肿瘤耐药性产生机制及中药逆转作用的研究进展  

Mechanism of Cancer Drug Resistance and Reversal Effect of Chinese Medicine:A Review

作　　者：黄惠铭 杨爱琳 田颖颖 刘亚鑫 欧阳里山 屠鹏飞[1] 胡仲冬 HUANG Hui-ming;YANG Ai-lin;TIAN Ying-ying;LIU Ya-xin;OUYANG Li-shan;TU Peng-fei;HU Zhong-dong(Modern Research Center for Traditional Chinese Medicine,School of Chinese Materia Medica,Beijing University of Chinese Medicine,Beijing 100029,China;School of Pharmacy,Binzhou Medical University,Yantai 264003,China)

机构地区：[1]北京中医药大学中药学院中药现代研究中心,北京100029 [2]滨州医学院药学院,山东烟台264003

出　　处：《中国实验方剂学杂志》2022年第1期92-99,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：北京市科技新星计划项目(Z191100001119083);中华中医药学会青年人才托举工程项目[CACM-2018-(QNRC2-B05)]。

摘　　要：恶性肿瘤严重危害人类生命和健康,我国癌症发病率和死亡率逐年上升,攻克肿瘤一直以来都是人类生存的一大难题。化学药物和分子靶向治疗是抗肿瘤临床通用方案,也是首选方案之一,此类药物靶标明确、疗效好,但不良反应大,且肿瘤细胞常常产生耐药性阻碍药效的发挥,从而使肿瘤治疗变得困难,故研究耐药性的产生机制及如何逆转耐药性具有重要的意义。聚焦中药,多年研究发现,其拥有成分复杂、靶点繁多、方组内药味相辅相成、毒性小等居多特点,大量实验研究证明,中药有效成分或其提取部位能够明显抑制肿瘤细胞增殖、迁移、侵袭,诱导其凋亡、自噬、分化、衰老等。临床上已将中药运用于肿瘤的防护、辅助治疗、后期巩固等,中药研究将为逆转肿瘤细胞耐药性及抑制肿瘤细胞开启不一样的新篇章。已有研究表明,中药与化疗药物联用可逆转肿瘤细胞耐药性,增加化疗药物疗效,现已成为肿瘤治疗的主流趋势。此文就肿瘤细胞由保护性自噬、基因突变、酶系的过高表达、信号通路异常、核糖核酸和相关蛋白表达异常等所产生的耐药性机制,以及从中药中分离出的单体成分、单药或其提取部位及经典抗癌名方逆转肿瘤细胞耐药性的机制进行综述,为进一步研究中药抗肿瘤作用奠定基础。Malignant tumor is a serious threat to human life and health. The prevalence and mortality of malignancies in China are increasing year by year. Conquering cancer has become a difficult problem for human beings. Chemical drug therapy combined with molecular targeted therapy is a general and preferred anti-tumor clinical scheme,but the side effects and the drug resistance of cancer cells often hinder the efficacy. Therefore,it is of great significance to study the mechanism of drug resistance and the methods to reverse drug resistance.Chinese medicine has the characteristics of complex components,multiple targets,low toxicity,etc. A large number of experimental studies have demonstrated that the effective components or extracts of Chinese medicine can inhibit the proliferation, migration, and invasion of cancer cells, and induce apoptosis, autophagy,differentiation,and senescence. In clinical practice,Chinese medicine has been applied to the protection against ttumor,adjuvant treatment,and later consolidation. The research on Chinese medicine is expected to promote drug resistance reversal and cancer therapy. Studies have shown that the combination of Chinese medicine and chemotherapy can reverse drug resistance and increase efficacy,which has become the mainstream trend of cancer treatment. This study reviewed the mechanisms of the drug resistance of cancer cells induced by selfprotective autophagy,gene mutation,high expression of enzymes,abnormal signaling pathways,and abnormal expression of RNA and protein,and summarized how compounds isolated from Chinese medicine,single drug and its extract,and classic anti-cancer prescription reversed the drug resistance to lay a solid foundation for the further investigation of the anti-tumor effect of Chinese medicine.

关 键 词：肿瘤 逆转耐药性 中药 作用机制 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]