amomi 3g Radix Codonopsis 15g Rhizoma Atractylodis Macrocephalae 12g Poria cocos 12g Pericarpium Citri Tangerinae 6g August Zagreb 12g Fructus Aurantii 9g Linderae 9g Green Sepals 9g Aquilaria 9g.
4. Spleen and kidney yang deficiency type: Lizhong decoction.
Codonopsis pilosula 15g fried atractylodes 12g stir-fried ginger charcoal 3g nutmeg 9g psoralea corylifolia 12g Schisandra 6g Evodia 3g aconite 6g cinnamon 3g.
Verb (abbreviation for verb) immunotherapy
It can improve the anti-tumor ability of patients and has developed rapidly in recent years, such as interferon, interleukin, transfer factor, tumor necrosis factor and so on. , and gradually widely used, not only can improve the immune ability of patients, but also can cooperate with chemotherapy.
Colon cancer is better after treatment, with a survival rate of over 50% for at least 5 years after radical operation, over 80% for early patients and only about 30% for late patients.
After colon cancer surgery, you should go to the hospital regularly for check-up and rehabilitation measures. The survival time after specific treatment is related to your physique, rehabilitation environment and postoperative radiotherapy and chemotherapy.
At present, the cause of colon cancer has not been really understood, and doctors have different views on whether colon cancer can be inherited.
A family was investigated abroad. In 75 years, * * * has more than 650 blood relatives, 96 of whom are patients with malignant tumors, most of which are colon cancer, accompanied by adenocarcinoma of other organs. It has been found that the risk of colon cancer among compatriots is five times higher than that of the general population; Family factors of colon cancer are more common than other digestive tract cancers. So many doctors think that genetic factors are related to colon cancer.
food therapy
(1) Lingzhou
20 water chestnuts with shells, honey 1 spoon, and appropriate amount of glutinous rice. (1) Wash and mash water chestnuts, put them into a crock and add water to cook them into a semi-paste. ② Add appropriate amount of glutinous rice to cook porridge, and add honey to taste when porridge is cooked. Take it regularly, which is beneficial to the function of moistening the stomach and intestines.
(2) Chop the eggs with lotus root juice.
8 grams of ebony, eggs 1 piece, and proper amount of lotus root juice. Mix the dark plum kernel and lotus root juice, put them into eggs, seal them with wet paper and steam them. Twice a day, each time 1 dose, has the functions of promoting blood circulation, stopping bleeding, cooling blood and hematochezia.
(3) Qumaigen Decoction
60 grams of fresh koji wheat root or 30 grams of dried root. Wash it with rice swill first, and add water to fry it into soup. Daily 1 dose has the effect of clearing away heat and promoting diuresis.
(4) Poria cocos eggshell powder
Poria cocos 30g, egg shell 9g. Melt Poria and egg shell, and grind into powder. Twice a day, each time 1 dose, with boiled water. This medicated diet has the function of nourishing liver and regulating qi, and can be used for patients with obvious abdominal pain and bloating, or radish porridge.
(5) Mulberry pork soup
50g of mulberry, jujube 10, and appropriate amount of lean pork. Mulberry is cooked with jujube, pork and salt until cooked. Often taken, it can tonify the middle warmer and replenish qi, and is used for people with small abdominal distension.
(6) Heidi soup
5 fresh lotus seeds, if there is no fresh lotus seeds, you can use dried lotus seeds instead and add a little rock sugar. First, wash the lotus seeds, cut into pieces, add appropriate amount of water, decoct for 1 hour, then take the soup and add rock sugar. Three times a day, this meal can be used for those who have the functions of clearing heat and cooling blood, stopping bleeding and hematochezia.
(7) Houttuynia cordata lotus seed soup
Houttuynia cordata10g. And 30 grams of lotus seed meat. Take it twice every morning and evening. It has the functions of clearing away heat, eliminating dampness, purging fire and detoxicating, and is suitable for those who are in urgent need.
(8) Stewed large intestine with papaya
Papaya 10g, fat pig's large intestine 30cm. Put papaya into the cleaned large intestine, tie both ends tightly, and stew until cooked. Eating soup and intestines, this diet has the functions of clearing away heat and regulating stomach, promoting qi circulation and relieving pain.
(9) Leech seaweed powder
Leech 15g, seaweed 30g. Dry leech and seaweed are ground into fine powder and divided into 10 packets. 2 packets a day, taken with yellow wine, this meal has the functions of removing blood stasis, clearing away heat and detoxifying.
(10) Lingyiteng decoction
Water chestnut 10, coix seed 12g, fresh perilla 12g. Tear perilla into pieces, and then decoct with water and coix seed. 3 grams a day, clearing away heat and toxic materials, strengthening the spleen and promoting diuresis.
(1 1) Braised pork intestines with cinnamon and sesame.
50 grams of cinnamon, 60 grams of black sesame, and about 30 centimeters of pork intestines. After cleaning the pig's large intestine, put cinnamon and sesame into the large intestine, tie both ends tightly, add water to cook, remove cinnamon and black sesame and season. Eat soup and intestines. This meal can be used for patients with qi deficiency, small abdominal distension and frequent defecation.
