乳腺癌已成为女性发病率最高的肿瘤，近年来发病人数呈逐年上升的趋势。组蛋白乙酰化是重要的表观遗传修饰之一，研究发现在乳腺癌病理进程中常伴随组蛋白乙酰化酶（histone acetyltransferases，HATs）与组蛋白去乙酰化酶（histone deacetylases，HDACs）的表达失衡，通过动态调控染色质结构和基因转录活性参与乳腺癌的发生发展。中医药在乳腺癌治疗中具有多成分、多靶点的特点，显示出独特的治疗优势。研究表明萜类、酚类、黄酮类、多糖类等中药单体、中药及复方能够通过调控HATs和HDACs的表达水平，逆转组蛋白乙酰化异常，进而诱导肿瘤细胞凋亡或焦亡，抑制乳腺癌细胞增殖、侵袭和转移。基于目前国内外研究现状，对中药活性成分、中药及复方调节组蛋白乙酰化水平从不同途径发挥抗乳腺癌作用的机制进行综述，以期为乳腺癌药物的研发和应用提供理论依据。

Breast cancer has emerged as the most prevalent malignancy among women, with its incidence showing an annual upward trend in recent years. Histone acetylation, a crucial epigenetic modification, has been found to participate in the pathogenesis and progression of breast cancer through dynamic regulation of chromatin structure and gene transcription activity, primarily mediated by the expression imbalance between histone acetyltransferases (HATs) and histone deacetylases (HDACs) during pathological processes. Traditional Chinese medicine (TCM) demonstrates unique therapeutic advantages in breast cancer treatment through its characteristics of multiple components and multiple targets. Studies have revealed that various TCM monomers, TCMs, and compound formulations containing terpenoids, phenols, flavonoids, and polysaccharides can regulate HAT and HDAC expression levels, thereby reversing aberrant histone acetylation patterns. These mechanisms ultimately induce tumor cell apoptosis or pyroptosis while inhibiting proliferation, invasion, and metastasis of breast cancer cells. This review systematically summarizes current research progress regarding the mechanisms by which TCM active components, TCMs and compound formulations exert anti-breast cancer effects through histone acetylation regulation across multiple pathways. The findings aim to provide theoretical foundations for the research and development and application of breast cancer drugs.

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河南省科技研发计划联合基金（优势学科培育类）重点项目（222301420024）；河南省科技攻关项目（242102310582）；河南省博士后科研项目（202103092）