Progress in traditional Chinese medicine for chemotherapy-induced nausea and vomiting, based on the theory of "Fuzheng Quxie" and "Hewei Jiangni".

Chemotherapy-induced nausea and vomiting (CINV) is among the most prevalent adverse reactions in cancer treatment. It significantly diminishes the quality of life of patients and their treatment compliance. Traditional Chinese medicine (TCM) exhibits unique characteristics and potential for the prevention and treatment of CINV. This review summarizes the latest research progress on TCM for CINV, encompassing the theoretical foundation, mechanism of action, and clinical evidence. "Fuzheng Quxie" formulas (reinforcing healthy Qi and eliminating pathogenic factors) and herbs (e.g., Liu-Jun-Zi-Tang, ginseng) enhance the body's tolerance to chemotherapy by enhancing immunity, reducing inflammation and oxidative damage, and promoting tissue repair. "Hewei Jiangni" formulas (harmonizing the stomach and directing rebellious Qi downward), including Xiao-Ban-Xia-Tang, ginger, and external therapies (e.g., acupuncture, moxibustion, acupoint application) directly alleviate nausea and vomiting by regulating gastrointestinal motility, antagonizing emesis-related receptors, and inhibiting inflammatory pathways. Clinical research shows that combining TCM with conventional antiemetic regimens improves the control of delayed CINV and enhances patients' quality of life, while maintaining a favorable safety profile. However, current evidence remains limited by small sample sizes, insufficient mechanistic investigations, and lack of standardized treatment plans. Future research should prioritize high-quality and large-sample clinical trials and clarify its mechanism of action using modern scientific approaches, so as to promote the standardized and efficient application of TCM for the prevention and treatment of CINV.