结直肠癌是临床常见的恶性肿瘤，其发病率和死亡率分别位居所有恶性肿瘤的第3位与第2位。随着我国居民饮食结构的改变，结直肠癌发病率呈持续上升趋势。肿瘤微环境（TME）是肿瘤细胞赖以生存的复杂内环境，免疫细胞作为其关键组成部分，直接决定机体免疫系统对肿瘤细胞的识别与清除能力，在结直肠癌的发生发展、侵袭转移及免疫逃逸过程中发挥着核心调控作用。中医药凭借多成分、多靶点、多通路的整体调节优势，在调控结直肠癌免疫微环境方面展现出独特的应用潜力。研究表明，多糖类、黄酮类、皂苷类等中药活性成分，以及四君子汤、痛泻要方、参苓白术散等经典复方，可通过调控肿瘤相关巨噬细胞（TAMs）、T淋巴细胞、自然杀伤细胞（NK）、树突状细胞（DCs）、髓源性抑制细胞（MDSCs）等关键免疫细胞功能，改善结直肠癌的免疫抑制状态，进而抑制肿瘤进展。系统综述近年来中药活性成分及复方通过调控免疫细胞干预结直肠癌的分子机制研究进展，以期为结直肠癌免疫治疗策略的优化提供新的思路与实验参考。

Colorectal cancer is a common malignant tumor in clinical practice, with its incidence and mortality ranking third and second among all malignant tumors respectively. With the change in dietary structure of Chinese residents, the incidence of colorectal cancer has been continuously increasing. The tumor microenvironment(TME) is a complex internal environment in which tumor cells survive, and immune cells, as its key components, directly determine the ability of the body's immune system to recognize and eliminate tumor cells. In the process of the occurrence, development, invasion, metastasis, and immune escape of colorectal cancer, the TME plays a core regulatory role. Traditional Chinese medicine, with its overall regulatory advantages of multiple components, multiple targets, and multiple pathways, shows unique application potential in regulating the immune microenvironment of colorectal cancer. Studies have shown that active components of traditional Chinese medicine such as polysaccharides, flavonoids, and saponins, as well as classic formulas such as Sijunzhi Decoction, Tongxieyaofang, and Shenling Baizhu Powder, can regulate the functions of key immune cells such as tumor-associated macrophages(TAMs), T lymphocytes, natural killer cells(NK), dendritic cells(DCs), and myeloid-derived suppressor cells(MDSCs), thereby improving the immunosuppressive state of colorectal cancer and inhibiting tumor progression. This systematic review summarizes the research progress in the molecular mechanisms of traditional Chinese medicine active components and formulas regulating immune cells in the intervention of colorectal cancer in recent years, with the aim of providing new ideas and experimental references for the optimization of immunotherapy strategies for colorectal cancer.

R285.5

国家自然科学基金资助项目(82204981); 河南省特色骨干学科中医学学科建设项目(STG-ZYX06-202145); 河南省中医药科学研究专项课题(2021JDZX2002);河南省中医药科学研究专项课题(20-21ZY2115); 河南省中医院博士科研基金资助项目(2022BSJJ07);河南省中医院博士科研基金资助项目(2023BSJJ02); 河南中医药大学2024年度研究生社会调研类项目(2024SHDY011); 河南中医药大学研究生科研创新项目(2022KYCX057)