Colorectal cancer (CRC) cachexia is a common wasting syndrome in patients with advanced CRC. It is mainly characterized by progressive skeletal muscle wasting, lipolysis, systemic inflammatory response, and metabolic and immune dysregulation, which seriously impair patients’quality of life, treatment tolerance, and prognosis. In traditional Chinese medicine (TCM), this disease is generally classified into the category of “consumptive disease”, with its core pathogenesis characterized by “deficiency in origin and excess in superficiality” and “deficiency and excess inclusiofuzhengquxie”. Reinforcing healthy qi and dispelling pathogen are regarded as the principal therapeutic principles. By retrieving relevant domestic and international literature, this review systematically summarizes the pathogenesis of CRC cachexia, the regularity of syndrome differentiation and treatment in TCM, and the characteristics of the Application of prescriptions and drugs. Furthermore, it elucidates the pharmacological mechanisms by which active ingredients and Chinese herbal formulas intervene in cachexia through regulating inflammatory networks, improving skeletal muscle and adipose tissue metabolism, protecting mitochondrial function, and reshaping the immune microenvironment. Specifically, “reinforcing healthy qi” corresponds to the improvement of nutritional metabolism, protection of skeletal muscle, and regulation of immune function, whereas “dispelling pathogen” corresponds to the inhibition of inflammation, remodeling of the tumor microenvironment, and blockade of abnormal catabolism, thereby constructing a correlation between TCM therapeutic principles and the inflammation-metabolism-immunity regulatory network.

colorectal cancer cachexia  /  reinforcing healthy qi and dispelling pathogen  /  prescription and medication patterns  /  inflammation-metabolism-immunity regulation  /  mitochondrial function