中医药防治非小细胞肺癌靶向药相关皮肤不良反应的研究进展

Research Advances in Traditional Chinese Medicine for the Prevention and Treatment of Targeted Drug-Induced Skin Adverse Reactions in Non-Small Cell Lung Cancer

摘要: 非小细胞肺癌(NSCLC)患者在进行表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)靶向治疗时，发生相关皮肤不良反应的概率高达80%，严重影响患者的生活质量及治疗依从性。本文系统综述了EGFR靶向药相关皮肤毒性的病理机制、西医治疗的局限及中医药防治策略。目前西医治疗以局部激素及抗生素为主，但长期使用存在耐药性与副作用风险。而中医从“药毒”理论出发，针对不同病因病机，采用内服清热解毒方剂、外治熏洗湿敷等综合疗法，其能够显著改善症状，提高患者的生存治疗。现有临床研究表明，中西医结合方案可降低皮疹分级、提升生活质量，且安全性较高，但研究仍面临样本量小、机制探索不足等挑战。未来需开展大样本循证研究，结合网络药理学与AI技术挖掘中药活性成分，推动中西医协同治疗模式的规范化发展。

Abstract: The incidence of skin adverse reactions in patients with non-small cell lung cancer (NSCLC) undergoing epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) targeted therapy is as high as 80%, significantly impairing the quality of life and treatment compliance. This article provides a systematic review of the pathological mechanisms underlying EGFR-targeted drug-associated skin toxicity, the limitations of Western medicine interventions, and the prevention and treatment strategies offered by traditional Chinese medicine (TCM). Currently, topical hormones and antibiotics are the primary treatments in Western medicine; however, prolonged use poses risks of drug resistance and adverse effects. Based on the theoretical framework of “drug and toxin”, TCM employs comprehensive therapies tailored to different etiologies and pathogeneses, including internal administration of heat-clearing and detoxifying prescriptions and external treatments such as fumigation, washing, and wet compresses, which have been shown to markedly alleviate symptoms and improve patient survival. Existing clinical studies indicate that the integration of TCM and Western medicine can effectively reduce the severity of skin rashes, enhance quality of life, and ensure high safety. Nevertheless, research in this field still encounters challenges, such as limited sample sizes and insufficient mechanistic exploration. Future directions should focus on large-scale evidence-based studies, leveraging network pharmacology and artificial intelligence technologies to identify active ingredients in TCM, thereby promoting the standardized development of collaborative treatment models combining TCM and Western medicine.