消化道肿瘤患者营养不良是临床常见问题,不仅导致免疫力下降,还严重影响治疗效果、康复及预后。 其主要原因 包括肿瘤代谢消耗、摄入不足、炎症因子释放及放化疗不良反应等。 近年来,心理因素作为营养不良的潜在诱因逐渐受到关 注。 肿瘤诊断及治疗过程极易对患者心理造成沉重打击,诱发焦虑、抑郁等心理困扰。 心理应激状态可能引起胃肠功能紊 乱,影响营养摄取和吸收。 同时,肿瘤相关心理困扰叠加治疗过程中的不适感,还可诱发厌食、乏力、恶心、腹胀等躯体化症 状。 患者往往对这些症状产生过度关注或情绪反应,进一步减少饮食摄入,加剧营养不良。 目前,肿瘤患者的营养治疗多聚 焦于营养成分的补充和干预,而对心理因素关注仍显不足。 本文从心身医学的角度探讨心理因素在肿瘤患者营养不良中的 作用,强调在肿瘤诊治中应建立生物-社会-心理相结合的医学模式。 通过早期识别和干预心理困扰,可有效改善患者的营养 状态,提升治疗和康复效果,为肿瘤患者的综合管理提供新的思路和方向。

Malnutrition is a prevalent clinical issue among gastrointestinal cancer patients contributing not only to impaired immune function but also to diminished treatment efficacy delayed rehabilitation and poorer prognosis. The primary causes of malnutrition include tumor - induced metabolic alterations insufficient dietary intake the release of inflammatory mediators and adverse effects associated with radiotherapy and chemotherapy. In recent years psychological distress has emerged as significant contributors to malnutrition warranting greater attention. The process of cancer diagnosis and treatment often triggers profound psychological distress such as anxiety and depression. These psychological stresses may disrupt gastrointestinal function by impairing nutrient intake and absorption. Furthermore tumor-related psychological distress compounded by visceral discomfort arising during treatment frequently induces somatic symptoms such as anorexia fatigue nausea and abdominal distension. Patients may excessively focus on these symptoms exacerbating emotional reactions further reducing food intake and intensifying malnutrition. Current nutritional interventions for cancer patients primarily emphasize the supplementation of specific nutrients with insufficient attention given to the impact of psychological factors. This paper explored the role of psychological distress in cancer - related malnutrition through the lens of psychosomatic medicine. It underscored the necessity of adopting an integrated biopsychosocial medical model in cancer care. Early identification and targeted intervention for psychological and emotional disturbances have the potential to significantly enhance patients' nutritional status improve treatment outcomes and facilitate recovery. This approach provides novel insights and directions for the comprehensive management of cancer patients.