Sun Xue, Nie Fangfang, Sun Jizhuo, Zhang Jingdong, Wang Yuanhe
The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People's Republic of China.
Medical Oncology Department of Gastrointestinal Cancer, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning Province, People's Republic of China.
Ther Clin Risk Manag. 2025 Jul 31;21:1187-1218. doi: 10.2147/TCRM.S531645. eCollection 2025.
BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is a major burden for cancer patients, often poorly managed by conventional antiemetics, prompting exploration of medicinal plant therapies for better supportive care. OBJECTIVE: This systematic review critically evaluates medicinal plants for CINV, detailing bioactive compounds, diverse antiemetic mechanisms, and promising chemosensitizing and immunomodulatory properties. METHODS: A comprehensive literature search and critical analysis of studies investigating medicinal plants for CINV were performed. KEY FINDINGS: This review synthesizes evidence for 22 botanicals. Ginger (gingerols, shogaols) acts via 5-hydroxytryptamine 3 (5-HT₃) receptor antagonism and substance P/neurokinin-1 (NK-1) inhibition, and offers chemosensitization by downregulating P-glycoprotein. Cannabis (THC, CBD) modulates the endocannabinoid system and 5-HT₃ receptors for CINV relief and may enhance chemotherapy sensitivity. Mint (menthol, menthone) relaxes gastrointestinal smooth muscle and offers anti-inflammatory benefits. Chamomile (apigenin) has antispasmodic/anxiolytic effects; its apigenin also sensitizes cancer cells to chemotherapy. Turmeric (curcumin) acts on neurotransmitter systems, offers potent anti-inflammatory/antioxidant effects, and boosts chemosensitivity via NF-κB/P-gp modulation. Plants like , lemon, fennel, and licorice show varied mechanisms (gastrointestinal regulation, anti-inflammatory, neurotransmitter modulation). Many botanicals show chemosensitizing (inhibiting efflux pumps, promoting apoptosis) and immunomodulatory (affecting cytokines, immune cells) properties. Synergistic plant combinations (eg, ginger with P. ternata or turmeric) are noted for enhanced efficacy and safety. CONCLUSION: Medicinal plants offer a compelling, multi-targeted approach for CINV management, with potential beyond symptomatic relief via their antiemetic, chemosensitizing, and immunomodulatory actions. Rigorous clinical trials are needed to integrate these botanicals into evidence-based supportive cancer care.
背景：化疗引起的恶心和呕吐（CINV）是癌症患者的主要负担，传统止吐药往往难以有效控制，这促使人们探索药用植物疗法以提供更好的支持性护理。 目的：本系统评价对用于CINV的药用植物进行了批判性评估，详细阐述了生物活性化合物、多种止吐机制以及有前景的化学增敏和免疫调节特性。 方法：对研究用于CINV的药用植物的研究进行了全面的文献检索和批判性分析。 主要发现：本评价综合了22种植物药的证据。生姜（姜辣素、姜烯酚）通过5-羟色胺3（5-HT₃）受体拮抗作用和P物质/神经激肽-1（NK-1）抑制发挥作用，并通过下调P-糖蛋白实现化学增敏。大麻（四氢大麻酚、大麻二酚）调节内源性大麻素系统和5-HT₃受体以缓解CINV，并且可能增强化疗敏感性。薄荷（薄荷醇、薄荷酮）可松弛胃肠道平滑肌并具有抗炎作用。洋甘菊（芹菜素）具有解痉/抗焦虑作用；其芹菜素还可使癌细胞对化疗敏感。姜黄（姜黄素）作用于神经递质系统，具有强大的抗炎/抗氧化作用，并通过调节NF-κB/P-糖蛋白增强化学敏感性。柠檬、茴香和甘草等植物表现出不同的作用机制（胃肠道调节、抗炎、神经递质调节）。许多植物药具有化学增敏（抑制外排泵、促进细胞凋亡）和免疫调节（影响细胞因子、免疫细胞）特性。值得注意的是，植物药的协同组合（如生姜与半夏或姜黄）具有更高的疗效和安全性。 结论：药用植物为CINV的管理提供了一种引人注目的多靶点方法，其止吐、化学增敏和免疫调节作用可能带来超越症状缓解的潜在益处。需要进行严格的临床试验，以便将这些植物药纳入循证的癌症支持性护理中。
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