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| 针灸在肿瘤靶向和免疫治疗中的辅助价值：机制探讨、临床实践及未来方向 |
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胡玉星1, 张泽鑫1, 何自衍1, 王天麟1, 常雪松2,3, 何怡瀚2,3, 张海波2,3
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1.广州中医药大学第二临床医学院, 广州 510006;2.广东省中医院, 广州 510120;3.广州市肿瘤针药防治重点实验室, 广州 510120
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| 摘要: |
| 靶向治疗、免疫治疗是近年来抗肿瘤研究的热点，但存在驱动基因阴性、程序性死亡受体-1配体（PDL1）低表达、治疗后耐药、靶向和免疫治疗不良反应等限制。针灸辅助手术、放化疗的研究基础较为坚实，辅助靶向和免疫治疗的研究相对稀缺。文章总结了针灸辅助靶向和免疫治疗的作用机制、临床实践及未来方向。作用机制包括：1）提升患者免疫功能以增敏免疫治疗（提升放化疗期间免疫功能、增强围手术期免疫功能以减少术后炎症反应、缓解治疗肿瘤并发症、防止肿瘤复发）；2）调控肿瘤免疫微环境以助于解除免疫抑制；3）调控肿瘤靶向和免疫治疗相关通路，尤其是调节程序性死亡受体-1（PD-1）/PD-L1通路。临床实践包括：1）增强靶向和免疫治疗抗肿瘤效果；2）减轻表皮生长因子抑制剂相关皮肤毒性；3）治疗消化道不良反应；4）改善癌因性疲乏；5）提升免疫功能，提高生存质量等。最后归纳阐述了当前针灸辅助肿瘤靶向和免疫治疗研究的局限性及未来需解决的问题。 |
| 关键词: 针刺 艾灸 靶向治疗 免疫治疗 |
| DOI：10.11656/j.issn.1672-1519.2026.01.08 |
| 分类号:R730.5 |
| 基金项目:国家重点研发计划“中医药现代化”专项课题（2023YFC3503303）；广州地区中西医协同临床重大创新技术建设项目[穗卫函（2023）2318 号]；广州市科技计划项目（2025A03J4133）；广州地区中医药重大科技项目（2025ZD007）；大学生创新创业训练计划（202510572021，202510572106，202510572225）。 |
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| Adjuvant value of acupuncture in targeted therapy and immunotherapy：Mechanisms，clinical practice，and future directions |
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HU Yuxing1, ZHANG Zexing1, HE Ziyan1, WANG Tianlin1, CHANG Xuesong2,3, HE Yihan2,3, ZHANG Haibo2,3
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1.Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China;2.Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China;3.Guangzhou Key Laboratory of Acupuncture and Medicine Research, Guangzhou 510120, China
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| Abstract: |
| Targeted therapy and immunotherapy have emerged as hotspots in anti-tumor research in recent years，yet limitations persist， including driver gene negativity，low PD-L1 expression，post-treatment resistance，and adverse reactions to targeted and immunotherapy. While research foundations for acupuncture-assisted surgery and radiotherapy / chemotherapy are relatively robust，studies on acupuncture-assisted targeted and immunotherapy remain scarce. We summarized the mechanisms，clinical practice，and future directions of acupuncture-assisted targeted immunotherapy. Mechanisms include：1）enhancing patient immune function to sensitize immunotherapy（boosting immune function during radiotherapy and chemotherapy ，strengthening perioperative immune function to reduce postoperative inflammatory responses，alleviating treatment-related tumor complications，and preventing tumor recurrence）； 2）modulating the tumor immune microenvironment to help reverse immune suppression；3）regulating pathways related to tumor-targeted immunotherapy，particularly modulating the PD-1/PD-L1 pathway. Clinical applications include：1）enhancing the antitumor efficacy of targeted immunotherapy；2） alleviating skin toxicity associated with epidermal growth factor inhibitors；3） treating gastrointestinal adverse reactions；4）improving cancer-related fatigue；5）boosting immune function and enhancing quality of life. Finally，we summarized the current limitations in acupuncture research supporting targeted immunotherapy for tumors and identifies future research challenges. |
| Key words: acupuncture moxibustion targeted therapy immunotherapy |
