Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by numbness, paresthesia and hyperalgesia at the extremities. It is a common side effect of tumor therapy and the main cause of tumor treatment failure and poor quality of life. Duloxetine is the only first-line drug recommended by the latest CIPN treatment guidelines, but its efficacy is not ideal.  Modern studies show that CIPN pathogenesis is numerous, and the treatment of CIPN is still limited to a single mechanism and the treatment effect is not ideal.  Clinical practice observed that Chinese medicine treatment CIPN patients can obviously alleviate pain, and modern pharmacological studies show that Chinese medicine can alleviate CIPN symptoms through a variety of mechanisms, this study on the CIPN protection mechanism and Chinese medicine treatment CIPN mechanism to do a summary.

Zhang Simin, Quan Jianfeng. Research on the Mechanism of Traditional Chinese Medicine in Treating Chemotherapy Induced Peripheral Neuropathy. International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 12: 46-53. https://doi.org/10.25236/IJFM.2023.051207.

[1] Wang Yue, Bai Yanni, Zheng Yujie, et al. Reliability and Validity of Chinese Version of Chemotherapy-induced Peripheral Neuropathy Assessment Tool [J]. Nursing Journal of Chinese People's Liberation Army, 2018, 35(5):14-18. 

[2] Grisold Wolfgang, Cavaletti Guido, Windebank Anthony J, et al. Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention [J]. Neuro-oncology, 2012, 144(4):iv45-54. 

[3] Chinese Association of Cancer Supportive Therapy Professional Committee, Chinese Association of Cancer Clinical Chemotherapy Professional Committee, Ba Yi, et al. Chinese Expert Consensus on Diagnosis and Treatment of Chemotherapy-induced Peripheral Neuropathy (2022 Edition) [J]. Chinese Journal of Cancer, 2022, 44(9):928-934. 

[4] Xu Ge, Lian Naqi, Yu Yang, et al. Research Progress in Pathogenesis and Treatment of Chemotherapy-induced Peripheral Neuropathy [J]. Medical Recapitulate, 2020, 26(18):3601-3605+3611. 

[5] Clavo Bernardino, MartínezSánchez Gregorio, RodríguezEsparragón Francisco, et al. Modulation by Ozone Therapy of Oxidative Stress in Chemotherapy-Induced Peripheral Neuropathy: The Background for a Randomized Clinical Trial [J]. International Journal of Molecular Sciences, 2021, 22(6):2802-2802. 

[6] Hu Jiarui, Fan Jieting, He Xiaohua, et al. Research progress of peripheral neuropathy caused by paclitaxel [J]. Chinese Journal of New Drugs and Clinical Remedies, 2023, 42(10):616-621. 

[7] Renata Zajączkowska, Magdalena Kocot-Kępska, Wojciech Leppert, et al. Mechanisms of Chemotherapy-Induced Peripheral Neuropathy [J]. International Journal of Molecular Sciences, 2019, 20(6):1451-1451. 

[8] Clavo Bernardino, Rodríguez Abreu Delvys, Galván Saray, et al. Long-term improvement by ozone treatment in chronic pain secondary to chemotherapy-induced peripheral neuropathy: A preliminary report [J]. Frontiers in Physiology, 2022, 13:935269-935269. 

[9] Albers James W, Chaudhry Vinay, Cavaletti Guido, et al. Interventions for preventing neuropathy caused by cisplatin and related compounds.[J]. The Cochrane database of systematic reviews, 2014, (3):CD005228. 

[10] Fumagalli Giulia, Monza Laura, Cavaletti Guido, et al. Neuroinflammatory Process Involved in Different Preclinical Models of Chemotherapy-Induced Peripheral Neuropathy [J]. Frontiers in Immunology, 2021, 11:626687-626687.

[11] Aina Calls, Valentina Carozzi, Xavier Navarro, et al. Pathogenesis of platinum-induced peripheral neurotoxicity: Insights from preclinical studies [J]. Experimental Neurology, 2020, 325:113141. 

[12] Doyle TM, Salvemini D. Mini-Review: Mitochondrial Dysfunction and Chemotherapy-induced Neuropathic Pain [J].Neuroscience Letters, 2021, 760:136087. 

[13] Zhang Jixiang, Ma Jiacheng, Trinh Ronnie T, et al. An HDAC6 inhibitor reverses chemotherapy-induced mechanical hypersensitivity via an IL-10 and macrophage dependent pathway [J]. Brain, behavior, and immunity, 2021, 100:287-296.

