当期文章

癌痛的机制与中医药的多靶点治疗潜力(英文)

徐国群^1,2, 田颖鑫^1,3, 司广一¹, 卜晓娜¹, 张敏¹, 焦慧凤², 潘海莉^1,*

¹南通大学特种医学研究院，南通 226019；²南昌大学江西医学院基础医学院，南昌 330031；³南昌大学生物医学创新研究院，南昌 330031

摘要

癌痛是晚期恶性肿瘤患者中最普遍且最具致残性的症状之一，其发生机制涉及外周、中枢和全身性多重通路。传统镇痛药物(包括阿片类和非甾体抗炎药)常因疗效不足、耐受性和依赖风险而受限。传统中医药(Traditional Chinese Medicine,TCM)凭借其多组分、多靶点和系统调节特性，在癌痛管理中展现出显著潜力。本综述全面概述了癌痛的临床分类、潜在机制(包括神经浸润、炎症介质与离子通道失调、中枢敏化、神经-免疫串扰、代谢重编程和肠-脑轴破坏)以及癌痛治疗中代表性中药的镇痛作用。例如，四氢小檗碱(tetrahydroberberine)、左旋四氢巴马汀(levo-tetrahydropalmatine)和胡椒碱(piperine)等生物活性成分通过抑制炎症级联反应、调节神经递质系统、保护神经完整性，展现出镇痛效应，从而改善患者生活质量。此外，本文还总结了常用临床前模型(包括骨癌痛模型、胰腺癌痛模型和化疗诱导的外周神经病变模型)在癌痛机制研究和疗效评估中的应用。本文同时讨论了当前临床证据的局限性(如样本量小、随访期短、动物模型向临床转化有限)以及标准化、机制阐明和临床试验设计方面的主要挑战。未来方向应聚焦于精准疼痛表型分型、整合多靶点干预策略、严格的疗效-安全性验证、给药系统创新，以促进TCM在癌痛管理中实现标准化和全球化应用。

关键词： 癌痛; 镇痛药物; 传统中医药; 临床前模型; 骨癌痛

Mechanisms of cancer pain and the multitarget therapeutic potential of Traditional Chinese Medicine

XU Guo-Qun^1,2, TIAN Ying-Xin^1,3, SI Guang-Yi¹, BU Xiao-Na¹, ZHANG Min¹, JIAO Hui-Feng², PAN Hai-Li^1,*

¹Institute of Special Environmental Medicine, Nantong University, Nantong 226019, China；²School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang 330031, China；³Institute of Biomedical Innovation, Nanchang University, Nanchang 330031, China

Abstract

Cancer pain is one of the most prevalent and debilitating symptoms in patients with advanced malignancies, arising from multifactorial mechanisms involving peripheral, central, and systemic pathways. Conventional analgesics, including opioids and nonsteroidal anti-inflammatory drugs, are often limited by their insufficient efficacy, tolerance, and risk of dependence. Traditional Chinese Medicine (TCM), characterized by its multi-component, multi-target, and systemic regulatory properties, has shown promising potential in cancer pain management. This review provides a comprehensive overview of the clinical classification and underlying mechanisms of cancer pain (including nerve infiltration, dysregulation of inflammatory mediators and ion channels, central sensitization, neuro-immune crosstalk, metabolic reprogramming, and gut-brain axis impairment), as well as the analgesic effects of representative TCM agents in cancer pain management. For example, bioactive components such as tetrahydroberberine, levo-tetrahydropalmatine, and piperine exert analgesic effects, thereby improving the quality of life of patients by inhibiting inflammatory cascades, regulating neurotransmitter systems, and preserving neural integrity. Commonly used preclinical models, including bone cancer pain, pancreatic cancer pain, and chemotherapy-induced peripheral neuropathy models, are summarized for their utility in mechanistic studies and efficacy evaluations. This review also discusses the current limitations of clinical evidence, such as small sample sizes, short follow-up periods, and limited translation from animal models, alongside major challenges in standardization, mechanistic elucidation, and clinical trial design. Future directions should focus on precise pain phenotyping, integrated multi-target interventions, rigorous efficacysafety validation, and innovations in drug delivery to facilitate the standardization and global adoption of TCM in cancer pain management.

Key words: cancer pain; analgesics; Traditional Chinese Medicine (TCM); preclinical models; bone cancer pain

收稿日期：　　录用日期：

通讯作者：潘海莉　　E-mail:

DOI: 10.13294/j.aps.2026.0017

引用本文：

徐国群, 田颖鑫, 司广一, 卜晓娜, 张敏, 焦慧凤, 潘海莉. 癌痛的机制与中医药的多靶点治疗潜力(英文)[J]. 生理学报 2026; 78 (1): 16-46.

XU Guo-Qun, TIAN Ying-Xin, SI Guang-Yi, BU Xiao-Na, ZHANG Min, JIAO Hui-Feng, PAN Hai-Li. Mechanisms of cancer pain and the multitarget therapeutic potential of Traditional Chinese Medicine. Acta Physiol Sin 2026; 78 (1): 16-46