肺癌骨转移的中医药治疗研究进展
Research Progress of Traditional Chinese Medicine in the Treatment of Bone Metastasis of Lung Cancer
DOI: 10.12677/tcm.2025.145327, PDF,    科研立项经费支持
作者: 周天豪:广西中医药大学研究生院,广西 南宁;丰 哲:广西中医药大学附属瑞康医院关节科,广西 南宁
关键词: 中医药治疗肺癌骨转移研究进展Chinese Medicine Treatment Bone Metastasis of Lung Cancer Research Progress
摘要: 肺癌骨转移是晚期肺癌患者死亡及生活质量恶化的关键因素,约20%~60%的患者病程中会发生骨转移,从而引发骨痛、骨折等高发骨骼相关事件。现代医学治疗手段存在耐药性、肾损伤及经济负担等局限。中医药通过多途径干预展现出独特优势:内治法中,经典方剂联合西药可显著缓解疼痛、降低肿瘤标志物,单味药提取物通过诱导癌细胞凋亡抑制肿瘤;外治法如温经止痛方穴位外敷可协同增强镇痛效果;针灸调节疼痛相关血清因子,减少阿片类药物用量及副作用。研究证实,中医药通过调控相关信号通路、改善骨代谢及免疫功能,联合治疗使骨相关事件减少。本研究拟推动中医药与现代医学融合,为优化治疗方案提供循证依据。
Abstract: Bone metastasis of lung cancer is a key factor in the death and deterioration of quality of life of patients with advanced lung cancer. About 20%~60% of patients have bone metastasis during the course of the disease, causing high incidence of bone-related events such as bone pain and fracture. Modern medical methods have limitations such as drug resistance, renal injury and economic burden. Traditional Chinese medicine shows unique advantages through multi-channel intervention: in the internal treatment, classical prescriptions combined with western medicine can significantly relieve pain and reduce tumor markers, and single drug extracts inhibit tumors by inducing apoptosis of cancer cells; external treatment such as acupoint external application of Wenjing Zhitong prescription can synergistically enhance the analgesic effect; acupuncture regulates pain-related serum factors and reduces opioid dosage and side effects. Studies have confirmed that traditional Chinese medicine can reduce bone-related events by regulating related signaling pathways, improving bone metabolism and immune function, and combined treatment. This study intends to promote the integration of traditional Chinese medicine and modern medicine, and provide evidence-based basis for optimizing the treatment plan.
文章引用:周天豪, 丰哲. 肺癌骨转移的中医药治疗研究进展[J]. 中医学, 2025, 14(5): 2200-2205. https://doi.org/10.12677/tcm.2025.145327

参考文献

[1] Siegel, R.L., Miller, K.D., Fuchs, H.E. and Jemal, A. (2022) Cancer Statistics, 2022. CA: A Cancer Journal for Clinicians, 72, 7-33. [Google Scholar] [CrossRef] [PubMed]
[2] WHO Classification of Tumours Editorial Board (2021) Thoracic Tumours. 5th Edition, International Agency for Research on Cancer.
[3] Riihimäki, M., Hemminki, A., Fallah, M., Thomsen, H., Sundquist, K., Sundquist, J., et al. (2014) Metastatic Sites and Survival in Lung Cancer. Lung Cancer, 86, 78-84. [Google Scholar] [CrossRef] [PubMed]
[4] Katakami, N., Kunikane, H., Takeda, K., Takayama, K., Sawa, T., Saito, H., et al. (2014) Prospective Study on the Incidence of Bone Metastasis (BM) and Skeletal-Related Events (SREs) in Patients (Pts) with Stage IIIB and IV Lung Cancer-CSP-HOR 13. Journal of Thoracic Oncology, 9, 231-238. [Google Scholar] [CrossRef] [PubMed]
[5] Saad, F., Lipton, A., Cook, R., Chen, Y., Smith, M. and Coleman, R. (2007) Pathologic Fractures Correlate with Reduced Survival in Patients with Malignant Bone Disease. Cancer, 110, 1860-1867. [Google Scholar] [CrossRef] [PubMed]
[6] 董智, 赵军, 柳晨, 等. 肺癌骨转移诊疗专家共识(2019版) [J]. 中国肺癌杂志, 2019, 22(4): 187-207.
