中医药外治化疗诱导的周围神经毒性及手足综合征的用药规律及共性策略研究
External Traditional Chinese Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome: Patterns of Use and Shared Therapeutic Strategies
陈昱帆 1殷玉琨 1李淏 2崔译元 1冯利3
作者信息
- 1. 100021 北京市，国家癌症中心国家肿瘤临床医学研究中心，中冯利国医学科学院北京协和医学院肿瘤医院中医科
- 2. 100700 北京市，北京中医药大学东直门医院
- 3. 100021 北京市，数智中医肿瘤防治北京市重点实验室;100021 北京市，国家癌症中心国家肿瘤临床医学研究中心，中冯利国医学科学院北京协和医学院肿瘤医院中医科
- 折叠
摘要
背景 化疗诱导的周围神经毒性（CIPN）和手足综合征（HFS）是影响肿瘤患者治疗耐受性和生活质量的重要因素，二者常合并发生，中药外治疗效良好。目的 本研究旨在系统分析CIPN和HFS的用药规律，明确核心药物组合、性味归经特点及证候分布，为采取联合化疗方案患者产生的常见手足并发症提供中药防治策略。方法 检索中国知网（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、中国生物医学文献数据库（CBM）和Pubmed建库至2025年10月的相关文献。采用双人背靠背独立录入方法提取中药名称、性味等关键信息构建数据库。应用COOC 14.9软件进行邻接表统计，计算中药及相关特性出现及共现的频次和频率。应用SPSS 27.0软件进行聚类分析，以质心聚类法的杰卡德（Jaccard）相似系数为度量标准。应用Origin 2025软件进行性味与归经相关性分析，相关性强度以Pearson相关系数（r）表示，并绘制径向条形图、功效雷达图、热图进行结果可视化。结果 共纳入198篇文献，经频次统计可知，治疗CIPN的药物主要为桂枝、红花等，治疗HFS的药物主要为桂枝、当归等，二者使用的外治中药中有90味相同，其中药性以温、寒、平为主，药味以辛、苦、甘居多，归经集中于肝、脾、肾经，二病均以血瘀证、气虚证为核心证候。性味归经的相关性分析结果显示，归肝经的苦味药（r=0.8）和归胃经的寒性药（r=0.67）在合病时使用频率最高。二者用药也有不同之处，CIPN更常见寒证与血虚证，HFS则多兼热毒证；治疗CIPN中药以祛风湿药为主，治疗HFS中药以清热药为主。结论 中医药外治法防治CIPN与HFS以“化瘀伐毒、寒温并用、兼补脏腑”为共性策略，推荐黄芪桂枝五物汤与芍药甘草汤作为核心方剂，但临床需根据病变特点进行差异化用药。
Abstract
BackgroundChemotherapy-induced peripheral neuropathy (CIPN) and hand-foot syndrome (HFS) significantly compromise treatment tolerance and quality of life in cancer patients. The two above adverse effects often co-occur, yet external Traditional Chinese Medicine (TCM) therapies have demonstrated notable efficacy. ObjectiveThis study systematically characterizes the usage patterns of external TCM for CIPN and HFS, identifies core herbal combinations, elucidates their pharmacological properties and meridian tropism, and maps associated syndrome distributions, providing evidence-based strategies for the prevention and management of hand-foot complications in patients undergoing combination chemotherapy. MethodsWe systematically retrieved literature up to October 2025 from China National Knowledge Infrastructure (CNKI), China Science Periodical Database (CSPD), Chinese Science and Technology Periodical Database (CCD), China Biology Medicine Database (CBM), and PubMed. Key information, including TCM names and properties, was extracted independently by two researchers to build a comprehensive database. Co-occurrence analysis was performed using COOC 14.9 to quantify the frequency and co-use of herbs and their attributes. Cluster analysis was conducted in SPSS 27.0 using centroid clustering with the Jaccard similarity coefficient. Correlations between TCM properties and meridian tropisms were analyzed in Origin 2025 using Pearson correlation coefficient (r), with results visualized via radial bar charts, efficacy radar plots, and heatmaps. ResultsA total of 198 studies were included. For CIPN, the most frequent herbs were Cinnamomi Ramulus and Carthami Flos, while for HFS, Cinnamomi Ramulus and Angelicae Sinensis Radix predominated. Ninety herbs overlapped between the two diseases, sharing common traits: mainly warm, cold, or neutral properties; predominantly pungent, bitter, or sweet tastes; and belonging to liver, spleen, or kidney meridian tropisms. Both were primarily associated with blood stasis and Qi deficiency patterns. Correlation analysis showed that bitter liver-meridian herbs(r=0.80) and cold stomach-meridian herbs (r=0.67) were most frequently used in comorbid cases. Differences included a higher prevalence of cold and blood-deficiency patterns in CIPN, versus heat-toxin patterns in HFS. CIPN treatments mainly involved wind-damp dispersing herbs, whereas HFS relied on heat-clearing herbs. ConclusionExternal TCM interventions for CIPN and HFS converge on the strategies ofpromoting blood circulation and detoxification, balancing cold and warm properties, and supporting organ function. Huangqi Guizhi Wuwu Decoction and Shaoyao Gancao Decoction emerged as core prescriptions. However, clinical use should be individualized based on disease-specific features.关键词
化疗诱导的周围神经毒性/化疗相关性手足综合征/中医药/防治结合/外治法/数据挖掘/用药规律引用本文复制引用
陈昱帆,殷玉琨,李淏,崔译元,冯利.中医药外治化疗诱导的周围神经毒性及手足综合征的用药规律及共性策略研究[EB/OL].(2026-05-13)[2026-05-14].https://chinaxiv.org/abs/202605.00090.学科分类
中医学/肿瘤学/医学研究方法
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