肺癌是全球癌症相关死亡的首要原因，其发病率与病死率均居高不下，严重威胁人类健康。自噬作为细胞内重要的降解与清除机制，在肺癌发展进程中呈现显著的“双面性”特征——既能够抑制肿瘤的发生与早期发展，又可在肿瘤进展阶段促进肿瘤细胞存活、抵御外界应激。研究表明，多种中药活性成分（如穿心莲内酯、黄芩素、大黄素等）可通过调控雷帕霉素靶蛋白（m TOR）、丝裂原活化蛋白激酶（MAPK）、腺苷酸活化蛋白激酶（AMPK）等关键信号通路，精准调控肺癌细胞自噬水平，平衡其“双面性”，在抗肺癌治疗中展现出巨大潜力。此外，中药活性成分与化疗药物（如吉西他滨、贝伐珠单抗、顺铂等）联用，可通过抑制肿瘤细胞保护性自噬以减少化疗耐药，或促进肿瘤细胞自噬性死亡以增强其对药物的敏感性，进而提升化疗药物的抗肿瘤效力并减轻其不良反应；与纳米材料联用则可实现中药活性成分的靶向递送，精准调控自噬通路，同时提高其生物利用度，在抗肺癌治疗中展现出良好应用前景。系统综述中药活性成分通过调控自噬发挥抗肺癌作用、协同减弱化疗药物耐药性的相关研究及作用机制，并探讨纳米材料在中药活性成分调控自噬抗肺癌中的应用前景，旨在为肺癌综合治疗提供兼具传统医学智慧与现代科学依据的新策略。

Lung cancer is the leading cause of cancer-related deaths worldwide, with persistently high incidence and mortality rates, posing a serious threat to human health. Autophagy, as an important intracellular degradation and clearance mechanism, exhibits a significant “dual nature” in the development of lung cancer——it can both inhibit tumor occurrence and early development, and promote tumor cell survival and resistance to external stress in the tumor progression stage. Studies have shown that various active components of traditional Chinese medicine(such as andrographolide, baicalein, emodin, etc.) can precisely regulate the autophagy level of lung cancer cells by modulating key signaling pathways such as mammalian target of rapamycin(mTOR), mitogen-activated protein kinase(MAPK), and adenosine monophosphate-activated protein kinase(AMPK), balancing its “dual nature”, and demonstrating great potential in anti-lung cancer treatment. In addition, the combination of active components of traditional Chinese medicine with chemotherapy drugs(such as gemcitabine, bevacizumab, cisplatin, etc.) can reduce chemotherapy resistance by inhibiting protective autophagy in tumor cells or enhance the sensitivity of tumor cells to drugs by promoting autophagic cell death, thereby enhancing the anti-tumor efficacy of chemotherapy drugs and reducing their adverse reactions; the combination with nanomaterials can achieve targeted delivery of active components of traditional Chinese medicine, precisely regulate autophagy pathways, and simultaneously improve their bioavailability, showing good application prospects in anti-lung cancer treatment. This paper systematically reviews the research and mechanisms of action of active components of traditional Chinese medicine in regulating autophagy to exert anti-lung cancer effects and synergistically reduce chemotherapy drug resistance, and discusses the application prospects of nanomaterials in regulating autophagy by active components of traditional Chinese medicine in anti-lung cancer treatment, aiming to provide new strategies for comprehensive treatment of lung cancer that integrate traditional medical wisdom and modern scientific evidence..

R285.5

中央本级重大增减支项目(2060302-2101-11); 江西省教育厅科学技术研究项目(GJJ2400806); 江西中医药大学博士科研启动基金项目(2024BSZR014)