结直肠癌是全球范围内发病率和死亡率均居前列的消化道恶性肿瘤，其发生、发展与肿瘤细胞代谢重塑进程密切相关。糖代谢重编程作为肿瘤最显著的代谢特征之一，核心表现为肿瘤细胞葡萄糖摄取能力提升、糖酵解通路异常激活，不仅为肿瘤细胞快速增殖提供能量和生物合成原料，还参与调控肿瘤侵袭转移、微环境重塑、治疗耐受等关键生物学过程。近年来，大量研究证实，中药活性成分、提取物及复方可通过调控葡萄糖转运蛋白、糖代谢关键酶、相关转录因子及信号通路，干预结直肠癌糖代谢重编程机制，发挥抑制肿瘤增殖、逆转治疗耐受、延缓肿瘤复发转移的抗肿瘤作用。从糖代谢重编程与结直肠癌发生、发展的内在关联出发，系统总结中药活性成分、中药提取物及复方通过靶向糖代谢途径抗结直肠癌的研究成果，以期为中药临床治疗结直肠癌提供理论依据与实践思路。

Colorectal cancer (CRC) is one of the most common and deadly gastrointestinal malignancies worldwide, with its development closely linked to metabolic reprogramming in tumor cells. Glycolytic reprogramming, one of the most prominent metabolic hallmarks of cancer, is characterized by enhanced glucose uptake and aberrant activation of glycolytic pathways. This not only provides energy and biosynthetic precursors for rapid tumor cell proliferation but also plays a critical role in regulating key biological processes such as tumor invasion, metastasis, microenvironment remodeling, and therapeutic resistance. In recent years, numerous studies have demonstrated that active components, extracts, and traditional Chinese medicine (TCM) formulas can modulate glucose transporters, key enzymes in glucose metabolism, related transcription factors, and signaling pathways, thereby interfering with the metabolic reprogramming mechanisms in CRC and exerting anti-tumor effects including inhibition of tumor growth, reversal of drug resistance, and delay of tumor recurrence and metastasis. Based on the intrinsic connection between metabolic reprogramming and CRC pathogenesis, this review systematically summarizes current research on TCM active ingredients, extracts, and Form targeting glucose metabolism pathways to combat CRC, aiming to provide theoretical foundations and practical insights for the clinical application of TCM in CRC treatment.

R285.5

国家中医药管理局“张仲景传承与创新专项”（GZY-KJS-2022-041-1）；国家中医临床研究基地项目（2021JDZX2003）；河南省中医药科学研究专项（2023ZY2071）；河南中医药学科领军人才项目（豫卫中医函〔2021〕8号）；河南省重点研发与推广专项（科技攻关）（232102310280）