1. Introduction

Malignant tumor has become one of the top lethal diseases threatening human health globally. At present, comprehensive tumor treatment based on surgical resection combined with adjuvant chemoradiotherapy, targeted therapy and immunotherapy has significantly improved the clinical survival rate of early and middle-stage tumor patients. Nevertheless, surgical trauma damages human qi, blood and zang-fu organs directly. Most patients suffer from common postoperative symptoms including persistent fatigue, poor appetite, nausea and vomiting, abdominal distension, insomnia, limb numbness and depressed mood. In addition, postoperative chemotherapy and radiotherapy produce severe myelosuppression, oral mucositis and liver and kidney damage, forcing many patients to interrupt standardized anti-tumor treatment.

From the perspective of TCM, tumor surgery damages healthy qi of human body, leading to the core pathogenesis of deficiency of both qi and blood, zang-fu dysfunction, blood stasis and dampness retention. The core rehabilitation principle is tonifying qi and nourishing blood, invigorating spleen and stomach, removing residual blood stasis, strengthening healthy qi and eliminating pathogenic factors. Different from modern medicine which focuses on local wound healing and lesion clearance, TCM concentrates on reconstructing overall physical balance, repairing damaged human immunity and cutting off the internal environment suitable for tumor recurrence. In recent years, numerous clinical randomized controlled trials and pharmacological researches have verified that standardized TCM intervention can effectively accelerate postoperative physical recovery and improve long-term survival benefit of tumor patients. This paper summarizes specific TCM rehabilitation methods and their clinical value in detail.

2. Core Application of TCM in Tumor Postoperative Rehabilitation

2.1 Individualized Oral Chinese Herbal Medicine

Oral herbal decoction and patent Chinese medicine are the most fundamental and widely adopted TCM rehabilitation means for postoperative tumor patients. According to different postoperative stages and syndrome types, clinicians formulate targeted prescriptions based on accurate syndrome differentiation.

In the early postoperative stage (1-2 weeks after operation), patients are mostly diagnosed as qi-blood deficiency and spleen-stomach weakness, accompanied by poor appetite, fatigue and slow wound healing. Prescriptions such as Sijunzi Decoction and Bazhen Decoction are applied to tonify qi and nourish blood, invigorate spleen and harmonize stomach, so as to accelerate surgical wound healing and recover basic gastrointestinal function. In the middle and late postoperative stage combined with chemoradiotherapy, patients often suffer from bone marrow suppression, leukopenia and severe gastrointestinal reactions. Modified Danggui Buxue Decoction and Shenqi Fuzheng Injection are used to protect hematopoietic function and reduce cytotoxic damage caused by chemoradiotherapy. For high-risk patients with tumor recurrence, anti-tumor Chinese herbal components including astragalus, curcuma, scutellaria barbata and oldenlandia diffusa are added to clear away residual pathogenic factors and inhibit angiogenesis of tiny residual tumor lesions.

2.2 Acupuncture and Auricular Point Pressing

Acupuncture and auricular point therapy are safe and non-invasive external adjuvant therapies, which are suitable for tumor patients with weak physical condition who cannot tolerate large doses of oral drugs. Postoperative surgical pain, chemotherapy-induced nausea and vomiting, intractable insomnia and postoperative intestinal adhesion are all dominant indications of acupuncture treatment.

Common acupoints including Zusanli (ST36), Neiguan (PC6), Zhongwan (CV12) and Sanyinjiao (SP6) are selected to regulate gastrointestinal peristalsis and relieve cancer-related fatigue. Auricular point pressing targeting spleen, stomach, heart and brain acupoints can effectively improve postoperative sleep disorder and anxiety without any drug side effects. Relevant clinical data prove that perioperative acupuncture intervention can reduce the dosage of postoperative opioid analgesics, lower the risk of drug dependence, and shorten the overall hospital stay of tumor patients.

2.3 Tuina Massage and Herbal External Treatment

Postoperative tumor patients are confined to bed for a long time, which easily leads to poor blood circulation, limb edema, venous thrombosis and intestinal flatulence. Gentle standard Tuina massage acts on body meridians and acupoints to promote systemic qi and blood circulation, relieve limb edema and abdominal distension, and prevent postoperative venous thromboembolism. It is worth noting that local massage is prohibited for patients with limb tumor metastasis to avoid potential tumor metastasis risks.

