消化道肿瘤主要包括肝癌、胃癌、结直肠癌等，因其发病率与死亡率较高、预后不良，已严重威胁人类的身心健康。现代医学在治疗消化道肿瘤时，仍面临易复发转移、消化道反应明显、耐药性等诸多挑战，导致整体治疗效果欠佳，亟需寻找更高效、更安全的治疗策略。神经源性位点缺口同源蛋白（Notch）信号通路在调控消化道肿瘤细胞的增殖、分化和迁移等方面有重要作用，并持续参与肿瘤的发生发展，因而被视为抗消化道肿瘤治疗的重要靶点。中医药具有多途径、多机制、多通路的抗肿瘤特点，且不良反应小、优势显著，已成为当前消化道肿瘤综合治疗的重要手段之一。研究表明，中药活性成分如萜类、醌类、黄酮类等，以及中药复方如消癌解毒方、调脾安肠方、鳖甲煎丸等可通过调控Notch及相关信号通路，诱导细胞凋亡、抑制增殖侵袭与转移、阻滞细胞周期、抑制肿瘤干细胞与血管生成、逆转上皮-间质转化（EMT）和细胞耐药性等多种途径，发挥抗消化道肿瘤效应。对近年来中药活性成分及中药复方调控Notch信号通路的作用机制进行梳理总结，以期为临床抗消化道肿瘤新药的研发提供新的思路与参考。

Gastrointestinal tumors, primarily including hepatocellular carcinoma, gastric cancer, and colorectal cancer, are associated with high incidence and mortality rates as well as poor prognosis, thereby posing a severe threat to human physical and mental health. In the treatment of gastrointestinal tumors, modern medicine still faces multiple challenges, including high rates of recurrence and metastasis, prominent gastrointestinal adverse reactions, and drug resistance. These limitations result in unsatisfactory overall therapeutic efficacy and highlight the urgent need to explore more effective and safer treatment strategies. The Notch signaling pathway plays a critical role in regulating the proliferation, differentiation, and migration of gastrointestinal tumor cells and remains continuously involved in tumor initiation and progression, thus serving as an important target for anti-gastrointestinal tumor therapy. Traditional Chinese medicine possesses multi-pathway, multi-mechanism, and multi-target anti-tumor properties with minimal adverse effects and distinct advantages, and has become one of the key modalities in the comprehensive treatment of gastrointestinal tumors. Studies have demonstrated that active constituents of traditional Chinese medicine, including terpenoids, quinones, and flavonoids, as well as compound formulas such as Xiaoaijiedu Formula, Tiaopi Anchang Formula, and Biejia Jianwan, can exert anti-gastrointestinal tumor effects by modulating the Notch signaling pathway and related cascades. These effects are achieved through multiple mechanisms, including induction of cell apoptosis, inhibition of proliferation, invasion and metastasis, cell cycle arrest, suppression of tumor stem cells and angiogenesis, and reversal of epithelial-mesenchymal transition and drug resistance. This article systematically reviews and summarizes recent research on traditional Chinese medicine for gastrointestinal tumors. It focuses on the mechanisms by which active ingredients and compound formulas of traditional Chinese medicine regulate the Notch signaling pathway, aiming to provide new insights and references for the research and development of novel anti-gastrointestinal tumor agents.

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河南省科技攻关项目（262102311240）；河南省第三批中医药学科拔尖人才项目（豫卫中医药科教函〔2025〕14号）；河南省中医药科学研究专项课题（2025ZY2014）；河南省中医药科学研究专项课题（2023ZY2103）；河南省中医药科学研究专项课题（2022ZY2027）