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中草药防治抗肿瘤治疗所致药物性心肌损伤的研究进展

Research progress on the prevention and treatment of drug-induced myocardial injury caused by anti-tumor therapy with Chinese herbal medicine

  • 摘要: 随着化疗、免疫及靶向治疗的广泛应用,肿瘤治疗相关心脏毒性问题日益受到关注。药物性心脏损伤可显著影响患者的生存质量,甚至制约肿瘤治疗效果,其发生机制涉及氧化应激、炎症反应、线粒体损伤、细胞凋亡及免疫异常等多条通路。中草药因其有多靶点、低毒性及整体调节等优势,在心脏保护方面显示出良好潜力。本文综述抗肿瘤药物性心肌损伤的主要机制,重点介绍复方丹参滴丸、暖心康、芪苈强心胶囊、生脉散等中药方剂及其活性成分在防治心肌损伤中的研究进展,阐述其抗氧化、抗炎、免疫调节及保护线粒体功能等多途径发挥作用,并指出部分具有抗肿瘤活性的中草药在心脏保护与抗癌协同治疗中的潜在优势。未来仍需加强系统性临床研究,推动其转化应用。

     

    Abstract: With the widespread application of chemotherapy, immunotherapy, and targeted therapies, cardiotoxicity associated with cancer treatment has gained increasing attention. Drug-induced cardiac injury can significantly impair patients’ quality of life and may even limit the overall efficacy of anticancer therapy. The underlying mechanisms involve multiple signaling pathways, including oxidative stress, inflammatory responses, mitochondrial dysfunction, apoptosis, and immune dysregulation. Owing to their multitarget effects, low toxicity, and holistic regulatory properties, traditional Chinese herbal medicines have demonstrated considerable potential in cardioprotection. This review summarizes the principal mechanisms of anticancer drug–induced myocardial injury and highlights recent advances in the prevention and treatment of cardiotoxicity using traditional Chinese medicine formulations, such as Compound Danshen Dripping Pills, Nuanxinkang, Qili Qiangxin Capsules, and Shengmai Powder, as well as their bioactive constituents. The cardioprotective effects of these agents are discussed in terms of their antioxidative, anti-inflammatory, immunomodulatory, and mitochondrial-protective actions. Furthermore, we highlight certain herbal medicines with intrinsic antitumor activity that exhibit unique advantages in synergistic cardioprotective and anticancer therapy. Future efforts should focus on well-designed, systematic clinical studies to facilitate the translational application of integrated Chinese and Western medicine in cardio-oncology.

     

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