中药逆转消化道肿瘤耐药微环境的机制研究进展

Research progress on mechanism of Chinese medicine reversing drug resistant microenvironment of gastrointestinal tumor

消化道肿瘤是常见的恶性肿瘤之一,其发病率高、复发转移率高、药物选择局限、治疗效果不佳等特点给临床医生和患者带来困扰。目前消化道肿瘤以化疗、靶向治疗为主,近几年来免疫治疗的出现也让消化道肿瘤治疗看到了曙光。但有限的药物选择中,药物耐药的发生常常是肿瘤患者治疗失败的重要原因之一,其机制是一个复杂的过程。肿瘤细胞的生长、增殖、转移及免疫逃逸和肿瘤微环境的改变密切相关,而中药的多靶点、价格低廉和不良反应相对较少的优点也为逆转肿瘤微环境耐药提供更多治疗选择。目前运用现代医学手段,从耐药细胞的摸索到动物模型的建立,中药逆转治疗耐药的研究均取得了很多进步。本文通过对国内外相关文献的查阅、分析,从实验研究出发,着重选择中药抑制跨膜蛋白介导、影响酶系统和促进凋亡通路的激活这三个方面,总结分析和详细介绍中药逆转消化道肿瘤机制。随着学科间的互相合作,寻找具有中医特色且适合临床的多药耐药逆转剂,可以为消化道肿瘤患者提供新的治疗思路和策略,也为中医药的推广提供依据。

The gastrointestinal tumor is one of the common malignant tumors.It makes trouble to clinicians and patients about high incidence,high recurrent metastasis,limited to drug selection,and poor treatment effects.At present,the primary therapeutic method of digestive tumor is chemotherapy and targeted.In recent years,the emergence of immunotherapy also allows the treatment of gastrointestinal tumor is needed urgently.However,with the limited drug selection,the occurrence of drug resistance is one of the important reasons for the treatment failure of tumor patients,and its mechanism is a complex process.The growth,proliferation,metastasis,and immune escape and changes of tumor cell in tumor microenvironment are closely related.The multi-target point of traditional Chinese medicine,low price,and relatively few adverse reactions are also reversed tumor micro-environmental resistance to provide more treatment options.At present,there is a modern medical means to establish a lot of progress in the exploitation of drug-resistant cells to the establishment of animal models.Through consultation and analysis of relevant literature at home and abroad,this paper has been analyzed from experimental research,and the three aspects of Chinese medicine inhibiting transmembrane protein-mediated,affecting the enzyme system and promoting apoptosis pathway,summarizing the analysis and detailed introduction Chinese medicine reversal digestive tract tumor mechanism.With the mutual cooperation between the discipline,find a new treatment ideas and strategies for patients with traditional Chinese medicine,providing new treatment ideas and strategies fordigestive tract tumors,and provides basis for the promotion of traditional Chinese medicine.