化疗引起骨髓抑制的机制及中医药防治的研究进展  

Research progress on mechanism of chemotherapy induced myelosuppression and its prevention and treatment with traditional Chinese medicine

作　　者：于姣姣 王杰[1] 陈超[1] YU Jiaojiao;WANG Jie;CHEN Chao(Department of General Surgery,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院普外科,上海200062

出　　处：《中国医药导报》2023年第22期47-50,共4页China Medical Herald

基　　金：国家自然科学基金面上项目(81973625);上海市医学重点专科建设项目(ZK2019B18)。

摘　　要：骨髓抑制是化疗后常见并发症,患者会出现免疫抑制、贫血、出血等临床表现,严重时患者不能完成足量、全程的化疗。引起骨髓抑制的机制主要包括2个方面:一方面,化疗通过诱导造血干细胞衰老和造血祖细胞凋亡,影响骨髓的造血功能;另一方面,化疗还能通过诱导骨髓成骨-成脂分化异常,破坏造血生态位,导致信号通路异常,造血生长因子紊乱,影响造血微环境。在治疗骨髓抑制方面,传统医学凭借其多靶点、毒副作用小、成本低等优势得到临床重视,相关的临床研究和基础动物研究等在不断进行中并取得一定进展。因此,本文主要对化疗造成骨髓抑制的机制及中医药防治相关研究进展进行综述,为临床化疗药物选择及骨髓抑制的防治提供参考。Myelosuppression is a common complication during chemotherapy.Patients may have immunosuppression,anemia,bleeding,and other clinical manifestations.In severe cases,patients cannot complete sufficient and full chemotherapy.The mechanism of myelosuppression mainly includes two aspects:on the one hand,chemotherapy affects the hematopoietic function of bone marrow by inducing the aging of hematopoietic stem cells and apoptosis of hematopoietic progenitors;on the other hand,chemotherapy can also destroy the hematopoietic ecological niche by inducing abnormal osteogenic-dipogenic differentiation of bone marrow,leading to abnormal signal pathways,disorder of hematopoietic growth factors,and affecting the hematopoietic microenvironment.In the treatment of myelosuppression,traditional medicine has gained clinical attention by virtue of its multiple targets,small side effects,low cost,and other advantages.Relevant clinical research and basic animal research are ongoing and have made some progress.Therefore,this article mainly reviews the mechanism of myelosuppression caused by chemotherapy and related research progress of traditional Chinese medicine prevention and treatment,providing reference for clinical chemotherapy drug selection and prevention and treatment of myelosuppression.

关 键 词：化疗 骨髓抑制 相关机制 造血细胞 造血微环境 

分 类 号：R551.3[医药卫生—血液循环系统疾病]