Integrated traditional and western medicine spleen-stomach support in geriatric gastrointestinal cancer care

Table 1 Main application areas and core strategies of the integrated traditional Chinese and western medicine “strengthening and protecting the spleen and stomach” approach in supportive care for elderly patients with advanced gastrointestinal tumors

Application area	Core TCM strategy	Synergy point of integrated treatment
Improving nutritional status & CACS	Invigorating spleen to promote transportation, supplementing qi and nourishing blood (e.g., Xiangsha Liujunzi decoction, Shenling Baizhu powder); Acupuncture (ST36, CV12)	Combining with nutritional support; utilizing Chinese medicine/acupuncture to restore spleen and stomach function, regulate inflammation and metabolism, achieving synergy between “function” and “substance”
Managing treatment-related toxicities
Nausea and vomiting (CINV/RINV)	Harmonizing stomach and descending rebellious qi (e.g., Xiaobanxia decoction, Xuanfu Daizhe decoction)	Combined with standard antiemetic regimens to reduce the incidence of delayed vomiting and improve patient tolerance
Radiation enteritis/targeted drug-related diarrhea	Invigorating spleen for dampness, astringing intestines to stop diarrhea (e.g., Shenling Baizhu powder, Zhenren Yangzang decoction)	Synergize with conventional antidiarrheal therapy to protect the intestinal mucosa, regulate gut microbiota, and shorten the duration of diarrhea
Myelosuppression (CIM)	Supplementing qi to generate blood, invigorating spleen and tonifying kidney (e.g., Danggui Buxue decoction, Jianpi Yishen granules)	Combined with hematopoietic growth factors to reduce the incidence of severe myelosuppression and promote endogenous hematopoietic recovery
Oral mucositis	Clearing heat and removing toxicity, supplementing qi and nourishing yin (Chinese herbal mouthwash)	Direct action on the lesion to reduce inflammation and promote mucosal repair, showing superior effects compared to conventional mouthwashes
Alleviating cancer pain & opioid side effects	Invigorating spleen and supplementing qi to treat the root, promoting qi and activating blood to treat the branch (modified Xiangsha Liujunzi decoction)	Synergize with opioids for analgesia while reducing side effects like constipation, improving the overall symptom cluster
Improving CRF	Invigorating spleen and supplementing qi to nourish the source of qi and blood (e.g., Buzhong Yiqi decoction, Bazhen Huaji decoction)	Combined with Western symptomatic management and non-pharmacological interventions to fundamentally improve fatigue and enhance quality of life

TCM: Traditional Chinese medicine; CACS: Cancer anorexia-cachexia syndrome; CINV: Chemotherapy-induced nausea and vomiting; RINV: Radiotherapy-induced nausea and vomiting/targeted therapy-induced nausea and vomiting; CIM: Chemotherapy-induced myelosuppression; CRF: Cancer-related fatigue.