[14] Gerdts Josiah, Brace E J, Sasaki Yo, et al. SARM1 activation triggers axon degeneration locally via NAD⁺ destruction [J]. Science (New York, N.Y.), 2015, 348(6233):453-457. 

[15] Martin Kolisek, Andreas Beck, Andrea Fleig, et al. Cyclic ADP-Ribose and Hydrogen Peroxide Synergize with ADP-Ribose in the Activation of TRPM2 Channels [J]. Molecular Cell, 2005, 18(1):61-69. 

[16] Li Y, Pazyra-Murphy MF, Avizonis D, etal. Activation of Sarm1 produces cADPR to increase intra-axonal calcium and promote axon degeneration in CIPN [J]. Cold Spring Harbor Laboratory, 2021(2): e202106080. 

[17] Gomez Kimberly, Stratton Harrison J, Duran Paz, et al. Identification and targeting of a unique NaV1.7 domain driving chronic pain [J]. Proceedings of the National Academy of Sciences of the United States of America, 2023, 120(32):e2217800120-e2217800120. 

[18] Li Wenyu, Bian Lihong, Wei Guoli, etal. A brief account of TCM syndromes of chemotherapy-related peripheral neuropathy [J]. Chinese Journal of Traditional Chinese Medicine Information;2022, 29(10):20-23. 

[19] Wang Xi, Zhang Yingwen. Pathogenesis and treatment of peripheral neuropathy induced by chemotherapy based on "liver-yang deficiency" theory [J]. World Science and Technology: Modernization of Traditional Chinese Medicine, 2022, 24(11): 4318-4324. 

[20] Zhou Xiaoyan, Wang Hao. Clinical Observation on the Treatment of Peripheral Neuropathy After Chemotherapy with Modified Buyang Huanwu Tang [J]. Guangming Traditional Chinese Medicine, 2021, 36(20):3469-3471. 

[21] Ki-Joong Kim, Jinyeon Hwang, Ji-Yeon Park, et al. Augmented Buyang Huanwu Decoction facilitates axonal regeneration after peripheral nerve transection through the regulation of inflammatory cytokine production [J]. Journal of Ethnopharmacology, 2020, 260:113063-113063. 

[22] Wang Lina, Wu Fuyou, Zhang Tao. The effect of Buyang Huanwu Tang on the treatment of acute cerebral infarction patients with Qi deficiency and blood stasis syndrome and its influence on hemodynamic indicators and blood viscosity [J]. Chinese medical innovation, 2022, 19(18):49-52. 

[23] Ding Rong, Huo Jie Ge, Wang Yue. Clinical Observation on Danggui Sini Decoction in Prevention and Treatment of Oxaliplatin Peripheral Neurotoxicity [J]. Journal of Nanjing University of Traditional Chinese Medicine, 2014, 30(5): 432-433. 

[24] Mihara Yuki, Egashira Nobuaki, Sada Hikaru, et al. Involvement of spinal NR2B-containing NMDA receptors in oxaliplatin-induced mechanical allodynia in rats [J]. Molecular Pain, 2011, 7(1):8. 

[25] Hu Ying, Huo Jiege, Cao Peng, et al. Danggui Sini Decoction for the Prevention and Treatment of Oxaliplatin-induced Chronic Peripheral Neuropathy [J]. Chinese Journal of Experimental Prescription, 2013, 19(20):255-258. 

[26] Peng Rentong. Observation on therapeutic effect of Danggui Sini Decoction and Yanghe Decoction on neurotoxicity induced by oxaliplatin [J]. Clinical research on chinese medicine, 2015, 7(12):88-90. 

[27] Liu Hui, Zhou Zhiyi, Wu Liying, et al. Clinical Observation on Huangqi Guizhi Wuwu Decoction in Treating Oxaliplatin Peripheral Neurotoxicity [J]. Shanghai Journal of Traditional Chinese Medicine, 2011, 45(03):44-47. 

[28] Ma Yilei, Zhou Guangrong, Ye Weicheng, et al. The effect of Huangqi Guizhi Wuwu Tang on the nerve conduction velocity of oxaliplatin induced peripheral neuropathy in rats [J]. Shanghai Journal of Traditional Chinese Medicine, 2011, 45 (1):75-78. 

