中医药干预乳腺癌治疗的研究进展

Summary of Research on Intervention of Chinese Medicine in Breast Cancer Treatment

乳腺癌是一种具有多种复杂机制的恶性肿瘤,当前研究者普遍认为其发病原因可能与生活环境,日常情绪,遗传,行为习惯等有关,但其具体的发病机制尚未研究清楚。全球乳腺癌患者的数量急剧增加,大多数国家的临床治疗手段也在不断地提升,目前临床上主要采用手术、放化疗、免疫治疗、内分泌治疗等常规方法,虽然提高了患者的生存率,仍然有复发和转移的概率,并且存在明显的后遗症,一些术后患者还会出现心理压力和负担,极大影响了生活质量。大量实验和临床经验证明,中医药由于其独特优势,在乳腺癌综合治疗中的地位不断提升,不管是在手术后康复治疗中,还是在配合放化疗过程中,都发挥了日渐凸显的作用。中医药可以提高人体免疫力,调节机体内环境,有效防止乳腺癌的复发和转移,改善术后恢复能力,减少放化疗的并发症,明显的提高患者生存质量,延长患者的生存时间。近年来,中医药治疗乳腺癌的效果让越来越多的患者对中国传统医药有了极大的信任,并且大多数患者都积极接受中医药的治疗,所以中医药干预治疗乳腺癌的机制和途径仍需要医务工作者进一步的研究与探索。此文通过查阅国内外最新文献,将从中医药干预治疗乳腺癌5个途径的研究进展予以综述,分别是对信号通路、免疫治疗与内分泌治疗、化疗、放疗的干预,信号通路干预主要从分泌型糖蛋白(Wnt)信号通路、促凋亡蛋白(Bax)/B淋巴细胞瘤-2(Bcl-2)/半胱氨酸的天冬氨酸蛋白水解酶-3(Caspase-3)信号通路、磷脂酰肌醇3-激酶(PI3K)/苏氨酸蛋白激酶(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)通路、一种高度保守的信号转导途径来调节细胞-细胞通信(Notch)信号通路、丝裂原活化蛋白激酶(MAPK)信号通路等方面进行阐述,此文旨在为中医药治疗乳腺癌提供借鉴和参考。

Breast cancer is a malignant tumor with a variety of complex mechanisms. Current researchers generally believe that its cause may be related to living environment,daily mood,heredity,behavior habits,et al,but its specific pathogenesis has not yet been studied clearly. With the rapid increase in the number of breast cancer patients worldwide, the clinical treatment methods in most countries have also been continuously improved. At present, the methods such as surgery, radiotherapy and chemotherapy,immunotherapy,and endocrine therapy are mainly adopted in clinical practice. These methods have increased the survival rate of patients,but still with the possibility of recurrence and metastasis,and there are obvious sequelae. Some postoperative patients also experience psychological pressure and burden,which would greatly affect the quality of life. A large number of experiments and clinical experience have proved that due to its unique advantages, traditional Chinese medicine(TCM) has serially improved its current status in the extensive treatment of breast cancer. No matter in post-operative rehabilitation or in the process of co-radiation and chemotherapy,it has played an increasingly prominent role. TCM can improve human immunity,regulate the body’s environment,effectively prevent the recurrence and metastasis of breast cancer,improve postoperative recovery,reduce the complications of radiation treatment and iatrochemistry,expressively improve the quality of life of patients,and prolong the survival time of patients. In recent years,the effectiveness of TCM in the treatment of breast cancer has brought more and more great trust from the patients in TCM,and most patients are willing to actively receive TCM treatment,so the mechanisms and approaches of TCM intervention in the treatment of breast cancer still need further research and exploration by our medical workers. By consulting the latest domestic and foreign literature,we reviewed the research progress on five approaches of TCM intervention in the treatment of breast cancer, including signaling pathways, immunotherapy, endocrine therapy,chemotherapy,and radiotherapy. Signal pathway intervention was explained mainly based on wingless-type MMTV integration site family members(Wnt)signaling pathway,B-cell lymphoma-2(Bcl-2)-associated X protein(Bax)/Bcl-2/cysteinyl aspartate specific proteinase-3(Caspase-3)signaling pathway,phosphatidylinositol3-kinase(PI3 K)/protein kinase B(PKB/Akt)/mammalian target of rapamycin(m TOR)signaling pathway,a highly conserved signal transduction pathway to regulate cell-cell communication(Notch)signaling pathway,mitogen-activated proteinkinase(MAPK)signaling pathway,etc. This article aims to provide reference for the treatment of breast cancer by Chinese medicine.