(12) Rhubarb and Sophora japonica honey beverage
Raw materials: 4 grams of rhubarb, 30 grams of Sophora japonica, 0/5 grams of honey/kloc-,2 grams of green tea.
Method: First, remove impurities from raw rhubarb, wash it, dry it in the sun or dry it in the sun, cut it into pieces, put it in a casserole, add appropriate amount of water, boil it for 5 minutes, and then remove residues and leave juice for later use. Put Sophora japonica and tea leaves in a pot, add appropriate amount of water, boil, pour in raw rhubarb decoction, leave the fire, cool slightly, and mix well with honey while it is hot.
Usage: Take it twice in the morning and evening.
Efficacy: clearing away heat and toxic materials, cooling blood and stopping bleeding. This dietotherapy prescription is suitable for patients with colorectal cancer with hematochezia, scarlet blood and hematochezia after cancer operation.
(13) purslane Sophora japonica porridge
Raw materials: fresh purslane100g, Sophora japonica 30g, japonica rice100g, and brown sugar 20g.
Methods: First, fresh purslane was picked up, washed, blanched in boiling water pot, fished out, neatly packed and cut into pieces for later use. Sorting Flos Sophorae Immaturus, cleaning, air drying or sun drying, and grinding into fine powder for later use. Wash the japonica rice, put it in a casserole, add some water, and boil it over high fire. When the porridge is ready, add the fine powder of Sophora japonica, the crushed purslane and brown sugar, and then simmer until it boils.
Usage: Take it twice in the morning and evening.
Efficacy: Sophora japonica is cool and bitter, and has the functions of clearing away heat and blood, clearing liver and purging fire to stop bleeding. This dietotherapy prescription is suitable for hematochezia and scarlet caused by patients with colorectal cancer.
Syndrome differentiation treatment of traditional Chinese medicine
Heat-toxic hyperactivity type
clinical picture
Abdominal distension and pain, frequent defecation, pus and mucus in stool, loss of appetite, yellow greasy fur and thready pulse.
Dietotherapy medicated diet
1, hawthorn Tianqi porridge: 20 grams of hawthorn, 5 grams of Tianqi (ground), 60 grams of japonica rice, honey 1 spoon, add appropriate amount of water, and cook porridge twice a day.
2, sea cucumber fungus pig intestine soup: 60 grams of sea cucumber, fungus 15 grams (water hair), pig intestine 1 about 50 cm (washed and cut into small pieces), boiled and seasoned.
3. Xiang Lian stewed pork intestines: Radix Aucklandiae 1 0g, Radix Chuanxiong 6g, pork intestines1segment (washed) 30cm, and Radix Notoginseng 5g. Put Radix Aucklandiae, Rhizoma Coptidis, and Radix Notoginseng together into the fat sausage, tie both ends tightly, stew the intestines with water, and take medicine and soup to eat the fat sausage.
Qi stagnation and blood stasis type
clinical picture
Abdominal distension and pain, hard abdominal mass, dark purple or purulent stool, or acute and heavy interior, dark purple tongue or ecchymosis, thin yellow fur, thin and astringent pulse.
Dietotherapy medicated diet
1. Pig blood crucian carp porridge: pig blood 200g, crucian carp 100g, rice 100g. Scaled crucian carp, removed intestinal impurities and gills, cut into small pieces, and cooked porridge with pig blood and rice. 65438+ 0-2 times a day.
2. Water chestnut, coix seed and notoginseng lean broth: water chestnut 15 tablets, coix seed 20g, notoginseng rice 5g, lean meat 60g (chopped), boiled until cooked, and salted.
Yin deficiency of liver and stomach
clinical picture
Abdominal pain is faint and the lump is palpable. Dry stool is granular or small and flat, with bitter taste and dry mouth, anorexia or vomiting, red tongue and rapid pulse.
Edible medicated diet
1, auricularia auricula+0.5g (water hair), daylily 30g, silky fowl 1 (about 500g) to remove hair and viscera. Stew black-bone chicken for 1 hour first, then add black fungus and water lily leaves until everything is cooked and rotten, and add salt to taste as seasoning.
2. Fairy porridge: 60 grams of raw Polygonum Multiflori Radix, 0/00 grams of japonica rice/kloc, 6 red dates (denuded), and appropriate amount of brown sugar. Decoct Polygonum multiflorum Thunb. Take the thick juice, remove the residue, and put glutinous rice and red dates into a casserole to cook porridge. When the porridge is ready, add brown sugar to taste and cook for a while.
3. Shuangshen Zhuxu Soup: Codonopsis pilosula 30g (finely cut and wrapped with gauze), sea cucumber 200g (soaked), kelp 50g, pig spine 50g (finely cut), appropriate amount of water, boiling with strong fire, simmering for 3h, seasoning with salt, removing Codonopsis pilosula residue, and eating meat with soup.
Dietary principles and requirements of colon cancer
First, diet therapy.
