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穴位刺激联合化疗抗癌的临床疗效及潜在机制:综述与展望

Clinical Efficacy and Potential Mechanisms of Acupoint Stimulation Combined With Chemotherapy in Combating Cancer: A Review and Prospects.

作者信息

Li Shanshan, Zhao Suhong, Guo Yi, Yang Yuanzhen, Huang Jin, Wang Jiaqi, Lu Shanshan, Wang Bin, Chai Chao, Xu Zhifang, Chin Yenlie

机构信息

Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Front Oncol. 2022 Apr 25;12:864046. doi: 10.3389/fonc.2022.864046. eCollection 2022.

Abstract

Although chemotherapy is the first-line treatment strategy for a variety of tumors, its side effects have limited its efficacy. This review summarizes the progress on the use of acupoint stimulation to combat chemotherapy-associated side effects, including chemotherapy-induced peripheral neuropathy (CIPN), cognitive impairment (CICI), and gastrointestinal toxicity (GI), as well as myelosuppression and immunosuppression. It was found that acupoint stimulation attenuated CIPN and GI by modulating the 5-hydroxytryptamine system in dorsal root ganglia, the dorsal horn of the spinal cord, and the duodenum by reducing oxidative stress and neuroinflammation. Acupoint stimulation also alleviated GI by activating vagal activity in the nucleus tractus solitarius and promoting the secretion of gastrointestinal neuropeptide hormones. Acupoint stimulation restored both bone marrow hematopoiesis and immune function to combat cancer. In addition, the combination of acupoint stimulation and chemotherapy could inhibit tumor growth by promoting tumor cell apoptosis and the enrichment of chemotherapeutic agents in tumor tissue and by modulating the tumor immune microenvironment and normalizing the vasculature. Multiple evidence also indicates that neuroimmune regulation may be involved in the effects of acupoint stimulation. In conclusion, the evidence suggests that acupoint stimulation can alleviate the side effects of chemotherapy and can also assist chemotherapeutic agents in inhibiting tumor growth, which expands the clinical application of acupoint stimulation in cancer treatment. However, more high-quality clinical studies are needed to confirm the clinical value of acupoint stimulation.

摘要

尽管化疗是多种肿瘤的一线治疗策略,但其副作用限制了其疗效。本综述总结了穴位刺激在对抗化疗相关副作用方面的进展,包括化疗引起的周围神经病变(CIPN)、认知障碍(CICI)和胃肠道毒性(GI),以及骨髓抑制和免疫抑制。研究发现,穴位刺激通过调节背根神经节、脊髓背角和十二指肠中的5-羟色胺系统,减轻氧化应激和神经炎症,从而减轻CIPN和GI。穴位刺激还通过激活孤束核中的迷走神经活动和促进胃肠神经肽激素的分泌来减轻GI。穴位刺激恢复了骨髓造血和免疫功能以对抗癌症。此外,穴位刺激与化疗联合使用可通过促进肿瘤细胞凋亡和化疗药物在肿瘤组织中的富集,以及调节肿瘤免疫微环境和使脉管系统正常化来抑制肿瘤生长。多项证据还表明,神经免疫调节可能参与穴位刺激的作用。总之,证据表明穴位刺激可以减轻化疗的副作用,还可以协助化疗药物抑制肿瘤生长,这扩大了穴位刺激在癌症治疗中的临床应用。然而,需要更多高质量的临床研究来证实穴位刺激的临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c58b/9082419/03bd64475cf4/fonc-12-864046-g001.jpg

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