中医药调控p53信号通路治疗结直肠癌的研究进展

Research advances in traditional Chinese medicine for colorectal cancer treatment via the p53 signaling pathway

关键词:  中医药  p53信号通路  结直肠癌  研究进展

Key words:  traditional Chinese medicine  p53 signaling pathway  colorectal cancer  research advance

摘要:

结直肠癌发病率和病死率逐年攀升，预后普遍较差，严重威胁人类健康。现有手术、放射治疗、化学治疗等常规治疗虽然可以在一定程度上控制病情，但仍然存在复发转移率高、不良反应多及耐药等问题，整体疗效不理想，亟需开发更加安全高效的新型治疗策略。p53信号通路在调控结直肠癌细胞的增殖、分化、凋亡及自噬等方面发挥重要作用，是抗癌治疗的关键靶点。中医药凭借多靶点、多层次、多通路的协同作用，在防治结直肠癌方面展现出独特优势，能够降低复发与转移风险，缓解放射治疗、化学治疗相关毒副反应，并改善患者生存质量。研究表明，生物碱类、黄酮类、皂苷类、多酚类、萜类等中药活性成分，以及健脾化瘀汤、补肾解毒散结方、复方浙贝颗粒等复方，均可以通过调控p53及其相关信号通路发挥抗结直肠癌作用。其机制包括诱导凋亡和自噬、阻滞细胞周期、改善肿瘤免疫微环境、逆转耐药性等。文章系统总结了近年来中医药调控p53信号通路治疗结直肠癌的研究进展，以期为新型抗结直肠癌药物的研发与临床应用提供参考。

Abstract:

The incidence and mortality of colorectal cancer are increasing annually，and its overall prognosis remains poor，posing a serious threat to human health. Although conventional treatments such as surgery， radiotherapy，and chemotherapy can control disease progression to some extent，they are limited by high recurrence and metastasis rates，adverse effects，and drug resistance，resulting in unsatisfactory therapeutic outcomes. Therefore，the development of safer and more effective therapeutic strategies is urgently needed. The p53 signaling pathway plays a pivotal role in regulating proliferation，differentiation，apoptosis，and autophagy of CRC cells and is considered a crucial target for anticancer therapy. Traditional Chinese medicine，with its multi-target，multi-level， and multi-pathway synergistic mechanisms，exhibits unique advantages in CRC prevention and treatment，including reducing recurrence and metastasis risk，alleviating chemoradiotherapy-induced toxicity，and improving patients’ quality of life. Studies have demonstrated that bioactive components such as alkaloids，flavonoids，saponins， polyphenols，and terpenoids，as well as herbal formulations including Jianpi Huayu Decoction，Bushen Jiedu Sanjie Formula，and Compound Zhejiang Fritillaria Granules，can exert anti-CRC effects by modulating p53 and its associated signaling pathways. The underlying mechanisms involve inducing apoptosis and autophagy，arresting the cell cycle，remodeling the tumor immune microenvironment，and reversing drug resistance. The review systematically summarizes recent advances in traditional Chinese medicine-mediated regulation of the p53 signaling pathway in CRC，aiming to provide insights and references for the development of novel anticancer agents and clinical applications.