化疗所致恶心呕吐的分子机制与精准防治研究进展
Molecular Mechanisms of Chemotherapy-Induced Nausea and Vomiting and Advances in Precision Prevention and Treatment
DOI: 10.12677/acm.2026.1631076, PDF,   
作者: 罗 楚, 杨梅林：南京中医药大学附属医院肿瘤科，江苏 南京；钱 军*：江苏省中医药防治肿瘤协同创新中心，江苏 南京
关键词: 化疗所致恶心呕吐；分子机制；遗传易感性；精准医学；Chemotherapy-Induced Nausea and Vomiting； Molecular Mechanisms； Genetic Susceptibility； Precision Medicine
摘要: 化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting, CINV)是肿瘤治疗中最常见且令患者困扰的不良反应之一，其发生率高达70%~90%，严重影响患者治疗依从性与生存质量。本文系统综述化疗所致呕吐的分子机制研究进展，深入解析经典神经递质信号通路的调控作用，探讨肠–脑轴交互、免疫微环境紊乱等新兴机制，阐述遗传学与表观遗传学对CINV易感性的影响，并基于上述机制提出精准防治策略与研究展望。当前研究表明，CINV的发生发展是神经信号通路异常、肠道微生态失衡、免疫炎症激活及遗传背景共同作用的结果，基于多组学技术的个体化干预有望为CINV防治提供新突破口。
Abstract: Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and distressing adverse reactions in cancer treatment, occurring in 70% to 90% of cases and significantly impairing patients’ treatment compliance and quality of life. This article systematically reviews recent advances in the molecular mechanisms of chemotherapy-induced vomiting, elucidates the regulatory roles of classical neurotransmitter signaling pathways, explores emerging mechanisms such as gut-brain axis interactions and immune microenvironment disruption, and discusses the influence of genetics and epigenetics on CINV susceptibility. Based on these mechanisms, precision prevention and treatment strategies along with future research directions are proposed. Current studies indicate that the development of CINV results from the combined effects of abnormal neural signaling, gut microbial imbalance, immune-inflammatory activation, and genetic background. Individualized interventions based on multi-omics technologies are expected to provide new breakthroughs for the prevention and management of CINV.
文章引用：罗楚, 杨梅林, 钱军. 化疗所致恶心呕吐的分子机制与精准防治研究进展[J]. 临床医学进展, 2026, 16(3): 2753-2763. https://doi.org/10.12677/acm.2026.1631076

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