[7] Zhao, X., Dai, X., Wang, S., Yang, T., Yan, Y., Zhu, G., et al. (2018) Traditional Chinese Medicine Integrated with Chemotherapy for Stage II-IIIA Patients with Non-Small-Cell Lung Cancer after Radical Surgery: A Retrospective Clinical Analysis with Small Sample Size. Evidence-Based Complementary and Alternative Medicine, 2018, Article ID: 4369027. [Google Scholar] [CrossRef] [PubMed]
[8] 刘玮, 孙炜, 王莉, 等. 羟考酮联合腕踝针治疗肺癌骨转移疼痛[J]. 吉林中医药, 2019, 39(7): 911-914.
[9] 毛昀, 陈峥, 褚雪镭, 等. 国医大师朱良春治疗骨转移临证经验[J]. 湖南中医药大学学报, 2020, 40(9): 1101-1105.
[10] 丰哲, 程琦, 韦坚, 等. 韦贵康从脾肾论治肺癌骨转移[J]. 中华中医药杂志, 2014, 29(3): 757-759.
[11] 杨晓, 王理槐, 刘华, 等. 基于肺-肾-骨轴探讨补肾法在肺癌骨转移防治中的应用[J]. 湖南中医药大学学报, 2022, 42(11): 1777-1781.
[12] 陆佳薇, 陈鹏. 补肾解毒汤对晚期肺癌骨转移患者疼痛状态、生存质量、肿瘤标志物的影响[J]. 环球中医药, 2020, 13(3): 439-441.
[13] 张硕. 复骨逐瘀颗粒联合放疗治疗肺癌骨转移的基础及临床研究[D]: [硕士学位论文]. 济南: 山东中医药大学, 2023.
[14] 张春梅, 唐敏莉, 郭宇轩, 等. 阳和汤联合唑来膦酸治疗肺癌骨转移癌痛的疗效及对血清NTX、ALP的影响[J]. 肿瘤药学, 2021, 11(5): 595-600.
[15] 钟毅, 周红, 伍耀衡, 等. 刘伟胜教授运用全蝎、蜈蚣治疗恶性肿瘤经验[J]. 新中医, 2001(7): 7-8.
[16] 马家宝, 杨正腾. 全蝎、蜈蚣、蟾酥和土鳖虫抗肿瘤作用研究进展[J]. 中医药导报, 2021, 27(5): 65-67+72.
[17] 王姣, 于佳, 胡万福, 等. 临床常用抗肿瘤中药的作用机制及抗肿瘤方剂分析[J]. 癌症进展, 2020, 18(9): 884-886+900.
[18] Liu, X., Cao, J., Huang, G., Zhao, Q. and Shen, J. (2019) Biological Activities of Artemisinin Derivatives beyond Malaria. Current Topics in Medicinal Chemistry, 19, 205-222. [Google Scholar] [CrossRef] [PubMed]
[19] Crespo-Ortiz, M.P. and Wei, M.Q. (2012) Antitumor Activity of Artemisinin and Its Derivatives: From a Well-Known Antimalarial Agent to a Potential Anticancer Drug. Journal of Biomedicine and Biotechnology, 2012, Article ID: 247597. [Google Scholar] [CrossRef] [PubMed]
[20] Xu, Q., Li, Z., Peng, H., Sun, Z., Cheng, R., Ye, Z., et al. (2011) Artesunate Inhibits Growth and Induces Apoptosis in Human Osteosarcoma HOS Cell Line in Vitro and in Vivo. Journal of Zhejiang University Science B, 12, 247-255. [Google Scholar] [CrossRef] [PubMed]
[21] Song, J.M., Molla, K., Anandharaj, A., Cornax, I., O’Sullivan, M.G., Kirtane, A.R., et al. (2017) Triptolide Suppresses the in Vitro and in Vivo Growth of Lung Cancer Cells by Targeting Hyaluronan-CD44/RHAMM Signaling. Oncotarget, 8, 26927-26940. [Google Scholar] [CrossRef] [PubMed]
[22] 张力文, 李柳宁, 何春霞等温经止痛方治疗肺癌骨转移患者癌痛的临床观察[J]. 重庆医学, 2019, 48(8): 1327-1329.
[23] 王惠琴, 李天浩, 雷琰, 等. 肺癌骨痛的中西医结合治疗临床研究[J]. 世界中医药, 2014, 9(2): 181-182+185.
