傳統中藥對緩解癌症化療副作用的實證醫學研究
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2025
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化療在癌症治療中被廣泛應用，但常常會引起嚴重的副作用，影響患者的生活品質。例如，乳癌患者使用阿黴素 (DOX) 可能引起心臟毒性和骨質疏鬆症，而大腸直腸癌患者使用奧沙利鉑 (OXA) 則常誘發視網膜與週邊神經病變。這些不良反應凸顯了緩解化療毒性的迫切需求。本研究探討了傳統中藥 (TCM) 減輕化療副作用的潛力。我們選取蛹蟲草 (CME)、金線蓮 (ARE) 和流蘇石斛 (DFE) 的萃取物進行評估。利用細胞和小鼠模型，檢視了這些萃取物對阿黴素 (DOX) 和奧沙利鉑 (OXA) 治療引起的不良反應的保護作用。為了鑑定這些萃取物的生物活性成分和抗氧化特性，我們採用了高效能液相層析 (HPLC) 和 1,1-二苯基-2-三硝基苯肼 (DPPH) 自由基清除試驗。結果表明，三種中藥萃取物均具有獨特的生物活性成分，並表現出強大的抗氧化活性。在細胞實驗中，採用MTT分析評估了CME和ARE對DOX誘導的H9c2心肌細胞損傷的保護作用，以及DFE對OXA誘導的ARPE-19視網膜細胞損傷的保護作用。結果顯示，CME和ARE顯著提高了經DOX處理的H9c2細胞的活力，而DFE則有效地維持了經OXA處理的ARPE-19細胞的活力。本研究進行動物實驗以評估中藥萃取物對化療小鼠的生理與分子層面影響。透過記錄體重變化與運動表現以評估整體健康狀況，並分別以心臟超音波影像系統檢測心臟功能、以電腦斷層掃描測量脛骨骨密度、以酵素免疫分析法（ELISA）分析血清免疫球蛋白（IgG、IgA、IgE）表現。心肌與視網膜組織中抗氧化蛋白（SOD2）、發炎蛋白（TNF-α）及凋亡蛋白（caspase-3）之表現，則透過免疫組織化學染色與西方墨點法進行分析。結果顯示，CME與ARE可提升DOX處理小鼠的心臟功能與脛骨骨密度，增加血清中IgG與IgA表現，並抑制IgE表現。CME與ARE可促進心肌組織中SOD2表現，同時抑制TNF-α與caspase-3的表現。DFE則可提升OXA處理小鼠視網膜中rhodopsin與SOD2的表現，並抑制TNF-α與caspase-3的表現。綜合上述結果，我們認為中藥萃取物CME、ARE與DFE可透過減緩氧化壓力、抑制發炎反應與凋亡等分子機制，有效保護細胞與小鼠模型免受化療副作用之傷害。
Chemotherapy is widely used in cancer treatment but often causes significant side effects that impair patient quality of life. For example, doxorubicin (DOX) in breast cancer is linked to cardiotoxicity and osteoporosis, while oxaliplatin (OXA) in colorectal cancer commonly induces retinal and peripheral neuropathy. These adverse effects highlight the urgent need for strategies to alleviate chemotherapy-induced toxicity. This study investigates the potential of traditional Chinese medicines (TCMs) to mitigate chemotherapy-induced side effects. Extracts from Cordyceps militaris (CME), Anoectochilus roxburghii (ARE), and Dendrobium fimbriatum (DFE) were selected for evaluation. Using both cellular and murine models, we examined their protective effects against adverse outcomes induced by DOX and OXA treatments. To characterize the bioactive components and antioxidant properties of these extracts, high-performance liquid chromatography (HPLC) and 1,1-diphenyl-2-trinitrophenylhydrazyl (DPPH) radical scavenging assays were employed. The results demonstrated that each TCM extract possesses distinct bioactive compounds and exhibits strong antioxidant activity. In cellular assays, MTT analysis was used to assess the protective effects of CME and ARE on DOX-induced damage in H9c2 cardiomyocytes, and of DFE on OXA-induced damage in ARPE-19 retinal cells. The findings revealed that CME and ARE significantly improved the viability of DOX-treated H9c2 cells, while DFE effectively preserved the viability of ARPE-19 cells exposed to OXA. In vivo experiments were conducted to evaluate the physiological and molecular effects of TCM extracts in chemotherapy-treated mice. Body weight and exercise performance were monitored to assess general health status. Cardiac function was evaluated using ultrasound imaging, tibial bone density via computed tomography, and serum immunoglobulin (Ig) levels (IgG, IgA, IgE) by ELISA. Cardiac and retinal tissue expressions of antioxidant (SOD2), inflammatory (TNF-α), and apoptotic (caspase-3) markers were analyzed using immunohistochemistry and western blotting. The results indicated that CME and ARE enhanced cardiac function and tibial bone density in DOX-treated mice, increased serum IgG and IgA levels, and suppressed IgE expression. These extracts also upregulated SOD2 while downregulating TNF-α and caspase-3 in myocardial tissue. Additionally, DFE improved retinal expression of rhodopsin and SOD2, and inhibited TNF-α and caspase-3 in OXA-treated mice. Taken together, our findings suggest that the TCM extracts CME, ARE, and DFE exert protective effects against chemotherapy-induced side effects in both cellular and murine models. These effects are likely mediated through molecular mechanisms involving attenuation of oxidative stress, suppression of inflammatory responses, and inhibition of apoptosis.