[29] Wu Aiping, Wu Linlong, Zhang Hongying, et al. Mechanism of Jiawei Huangqi Guizhi Wuwu Decoction in Inhibiting Mitochondrial Apoptosis and Preventing Oxaliplatin Peripheral Mental Channel Toxicity [J]. Western Medicine, 2023, 35(2): 182-187. 

[30] Zhang, Wang, et al. Chemical Constituents and Pharmacological Effects of Astragalus membranaceus and Q-marker Prediction Analysis [J]. Chinese Journal of New Drugs, 2023, 32(04):410-419. 

[31] Liang Wannian, Li Haichi, Zhong Chao, et al. Study on Optimization of Extraction Process of Astragalus Polysaccharides by High Pressure Crushing and Antioxidant Activity in Vitro [J]. China Pharmaceutical, 2022, 31(11):28-32. 

[32] Hou Minna, Hou Shaoping, Hu Yaru, et al. Study on co-extraction technology optimization and antioxidant activity of polysaccharides and saponins from Astragalus mongholicus Bunge [J]. China Food Additives, 2022, 33(6):16-23. 

[33] Tian Chongmei, Xing Mengyu, Xia Daozong. Study on the Extraction and Antioxidant Activity of Radix Astragali Polysaccharides [J]. Lishizhen Medicine and Materia Medica Research, 2018, 29(9):2072-2076. 

[34] Qu Wenying, Xie Jianguo, Liang Anxin, et al. The effect of astragalus polysaccharide on nerve cell activity, cognitive function and Caspase-9 expression in Alzheimer's disease rats [J]. Stroke and neurological diseases, 2021, 28(5): 543-549. 

[35] Guo Tonglin, Zhen Yanjie, Zhao Yuwei, et al. Study on estrogen like neuroprotective effect of quercetin solid lipid nanoparticles on PC12 cells injured by Aβ25-35 [J]. Chinese Pharmacological Bulletin, 2020, 36(10):1409-1415. 

[36] Chang-Cheng Lyu, Shu-Juan Shu. Ligustilide attenuates hyperalgesia in an inflammatory pain rat model: involvement of spinal ERK/MAPK pathway and proinflammatory cytokines [J]. Medicinal Chemistry Research, 2018, 27(4):1292-1297. 

[37] Zhao Linxia, Jiang Baochun, Wu Xiaobo, et al. Ligustilide attenuates inflammatory pain via inhibition of NFκB-mediated chemokines production in spinal astrocytes [J]. The European journal of neuroscience, 2014, 39(8):1391-402. 

[38] Xu Chong, Shen Limin, Yuan Wenjie. Danggui polysaccharides are processed through Wnt/ β- The catenin signaling pathway inhibits oxidative stress damage and inflammatory response in chondrocytes of osteoarthritis [J]. Shaanxi Traditional Chinese Medicine, 2022, 43(06):700-703 +770. 

[39] Jiang Huanhuan, Zhou Yaming, Wang Lifeng, et al. Experimental study on in vitro antioxidant activity of Huangqi Danggui medicine with different ratios [J]. Guangzhou Chemical, 2022, 50(18):40- 43. 

[40] Wei Wei, Cao Huiqin, Cui Xing. Mechanism of paeoniflorin in bortezomib-related peripheral neuropathy [J]. Liaoning Journal of Traditional Chinese Medicine:1-8[2023-09-14]. 

[41] Wu Dan. Study on the analgesic effects of paeoniflorin on inflammatory pain and neuropathic pain in rats and the underlying mechanism [D]. Youjiang Medical University For Nationalities, 2023. 

[42] Lingling Zhang, Wei Wei. Anti-inflammatory and immunoregulatory effects of paeoniflorin and total glucosides of paeony [J]. Pharmacology and Therapeutics, 2020, 207:107452. 

[43] Wang Haiyan, Li Jiaxuan, Wei Lifen, et al. Preparation Process Optimization of Ligustrum chuanxiong Protein-Dextran Conjugate and Its Antioxidant Properties [J]. Food Research and Development, 2023, 44(17):90-98. 

[44] Hou Yongzhong, Zhao Guangrong, Yang Jie, et al. Protective effect of Ligusticum chuanxiong and Angelica sinensis on endothelial cell damage induced by hydrogen peroxide [J]. Life Sciences, 2004, 75(14):1775-1786.