Therapeutic roles of acupuncture in the treatment of chemotherapy induced nausea and vomiting

Chemotherapy-induced nausea and vomiting(CINV) remains one of the most disruptive complications during cancer treatment, often persisting despite standard antiemetic regimens. As clinical practice seeks supplementary strategies to enhance symptom control, acupuncture and moxibustion have emerged as promising adjunctive therapies. Existing trials and meta-analyses indicate their therapeutic potential, yet the neurobiological basis for these effects has not been fully elucidated. This study synthesizes current evidence to outline how acupuncture and moxibustion intervene in the peripheral and central pathways involved in CINV. Particular attention is given to their regulatory influence on vagal afferent signaling, gastrointestinal sensory pathways, and key neurotransmitter systems—such as 5-HT, SP, DA, and GABA—alongside modulation of brainstem nuclei and higher-order neural circuits implicated in emetic responses. The analysis also identifies procedural and methodological constraints in present clinical studies and highlights unresolved mechanistic questions. By integrating findings from neurophysiology and oncology-related symptom research, this review offers a foundation for more precise mechanistic investigations and for optimizing acupuncture-based interventions in CINV management. 化疗诱发性恶心与呕吐(chemotherapy-induced nausea and vomiting, CINV)仍是肿瘤治疗过程中最具挑战性的并发症之一, 即便在规范应用止吐药物方案的情况下, 部分患者症状仍难以得到充分控制.随着临床实践对辅助干预策略需求的不断增加, 针刺与艾灸逐渐被认为是具有潜力的辅助治疗手段.既往临床试验及荟萃分析显示, 其在缓解CINV方面具有一定疗效, 但其作用的神经生物学基础尚未得到系统阐明.本综述在整合现有证据的基础上, 系统概述针刺与艾灸对CINV相关外周及中枢通路的干预机制, 重点探讨其对迷走神经传入信号,胃肠感觉通路以及关键神经递质系统(如5-HT,SP,DA和GABA)的调控作用, 并分析其对参与呕吐反射的脑干核团及高级神经环路的影响.同时, 本文也指出当前临床研究在操作规范和方法学方面的局限性, 并总结尚待解决的关键机制问题.通过整合神经生理学与肿瘤相关症状研究领域的发现, 本综述为开展更为精细的机制研究以及优化针刺相关干预在CINV管理中的应用提供了理论基础.