[24] 王娟, 衣华强. 腕踝针疗法的临床应用研究进展[J]. 中国民间疗法, 2025, 33(1): 112-117.
[25] 陈妮. 癌痛护理结合腕踝针中医护理对肺癌术后患者疼痛及睡眠质量的影响[J]. 世界睡眠医学杂志, 2024, 11(11): 2432-2434.
[26] 吴盛, 宋益青, 张建军, 等. 补肾祛瘀针刺疗法加穴位注射治疗肺癌骨转移重度癌痛对5-HT、PGE2和ET-1水平的影响[J]. 针灸临床杂志, 2020, 36(11): 5-9.
[27] 吴苗苗. 电针联合穴位埋线治疗中度癌性疼痛的临床研究[D]: [硕士学位论文]. 南宁: 广西中医药大学, 2022.
[28] 翟道荡, 陈汉平, 王瑞珍, 等. 直接灸调节癌症患者细胞免疫功能的观察[J]. 针灸临床杂志, 1994(1): 25-27.
[29] 郝智慧, 徐兰凤. 艾灸抗肿瘤作用研究概况[J]. 江苏中医药, 2014, 46(1): 79-81.
[30] 许迎烈, 黄云胜, 徐森华. 艾灸治疗晚期肺癌骨转移疼痛疗效观察及与中医证素的相关性分析[J]. 四川中医, 2021, 39(2): 176-179.
[31] 郝仲芳. 单纯阿片药物治疗癌痛与姑息性化疗联合阿片药物控制癌痛的临床效果[J]. 医学信息, 2015(38): 22-23.
[32] 林宗航, 张磊, 付宝军, 等. 单核趋化蛋白-2中和抗体对骨癌痛大鼠脊髓背角磷酸化细胞外信号调节蛋白激酶表达的影响[J]. 国际麻醉学与复苏杂志, 2016, 37(11): 993-997.
[33] 姜义明, 张丽萍, 林美蓉. 耳穴压豆疗法对癌痛患者临床疗效的影响[J]. 广州中医药大学学报, 2019, 36(12): 1961-1966.
[34] Wu, S., Pan, Y., Mao, Y., Chen, Y. and He, Y. (2021) Current Progress and Mechanisms of Bone Metastasis in Lung Cancer: A Narrative Review. Translational Lung Cancer Research, 10, 439-451. [Google Scholar] [CrossRef] [PubMed]
[35] Miki, T., Yano, S., Hanibuchi, M., Kanematsu, T., Muguruma, H. and Sone, S. (2003) Parathyroid Hormone‐Related Protein (PTHrP) Is Responsible for Production of Bone Metastasis, but Not Visceral Metastasis, by Human Small Cell Lung Cancer SBC‐5 Cells in Natural Killer Cell‐Depleted SCID Mice. International Journal of Cancer, 108, 511-515. [Google Scholar] [CrossRef] [PubMed]
[36] 姚志红, 韩磊, 杨祚璋. 恶性肿瘤骨转移机制的研究进展[J]. 中华转移性肿瘤杂志, 2019, 2(1): 56-61.
[37] Ell, B. and Kang, Y. (2014) MicroRNAs as Regulators of Bone Homeostasis and Bone Metastasis. Bonekey Reports, 3, 549. [Google Scholar] [CrossRef] [PubMed]
[38] 初云霞, 王秀问. 恶性肿瘤骨转移分子机制的研究进展[J]. 中国肿瘤生物治疗杂志, 2009, 16(4): 422-426.
[39] Teng, X., Wei, L., Han, L., Min, D. and Du, Y. (2020) Establishment of a Serological Molecular Model for the Early Diagnosis and Progression Monitoring of Bone Metastasis in Lung Cancer. BMC Cancer, 20, Article No. 562. [Google Scholar] [CrossRef] [PubMed]
[40] Zhu, J., Wang, W., Xiong, Y., Xu, S., Chen, J., Wen, M., et al. (2022) Evolution of Lung Adenocarcinoma from Preneoplasia to Invasive Adenocarcinoma. Cancer Medicine, 12, 5545-5557. [Google Scholar] [CrossRef] [PubMed]
[41] Denisenko, T.V., Budkevich, I.N. and Zhivotovsky, B. (2018) Cell Death-Based Treatment of Lung Adenocarcinoma. Cell Death & Disease, 9, Article No. 117. [Google Scholar] [CrossRef] [PubMed]