Chemotherapy is widely used in cancer treatment but often causes significant side effects that impair patient quality of life. For example, doxorubicin (DOX) in breast cancer is linked to cardiotoxicity and osteoporosis, while oxaliplatin (OXA) in colorectal cancer commonly induces retinal and peripheral neuropathy. These adverse effects highlight the urgent need for strategies to alleviate chemotherapy-induced toxicity. This study investigates the potential of traditional Chinese medicines (TCMs) to mitigate chemotherapy-induced side effects. Extracts from Cordyceps militaris (CME), Anoectochilus roxburghii (ARE), and Dendrobium fimbriatum (DFE) were selected for evaluation. Using both cellular and murine models, we examined their protective effects against adverse outcomes induced by DOX and OXA treatments. To characterize the bioactive components and antioxidant properties of these extracts, high-performance liquid chromatography (HPLC) and 1,1-diphenyl-2-trinitrophenylhydrazyl (DPPH) radical scavenging assays were employed. The results demonstrated that each TCM extract possesses distinct bioactive compounds and exhibits strong antioxidant activity. In cellular assays, MTT analysis was used to assess the protective effects of CME and ARE on DOX-induced damage in H9c2 cardiomyocytes, and of DFE on OXA-induced damage in ARPE-19 retinal cells. The findings revealed that CME and ARE significantly improved the viability of DOX-treated H9c2 cells, while DFE effectively preserved the viability of ARPE-19 cells exposed to OXA. In vivo experiments were conducted to evaluate the physiological and molecular effects of TCM extracts in chemotherapy-treated mice. Body weight and exercise performance were monitored to assess general health status. Cardiac function was evaluated using ultrasound imaging, tibial bone density via computed tomography, and serum immunoglobulin (Ig) levels (IgG, IgA, IgE) by ELISA. Cardiac and retinal tissue expressions of antioxidant (SOD2), inflammatory (TNF-α), and apoptotic (caspase-3) markers were analyzed using immunohistochemistry and western blotting. The results indicated that CME and ARE enhanced cardiac function and tibial bone density in DOX-treated mice, increased serum IgG and IgA levels, and suppressed IgE expression. These extracts also upregulated SOD2 while downregulating TNF-α and caspase-3 in myocardial tissue. Additionally, DFE improved retinal expression of rhodopsin and SOD2, and inhibited TNF-α and caspase-3 in OXA-treated mice. Taken together, our findings suggest that the TCM extracts CME, ARE, and DFE exert protective effects against chemotherapy-induced side effects in both cellular and murine models. These effects are likely mediated through molecular mechanisms involving attenuation of oxidative stress, suppression of inflammatory responses, and inhibition of apoptosis.
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化療副作用, 阿黴素, 奧沙利鉑, 傳統中藥, 蛹蟲草, 金線蓮, 流蘇石斛, 抗氧化壓力, 發炎反應, 細胞凋亡, 心臟毒性, 週邊神經病變, Chemotherapy-induced side effects, Doxorubicin, Oxaliplatin, Traditional Chinese medicine, Cordyceps militaris extract, Anoectochilus roxburghii extract, Dendrobium fimbriatum extract, Oxidative stress, Inflammation, Apoptosis, Cardiotoxicity, Peripheral neuropathy