化疗诱发的周围神经病变（chemotherapy-induced peripheral neuropathy，CIPN）是肿瘤治疗中常见的周围神经系统损伤，具体表现为感觉异常、神经痛和运动障碍，显著影响患者生活质量及化疗进程。其核心毒性机制为化疗药物诱发线粒体功能障碍，引发线粒体氧化应激及能量代谢紊乱，继发钠/钙离子通道功能异常，从而导致神经元凋亡与神经纤维退化。CIPN属中医“血痹”的范畴，其核心病机为药毒耗气伤血、瘀阻络脉、四末失养。中医防治秉持“扶正通络、内外兼治”原则，构建多层次干预体系，为逆转神经损伤提供特色干预路径。系统阐释了CIPN的毒性机制及其在中医理论指导下的病机认识，重点探讨了中医药疗法防治CIPN的策略，并提出了“复方固本-协同增效-外治透络-针灸调枢”的综合治疗方案，为优化肿瘤患者的化疗方案、提高患者生存质量提供了重要的理论指导与实践路径。

Chemotherapy-induced peripheral neuropathy (CIPN) is a common peripheral nervous system injury in cancer treatment, specifically manifested as sensory abnormalities, neuropathic pain, and motor dysfunction, which significantly affects patients’ quality of life and chemotherapy progression. The core mechanism of CIPN involves the induction of mitochondrial dysfunction, leading to mitochondrial oxidative stress and metabolic dysfunction, followed by aberrant sodium/calcium channel function, resulting in neuronal apoptosis and nerve fiber degeneration. CIPN is classified as the “Xuebi” category in traditional Chinese medicine (TCM), results from drug toxicity, causing qi and blood deficiency and meridian obstruction. TCM interventions, based on “tonifying vital energy, activating meridians, and integrating internal-external therapy” aim to reduce nerve damage. This review summaries CIPN’s toxicological mechanisms and TCM-based pathogenesis, focusing on TCM therapeutic strategies. A treatment protocol, including “formula-based reinforcement, synergistic enhancement, external meridian penetration, and acupuncture regulation”, is proposed to improve chemotherapeutic outcomes and patient survival.

R285

现代中药新质生产力科技创新工程专项（24ZXZKSY00010）