化疗脑发病机制及治疗的研究进展

Research Progress on Chemo-brain:Pathogenesis and Treatment with Integrated Traditional Chinese Medicine and Western Medicine

化疗脑,即化疗相关认知损害,是化疗引起的副反应之一。15%～45%恶性肿瘤患者化疗后出现化疗脑。目前有关化疗脑的发病机制尚无明确定论,可能与海马区神经细胞受损、DNA损伤、炎症反应和化疗药物的毒性作用等因素相关。目前临床治疗上主要采用药物治疗和认知行为治疗等方法来治疗化疗脑。中医诊疗化疗脑中医治法根据辨证可分为益气健脾、滋阴补肾、疏肝解郁等,以达到养神而恢复认知功能的目的。全文综述化疗脑近年的中西医研究进展,以期为临床诊治提供一定的思路。

'Chemo-brain',or chemotherapy-induced cognitive impairment,is one of the adverse effects of chemotherapy,which occurs in 15%~45%of cancer patients after chemotherapy.The pathogenesis of chemo-brain is still controversial,which may be related to the hippocampal neuron injury,DNA damage,inflammation,chemotherapeutic drugs toxicity or other factors.The drug therapy and cognitive behavioral therapy are mainly used in the treatment of chemo-brain.According to the syndrome differentiation of traditional Chinese medicine,the principles of'nourishing qi to invigorate spleen','enriching yin and nourishing kidney'and'soothing liver and relieving depression'are applied to achieve'nourishing spirit'and restoring cognitive function.This article reviews the recent progress on chemo-brain research with Chinese and western medicine to provide some ideas for clinical diagnosis and treatment.