中西医结合防治乳腺癌化疗所致恶心呕吐的 研究进展

Research Progress on Integrated Traditional Chinese and Western Medicine for Managing Chemotherapy-Induced Nausea and Vomiting in Breast Cancer Patients

摘要: 化疗致恶心呕吐(chemotherapy-induced nausea and vomiting, CINV)是乳腺癌化疗过程中最常见的不良反应，严重影响患者的治疗依从性和生活质量；尽管目前在西医常规止吐方案在控制急性CINV已取得很大进展，但在延迟性CINV的防治、不同患者之间的个体疗效差异及止吐药本身副作用(如便秘、头痛)等多个方面仍然存在不同程度的局限性。近年来，中医药领域关于CINV的研究数量逐步增多，整体研究水平也在不断地提升，中西医结合治疗的方案日益受到医者的重视。现本文系统综述该领域的研究进展，通过总结和分析目前现有临床数据后发现：在常规西医方案基础上，联合中药内服或者针灸、穴位贴敷、穴位注射等中医外治特色疗法，也能显著提高延迟性CINV的完全缓解率，有效地改善患者生活质量，并减轻常规止吐药的不良反应。因此，本文可为临床工作者在个体化及综合防治CINV方案提供重要参考。

Abstract: Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and distressing adverse reactions during breast cancer chemotherapy in patients, significantly impacting treatment compliance and patients’ quality of life. While current conventional antiemetic regimens in Western medicine have achieved considerable progress in controlling acute CINV, limitations remain in multiple aspects, including the prevention and management of delayed CINV, interindividual variability in therapeutic response, and side effects of antiemetic drugs themselves (e.g., constipation, headache). In recent years, research on CINV in traditional Chinese medicine (TCM) has grown substantially, with the overall study quality continuously improving. Consequently, integrative treatment approaches combining Chinese and Western medicine have gained increasing attention. This review systematically summarizes advances in this field. Based on the synthesis and analysis of existing available clinical evidence, it indicates that integrating TCM interventions—such as oral herbal medicine, acupuncture, acupoint application, or acupoint injection—with conventional Western antiemetic regimens can significantly improve the complete response rate of delayed CINV, enhance patients’ quality of life, and mitigate adverse effects associated with conventional Western antiemetics. Thus, this article provides valuable insights for clinicians in formulating individualized and comprehensive strategies for CINV prevention and management.