Research progress of preventing CINV caused by cis-platinum with traditional Chinese and western medicine
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摘要: 化疗化疗后恶心呕吐反应(CINV)是化疗当中最为常见的不良反应,尤其在含有顺铂的化疗方案中,其发生率几乎达到100.0%,很多患者因为无法耐受持续的消化道反应特别是迟发性恶心呕吐而对化疗产生恐惧,甚至中断治疗,或即使坚持治疗,也因为控制不良的呕吐、进食差而发生营养不良、水电解质紊乱等并发症,使疾病不能得到及时有效的控制而影响肿瘤患者的生活质量、治疗依从性和治疗效果。目前,根据化疗相关性呕吐的发病机制,现代医学主要采用神经递质受体拮抗剂和激素的联合使用来治疗,随着5-HT受体拮抗剂、NK-1受体拮抗剂等止吐药物的广泛应用,化疗相关性呕吐的发生率和严重程度显著降低,但迟发性恶心呕吐仍未得到良好的控制。中医学认为本病乃正气亏虚、邪气犯胃、胃失和降、胃气上逆所致,故多采用扶正祛邪、降逆止呕之法来治疗,临床疗效明确。其中中医外治法因其副作用少、操作简单、疗效确切,逐渐受到医生和患者的重视,越来越多的患者采用针刺、艾灸及脐疗等方法来治疗该病。中医外治法治疗胃肠道疾病己有两千多年的历史,对调整脾胃功能具有良好的效果。国内外研究者对针刺等疗法的机制和临床疗效进行了大量研究,推荐针灸等外治法作为防治化疗相关性恶心呕吐的补充替代疗法,本文概述了近几年来其研究进展。Abstract: Chemotherapy-induced nausea and vomiting (CINV) is the most common adverse reaction,especially in chemotherapy containing cisplatin.The incidence rate nearly reaches 100%.The lasting intolerable reaction of alimentary canal,particularly the delayed nausea and vomiting,made the patients have a fear of chemotherapy,and even bring the treatment to a halt,or even if the treatment continued,the syndrome,caused by uncontrolled vomiting,hypo-alimentation,and inordinate water-electrolyte metabolism,would lead to a lower quality of life,decrease the medication compliance and influence the healing effect.Recently,based on CINV mechanism,modern medicine mainly use neurotransmitter receptor antagonist combined with hormone therapy to prevent CINV,and have already obtained certain result.Along with the comprehensive application of antiemetic like 5-HT receptor antagonist,NK-1 receptor antagonist,etc.,the incidence and severity of CINV was markedly reduced,but the delayed nausea and vomiting was not well-controlled.According to Traditional Chinese Medicine (TCM),the pathogenesis of CINV caused by cisplatin is the syndrome of qi asthenia (deficiency of vital energy) and the weakness in the stomach,i.e.,exogenous pathogenic agents invade stomach,which can result in stomach qi upward reverse and cause the disorder of the stomach qi.So,it is highly recommended to apply the therapy of "strengthening the body resistance to eliminate pathogenic factors" so that to "descend adverse qi and settle stomach" ,and it has determined curative effect clinically.Meanwhile,because of less adverse effect,easy to operate,and determined curative effect,external treatment of Traditional Chinese Medicine is gradually attracting the attention of doctors and patients.More and more patients accept acupuncture,moxibustion,and umbilical compress therapy.This kind of external treatment of TCM has been practiced for more than 2,000 years,and proved working well in regulating the function of the spleen and stomach.Researchers from domestic and abroad carried out massive investigation to study the mechanism of acupuncture and the analogue external treatment of TCM,as well as its clinical efficacy.They recommended the acupuncture and the analogue external treatment of TCM as the complementary and substitutive therapy for prophylaxis and treatment of CINV.In this paper,we review research advances in recent years.
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Key words:
- Traditional Chinese and western medicine /
- Cis-platinum /
- CINV /
- Research progress
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