中医药逆转非小细胞肺癌化疗耐药研究进展

Advances in Studies on Reversion of Chemoresistance of NSCLC by Traditional Chinese Medicine

目的:整理和分析中医药逆转非小细胞肺癌的基本情况,为中药干预肿瘤获得性耐药的机制研究提供思路。方法:收集、整理、分析目前有关中医药治疗非小细胞肺癌获得性耐药的研究文献。结果:中药对于NSCLC化疗耐药干预主要体现在降低细胞药物外排,减弱细胞核屏蔽、细胞药物代谢、核酸修复等功能,调整凋亡机制失衡,提高DNA拓扑异构酶Ⅱ(TopoⅡ)活性,抑制EMT导致的免疫逃逸等方面。研究涉及中药单体,单药及复方,药物剂型多样。结论:方药干预体现了扶正祛毒的辩证原则。气血阴阳亏虚是本,脏腑主要涉及肺、脾、肾,痰瘀毒聚是标。同时充分运用了有毒动物类药的解毒抗癌作用,把辩证与辨病相结合。"正虚邪聚"可能是NSCLC化疗获得性耐药的基本病机。

Objective ： By combing and analyzing the studies on reversion of chemoresistance of non - small cell lung cancer （NSCLC） by traditional Chinese medicine, to provide ideas for TCM reversion of chemoresistance of NSCLC. Method：We collected and collated current research literatures on reversion of chemoresistance of NSCLC by TCM, and summarized their characteristics. Results：The mechanism of TCM reverse chemoresistance of NSCLC involved mainly reducing functions of cell pump out drugs, nucleus wrapped drugs, cellular metabolism of drugs and nucleic acid repair and adjusting the imbalance of apoptosis and enhancing DNA topoisomerase Ⅱ （Topo Ⅱ ） activity. Suppression of immune escape was caused by EMT and so on. Researches involved medicine monomer, monotherapy compound and diverse forms, Conclusion：Recipe intervention reflects the principles of reinforcing the healthy qi and eliminating the pathogenic factors. The deficiency of qi and blood, Yin and Yang related to lung, spleen and kidney are root causes. Phlegm, blood stasis and cancerous toxin are pathological factors. By using anticancer drugs from the poisonous animals, we construct the basic principles of combining syndrome differentiation. Deficiency of healthy energy and excess of evil may be the basic pathogenesis for chemoresistance of NSCLC.