Published online Sep 15, 2026. doi: 10.4251/wjgo.120693
Revised: April 22, 2026
Accepted: June 11, 2026
Published online: September 15, 2026
Processing time: 151 Days and 6.5 Hours
Patients with diabetic nephropathy and gastric cancer often experience severe gastrointestinal reactions after chemotherapy, leading to insufficient nutrient intake and further exacerbating protein and energy consumption and kidney damage. Routine nursing care often focuses on symptom management, lacking targeted intervention to address the overall functional disorders arising from the comorbidity of diabetic nephropathy and gastric cancer. Traditional Chinese medicine (TCM) nursing care emphasizes a holistic approach and individualized intervention, using a comprehensive approach including medicinal diets, emo
To assess effect of syndrome differentiation nursing on gastrointestinal reactions and nutritional status in diabetic nephropathy with gastric cancer post-chemo
From August 2023 to August 2025, 100 diabetic nephropathy patients with gastric cancer were enrolled and randomly assigned to observation or control group (n = 50 each). Controls received routine chemotherapy nursing and diabetic nephropathy education; the observation group additionally received TCM syndrome differentiation nursing. Gastrointestinal reaction scores, serum nutritional indicators, TCM syndrome scores, and residual renal function parameters were compared pre- and post-nursing.
The observation group had lower nausea and vomiting (0.80 ± 0.08 vs 1.31 ± 0.13), constipation and bloating (0.94 ± 0.10 vs 1.30 ± 0.14), appetite loss (0.85 ± 0.08 vs 1.28 ± 0.11), and TCM syndrome scores (P < 0.01). Nutritional levels: Serum albumin (38.62 ± 5.94 g/L vs 33.64 ± 6.21 g/L), hemoglobin (132.58 ± 21.24 g/L vs 118.52 ± 20.38 g/L), total protein (64.48 ± 6.70 g/L vs 57.76 ± 7.74 g/L), all P < 0.001. Renal function: Serum creatinine (93.28 ± 10.12 μmol/L vs 105.88 ± 11.48 μmol/L), blood urea nitrogen (9.32 ± 1.62 mmol/L vs 11.08 ± 2.16 mmol/L), creatinine clearance rate (111.65 ± 14.30 mL/minute vs 119.96 ± 15.62 mL/minute), all P < 0.01.
Syndrome differentiation nursing plus routine care reduces gastrointestinal reactions, improves nutritional status, and protects residual renal function in diabetic nephropathy with gastric cancer post-chemotherapy.
Core Tip: This study shifts the paradigm of cancer supportive care from symptom-focused management to comorbidity-integrated intervention. By demonstrating that syndrome differentiation nursing simultaneously alleviates chemotherapy toxicity and stabilizes residual renal function in diabetic nephropathy patients with gastric cancer, it provides clinical evidence for the “spleen-kidney co-regulation” theory. The findings advocate for embedding traditional Chinese medicine pattern-based nursing into multidisciplinary co-management of oncology-nephrology complex conditions.