肿瘤的发生、发展和侵袭伴随着肿瘤免疫抑制微环境的形成。肿瘤免疫微环境呈现低免疫细胞浸润、高免疫抑制细胞分布、低pH和高乳酸水平等特征，这些特殊的理化属性既能维持肿瘤正常的发生、发展和侵袭，又能导致肿瘤细胞对临床治疗的抵抗。中草药细胞外囊泡是近年新兴的一类天然活性物质，源自中药鲜汁液或煎煮液。其组成包含脂质、蛋白质、核酸及小分子活性物等，呈球状纳米形态。近年来研究表明，中草药细胞外囊泡在肿瘤防治中的应用前景广阔，其优势在于能多靶点调节肿瘤免疫抑制微环境，激活免疫应答，改善抗肿瘤免疫反应。探究不同的中草药细胞外囊泡调节肿瘤免疫微环境的机制可以为肿瘤的免疫疗法提供新的方向和思路。综述近10年来中草药细胞外囊泡通过调控肿瘤免疫抑制微环境来阻滞肿瘤生长的机制，为中草药细胞外囊泡在肿瘤治疗中的应用提供新的方向。

The formation of the tumor immunosuppressive microenvironment accompanies the occurrence, development and invasion of tumors. The tumor immune microenvironment exhibits characteristics such as low immune cell infiltration, high distribution of immunosuppressive cells, a low pH, and high levels of lactic acid. These special physicochemical properties not only maintain the regular occurrence, development, and invasion of tumors but also lead to the resistance of tumor cells to clinical treatment. Extracellular vesicles of Chinese herbal medicine are a new type of natural active substance that has emerged in recent years, derived from the fresh juice or decoction of traditional Chinese medicine. Its composition includes lipids, proteins, nucleic acids, and small-molecule active substances, and it is in a spherical nanoscale morpholog. Studies from the past decade have demonstrated that extracellular vesicles derived from Chinese herbal medicine have broad application prospects in the prevention and treatment of tumors. Their advantages lie in their ability to regulate the tumor’s immunosuppressive microenvironment at multiple targets, activate the immune response, and enhance the anti-tumor immune response. Exploring the mechanisms by which different extracellular vesicles from Chinese herbal medicines regulate the tumor immune microenvironment can provide new directions and insights for tumor immunotherapy. This article reviews the mechanism by which extracellular vesicles from Chinese herbal medicines regulate the tumor immunosuppressive microenvironment and inhibit tumor growth over the past decade, providing a new direction for the application of extracellular vesicles from Chinese herbal medicines in tumor treatment.

R914；R285

国家重大人才工程青年项目；国家自然科学基金项目（82274104，82074024，82374042）；中药制药过程控制与智能制造技术国家重点实验室创新项目（NZYSKL240103）；江苏省优秀青年基金项目（BK20240144）；南京中医药大学优青培育项目（RC202407）；大学生创新创业项目（202210315056Y，202310315055Z）