Explore the Pathogenesis of Chemotherapy - Related Nausea and Vomiting from the Perspective of “Zhongqi - Gut Microbiota - Brain - Gut Axis”

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common adverse reactions in cancer patients during chemotherapy, which seriously affects patients’ quality of life and treatment compliance. Based on the traditional Chinese medicine (TCM) theory of “Zhongqi regulation and mediation”, this article aims to systematically explore the pathogenesis of CINV by combining with modern research on gut microbiota. As an exogenous “toxic pathogen”, chemotherapeutic drugs first attack the spleen and stomach, easily causing damage to Zhongqi, dysfunction of its regulation, disturbance of Qi movement (ascending and descending), and confusion between clarity and turbidity, thus leading to nausea and vomiting. Modern studies have shown that chemotherapy can lead to disorders in the structure of gut microbiota, decreased diversity, and abnormal metabolic functions. Such dysbiosis participates in the occurrence and development of CINV through multiple pathways, such as disrupting the intestinal barrier, activating immune-inflammatory responses, and interfering with gut-brain axis communication. This article proposes that the dysfunction of “Zhongqi regulation and mediation” may be the core TCM pathogenesis of CINV, while gut microbiota dysbiosis is an important pathological basis and mediating factor of this pathogenesis at the modern biological level. These two interact with each other and together form the complex pathological network of CINV through the gut-brain axis. This study attempts to provide a theoretical basis and new research ideas for the prevention and treatment of CINV from the perspective of “regulating Zhongqi and harmonizing gut microbiota” based on the “Zhongqi - gut microbiota - gut-brain axis” framework.