The main physiological function of colon is to absorb water and store food residues to form feces. The glands of colonic mucosa can secrete thick mucus, which is alkaline and can neutralize the fermentation products of feces. When colon cancer occurs, physiological function is destroyed, defecation function and general condition are affected, and symptoms such as diarrhea, defecation difficulty and weight loss appear. If you still don't pay attention to diet, eating some indigestible foods and cancer-promoting foods will aggravate the progress of colon cancer and make the whole body fail. Patients with colon cancer must pay attention to their daily diet.
Studies have proved that high-fat diet can promote the occurrence of intestinal tumors, especially polyunsaturated fatty acids, which can reduce blood lipid but promote cancer. Cholesterol itself does not cause cancer, but at the same time it reacts with cholic acid, which can promote cancer, indicating that cholic acid is a cancer-promoting factor. Therefore, patients with colon cancer should not eat too much fat, the total fat accounts for less than 30% of the total heat energy, and the proportion of animal and vegetable oil should be appropriate. In other words, in a day's meal, including the amount of fat in the food itself, plus cooking oil, the daily fat should be below 50 grams. Some friends are afraid of coronary heart disease and control animal fat very strictly. They often take vegetable oil as the main ingredient, and even don't eat animal oil, which will cause too much peroxide in the body. Because the carbon chain in vegetable oil is unstable and easy to oxidize, if you eat some animal fat properly, it will make the carbon chain stable and not easy to oxidize, and reduce the formation of free radicals in the body. Therefore, we must eat scientifically and pay attention to the reasonable proportion of oil. It is suggested that the ratio of saturated fatty acids to polyunsaturated fatty acids and monounsaturated fatty acids is 1: 1: 1.
Pay attention to eat more vegetables rich in dietary fiber, such as celery, leek, cabbage, radish and other green leafy vegetables. Vegetables rich in dietary fiber can stimulate intestinal peristalsis, increase defecation times, and take away carcinogenic and toxic substances in feces. If colon cancer bulges into the intestinal cavity and the intestinal cavity narrows, it is necessary to control the intake of dietary fiber, because excessive intake of dietary fiber will cause intestinal obstruction. At this time, digestible, soft and semi-liquid foods should be given, such as millet porridge, lotus root powder thick soup, rice soup, porridge, corn porridge, egg soup and tofu. These foods can reduce the irritation to the intestine, pass through the intestinal cavity smoothly and prevent intestinal obstruction.
Patients after colon cancer surgery should follow the doctor's advice to eat and drink like other patients undergoing gastrointestinal surgery. Diet should start from soft, gradually adapt to the body, and then add other diets. Be careful not to eat too much fat, and mix with sugar, fat, protein, minerals, vitamins and other foods reasonably. There should be cereals, lean meat, fish, eggs, milk, various vegetables and bean products every day, and the amount of each should not be too much. Only in this way can we supplement all kinds of nutrients needed in the body. If you can't eat normally in the early postoperative period, intravenous fluid replacement should be given priority to. Pay attention to strengthening nursing and diet nutrition after operation to promote the recovery of patients.
In the early stage of intestinal cancer, stool changes often occur, sometimes constipation, sometimes diarrhea and bloody stool. Some patients have constipation and diarrhea alternately. Therefore, patients with early colorectal cancer should pay attention to adjusting their stools and eat more foods with more crude fiber in their diet, such as potatoes, sweet potatoes, bananas and vegetables. But the processing should be careful to avoid the stimulation of the tumor site by too rough food. Foods rich in cellulose can make the stool have real capacity, which can not only prevent constipation, but also prevent diarrhea to some extent and ensure regular defecation every day.
Patients with advanced colorectal cancer have intestinal stricture due to the growth of malignant tumor invading the intestine, which blocks defecation to varying degrees and reduces food intake. At this time, we should pay attention to giving patients foods rich in nutrition and low in crude fiber, such as eggs, lean meat, bean products, flour and rice, and young leaf vegetables. And told patients to drink more honey water and eat more bananas and pears, among which honey has the best laxative effect.
Patients with intestinal cancer should not eat spicy food. Peppers, peppers and other foods have a stimulating effect on the anus and must not be eaten.
Second, one-day recipes for example (postoperative recovery period)
Breakfast: millet porridge (50 grams of millet), corn flour cake (50 grams of corn flour) and Chinese cabbage (50 grams of Chinese cabbage).
Meal: 1 apple (200g apple).
Lunch: steamed stuffed bun (50g eggs, Chinese cabbage 100g, celery 100g, flour 100g) and soup (50g tomatoes, 50g cucumbers and starch 10g).
Meal addition: make a small bowl of lotus root starch 1 (lotus root starch 30g, sugar 10g) and 2 vegetable biscuits (flour 20g).
Dinner: 50 grams of rice porridge (50 grams of rice), steamed bread (50 grams of flour), mixed tofu (North tofu100g), and steamed garlic mixed with tomato sauce (eggplant100g).
Meal: Sweet milk (fresh milk 250g, sugar 5g) and cake 50g.
10g edible oil, 6g salt.