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投稿时间:2025-12-03 网络发布日期:2026-05-22
投稿时间:2025-12-03 网络发布日期:2026-05-22
中文摘要: 化疗所致恶心呕吐(CINV)是肿瘤治疗中常见的不良反应,严重影响患者的生活质量与治疗依从性。本文系统综述了CINV的分类、发生机制及治疗药物的最新进展。根据发生时间,CINV可分为急性、延迟性、暴发性、难治性和预期性五类,其机制涉及外周与中枢两条主要途径。在治疗药物方面,从传统的多巴胺受体拮抗剂和5-羟色胺3(5-HT3)受体拮抗剂,到针对延迟性呕吐的神经激肽1(NK1)受体拮抗剂,以及具有多受体拮抗作用的奥氮平,止吐治疗方案不断优化。近年来,复合制剂(如奈妥匹坦帕洛诺司琼复方制剂)及个体化给药策略显著提升了防控效果。此外,部分止吐药物还显示出潜在抗肿瘤活性,为支持治疗赋予了新的内涵。文章还总结了特殊人群的用药注意事项,并展望了基于基因检测、新型剂型及人工智能预测模
型的个体化治疗方向。
Abstract:Chemotherapy-induced nausea and vomiting(CINV)is a common adverse reaction in tumor treatment,which seriously affects patients'quality of life and treatment compliance. This paper systematically reviews the classification,pathogenesis and latest research progress of therapeutic drugs for CINV. According to the onset time,CINV can be divided into five clinical phenotypes :acute,delayed,breakthrough,refractory and anticipatory,and its pathogenesis involves two main pathways:peripheral and central.In terms of therapeutic drugs,the antiemetic treatment regimens have been continuously optimized,ranging from traditional dopamine receptor antagonists and 5-hydroxytryptamine 3(5-HT3)receptor antagonists to neurokinin 1(NK1)receptor antagonists targeting delayed vomiting,and olanzapine with multi-receptor antagonistic effects. In recent years,compound preparations(such as netupitant-palonosetron combination)and individualized administration strategies have significantly improved the prevention and control effects.In addition,some antiemetic drugs have shown potential anti-tumor activities,endowing supportive care with new connotations. The paper also summarizes the precautions for drug use in special populations,and prospects the direction of individualized treatment based on gene detection,new dosage forms and artificial intelligence prediction models.
keywords: Chemotherapy - induced nausea and vomiting Dopamine receptor antagonists Glucocorticoids 5 - hydroxytryptamine 3 receptor antagonists NK1 receptor antagonists Olanzapine
文章编号: 中图分类号:R730.53 文献标志码:A
基金项目:卫生健康发展促进项目—肿瘤支持科研项目(33-1)
附件
| Author Name | Affiliation |
| WANG Jin,HAN Jiapeng,LI Ying,WANG Jirong | Department of Oncology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210011,China |
引用文本:
王锦, 韩家鹏, 李颖, 王继荣.化疗所致恶心呕吐的治疗药物研究进展[J].中国临床研究,2026,39(5):808-813.
王锦, 韩家鹏, 李颖, 王继荣.化疗所致恶心呕吐的治疗药物研究进展[J].中国临床研究,2026,39(5):808-813.
