胰腺癌作为全球范围内恶性程度高、预后极差的消化道肿瘤，其发病率与死亡率呈逐年攀升趋势。当前西医治疗虽在抑制肿瘤生长、缓解患者症状及延缓病情进展方面具有一定效果，但仍受限于不良反应显著、易诱发耐药性及患者生存率偏低等问题，导致整体抗胰腺癌疗效难以达到理想目标，因此探寻兼具高效性与低毒性的治疗方案已成为胰腺癌领域的研究重点。腺苷酸活化蛋白激酶（AMPK）信号通路在调控胰腺癌细胞增殖、凋亡、自噬及代谢重编程等生物学过程中发挥关键作用，是抗胰腺癌药物研发的重要作用靶点。中医药凭借多途径、多机制协同的抗胰腺癌效应，已成为当前胰腺癌综合治疗体系的重要组成部分，其中中药单体因具有结构明确、作用机制清晰及多靶点协同调控等特性，在抗胰腺癌研究中展现出良好应用潜力。已有研究证实，黄酮类、生物碱类、多酚类、皂苷类等成分可通过调控AMPK通路及其上下游相关因子，诱导胰腺癌细胞自噬与凋亡、抑制细胞糖酵解、逆转化疗耐药性、促进细胞铁死亡并抑制上皮-间质转化（EMT），进而有效阻滞胰腺癌进展。系统梳理并总结近年来中药单体成分抗胰腺癌的相关研究成果，重点剖析其通过AMPK信号通路发挥抗胰腺癌作用的具体机制，以期为胰腺癌的临床治疗及抗胰腺癌新药研发提供理论依据与参考。

Pancreatic cancer, as a highly malignant and poorly prognostic gastrointestinal tumor, has shown an increasing trend in both incidence and mortality rates globally. Although current western medical treatments can effectively inhibit tumor growth, alleviate patient symptoms, and delay disease progression, they remain limited by significant toxic side effects, a tendency to induce drug resistance, and low patient survival rates, making it difficult to achieve ideal therapeutic outcomes against pancreatic cancer. Therefore, exploring treatment regimens that combine high efficacy with low toxicity has become a key research focus in the field of pancreatic cancer. The adenosine monophosphate-activated protein kinase (AMPK) signaling pathway plays a critical role in regulating biological processes such as pancreatic cancer cell proliferation, apoptosis, autophagy, and metabolic reprogramming, serving as an important therapeutic target for anti-pancreatic cancer drug development. Traditional Chinese medicine (TCM) has emerged as a vital component of the comprehensive treatment system for pancreatic cancer due to its multi-pathway and multi-mechanism synergistic effects. TCM monomers, with their well-defined structures, clear mechanisms of action, and multi-target synergistic regulation, have demonstrated promising potential in anti-pancreatic cancer research. Existing studies have confirmed that flavonoids, alkaloids, polyphenols, saponins, and other compounds can modulate the AMPK pathway and its upstream/downstream factors, inducing autophagy and apoptosis in pancreatic cancer cells, inhibiting glycolysis, reversing chemotherapy resistance, promoting ferroptosis, and suppressing epithelial-mesenchymal transition, thereby effectively halting pancreatic cancer progression. Based on this, this paper systematically reviews and summarizes recent research findings on TCM’s anti-pancreatic cancer effects, with a focus on analyzing the specific mechanisms through which TCM exerts its anti-pancreatic cancer effects via the AMPK signaling pathway, aiming to provide theoretical foundations and references for TCM clinical treatment and the development of new anti-pancreatic cancer drugs.

R979.1

国家自然科学基金资助项目（82305074）；国家中医药管理局中国中医药科技发展中心联合研究项目（CXZH202304）；国家中医药管理局中医药循证能力提升项目（2019XZZX-XH005）；河南省中医药传承与创新人才工程（仲景工程）中医药学科领军人才项目（豫卫中医函[2021]08号）；2022年度河南省重点研发与推广专项（科技攻关）支持项目（222102310240）；河南省中医药科学研究专项（2023ZY2074）