Chinese herbal fumigation and hot compress are applied for patients with postoperative limb numbness and chemotherapy-induced peripheral neuropathy. Transdermal drug absorption can dredge blocked meridians, relieve nerve pain and numbness, and significantly improve patients’ daily activity ability.

2.4 Traditional Mind-Body Rehabilitation Exercises

Low-intensity TCM exercises including Tai Chi and Baduanjin are recommended for stable tumor patients in the late rehabilitation period. Different from high-intensity modern rehabilitation training, these gentle exercises coordinate breathing, physical movement and mental regulation, which can soothe liver qi, relieve postoperative depression and anxiety, enhance physical immunity, and will not increase physical burden of patients. Long-term adherence can effectively improve cancer-related fatigue, one of the most intractable long-term postoperative complications for tumor survivors.

3. Potential Therapeutic Mechanisms of TCM for Tumor Postoperative Recovery

3.1 Improving Body Immune Function

Tumor surgery and chemoradiotherapy will severely damage human immune cells and break immune homeostasis. Multiple active ingredients of Chinese herbal medicine can increase the number of T lymphocytes, B lymphocytes and natural killer (NK) cells, rebuild the body’s anti-tumor immune barrier, and help the human body recognize and clear residual micro-tumor lesions after surgery.

3.2 Inhibiting Tumor Recurrence and Metastasis

TCM treatment focuses on changing the internal tumor microenvironment. Effective herbal monomers can inhibit tumor angiogenesis, block epithelial-mesenchymal transition of cancer cells, and reduce the proliferation and migration ability of residual cancer cells, thereby cutting off the pathological basis of postoperative tumor recurrence and distant metastasis.

3.3 Alleviating Inflammatory Response and Oxidative Stress

Surgical trauma triggers persistent systemic inflammatory response and oxidative stress, which is closely related to poor wound healing and physical exhaustion. TCM interventions can down-regulate the expression of inflammatory factors such as TNF-α and IL-6, eliminate oxygen free radicals in vivo, reduce surgical inflammatory damage, and accelerate systemic physical repair.

4. Limitations and Future Prospects

4.1 Current Limitations

At present, the clinical application of TCM in tumor postoperative rehabilitation still has obvious shortcomings. First, most clinical trials are single-center small-sample researches, lacking multi-center, large-sample prospective double-blind controlled trials to provide high-level medical evidence. Second, TCM syndrome differentiation schemes lack unified international quantitative standards, leading to inconsistent treatment plans among different clinicians. Third, the active anti-tumor ingredients and exact signal pathways of most compound Chinese herbal prescriptions have not been fully clarified.

4.2 Future Research Directions

In the future, standardized unified TCM syndrome differentiation guidelines for different tumor types should be established. Modern multi-omics technology can be combined to explore the material basis and molecular mechanisms of classic anti-tumor prescriptions. Meanwhile, international standardized clinical research programs need to be promoted to improve the international recognition of TCM in oncology rehabilitation.

5. Conclusion

As a characteristic complementary medical therapy, TCM plays an irreplaceable dual role in tumor postoperative rehabilitation: repairing surgical physical trauma and preventing tumor recurrence. Combined with modern surgical treatment, radiotherapy and chemotherapy, TCM can effectively relieve various postoperative complications, protect normal human organs from anti-tumor drug damage, improve patients’ quality of life, and prolong long-term survival time of tumor patients. With the continuous development of modern evidence-based medicine, TCM will become an indispensable part of comprehensive whole-course tumor rehabilitation treatment.

References

1. Chen L, Wang Y. Clinical efficacy of integrated traditional Chinese and western medicine on postoperative rehabilitation of gastrointestinal tumor patients[J]. Journal of Chinese Integrative Medicine, 2024, 22(3): 198-205.

2. Zhang H, et al. Mechanism of astragalus-based herbal formula regulating postoperative immune function of lung cancer patients[J]. Journal of Ethnopharmacology, 2023, 312: 116589.

3. World Federation of Chinese Medicine Societies. International consensus on TCM intervention for cancer postoperative rehabilitation[J]. World Journal of Traditional Chinese Medicine, 2023, 9(2): 45-52.

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