胶质瘤是中枢神经系统常见的原发性恶性肿瘤，由于肿瘤的高浸润性及血脑屏障的限制，临床现有疗法疗效常不理想，患者面临高复发率与耐药性的严峻挑战。磷脂酰肌醇3-激酶/蛋白激酶B（PI3K/Akt）通路作为调控细胞增殖、代谢与存活的核心枢纽，在胶质瘤恶性进展及治疗抵抗中起关键作用，是重要的抗肿瘤靶点。中医药在防治胶质瘤中展现与“君、臣、佐、使”配伍原则一致的多成分、多靶点协同优势。单味药活性成分如黄酮类、皂苷类、生物碱类等可通过调控PI3K/Akt通路，诱导凋亡与自噬，阻滞细胞周期，逆转耐药，抑制上皮-间质转化（EMT）并改善免疫微环境。中药复方如蛇枝黄芩汤、抗瘤丸、西黄丸等通过多味药材协同作用于PI3K/Akt通路，以阻滞细胞周期、抑制EMT、改善免疫微环境。中西医结合应用中，穿心莲内酯、土贝母苷甲、参芪扶正注射液等可与现代疗法联合使用抑制PI3K/Akt信号通路以逆转EMT，抑制侵袭迁移、逆转化疗耐药和增效减毒。系统梳理总结中医药通过干预PI3K/Akt信号通路抗胶质瘤的最新研究进展，旨在为中西医结合治疗与中药新药研发提供理论依据与思路参考。

Glioma is a common primary malignant tumor in the central nervous system. Due to the high invasiveness of the tumor and the limitation of the blood-brain barrier, the current clinical therapies often have unsatisfactory efficacy, and patients face the severe challenges of high recurrence rate and drug resistance. The phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathway, as the core hub regulating cell proliferation, metabolism and survival, plays a crucial role in the malignant progression and treatment resistance of glioma, and is an important anti-tumor target. Traditional Chinese medicine demonstrates a multi-component, multi-target synergistic advantage in the prevention and treatment of glioma, consistent with the “king, minister, assistant and messenger” principle of compatibility. Active components of single herbs such as flavonoids, saponins, and alkaloids can regulate the PI3K/Akt pathway, induce apoptosis and autophagy, block the cell cycle, reverse drug resistance, inhibit epithelial-mesenchymal transition and improve the immune microenvironment. Chinese herbal compound formulas such as Shezhi Huangqin Decoction, Anti-tumor Pills, and Xihuang Pills exert their effects by the synergistic action of multiple herbs on the PI3K/Akt pathway, thereby blocking the cell cycle, inhibiting epithelial-mesenchymal transition, and improving the immune microenvironment. In the combination application of traditional and modern medicine, compounds such as andrographolide, tuberiginum glycoside I, and Shenqi Fuzheng Injection can be used in combination with modern therapies to inhibit the PI3K/Akt signaling pathway to reverse EMT, inhibit invasion and migration, reverse drug resistance, and enhance efficacy and reduce toxicity. This article systematically reviews and summarizes the latest research progress of traditional Chinese medicine in anti-glioma by interfering with the PI3K/Akt signaling pathway, aiming to provide theoretical basis and reference ideas for the combination of traditional and modern medicine treatment and new drug development.

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河南省第三批中医药青苗人才项目（豫卫中医药科教[2024]4号）；国家中医药管理局第六批全国老中医药专家学术经验继承工作（国中医药人教发[2017]29号）；全国名老中医药专家传承工作室建设项目（国中医药人教函[2022]75号）