结直肠癌作为全球高发的消化道恶性肿瘤，其发病率占世界排名前列。代谢重编程是结直肠癌的关键特征之一，涉及糖、脂质、氨基酸代谢的异常重构，并受磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白、缺氧诱导因子-1α、Myc原癌基因等信号通路精密调控。近年来，靶向代谢重编程已成为结直肠癌治疗的新兴策略。然而，化学药单靶点抑制剂面临耐药性等挑战。中医药在干预结直肠癌代谢重编程方面展现出多成分、多靶点的独特优势。在简要概述结直肠癌代谢重编程核心机制的基础上，重点系统综述了中药有效成分（小檗碱、人参皂苷、汉黄芩素等）及复方制剂（黄芩汤、乌梅丸等）通过调控关键代谢酶与信号通路，逆转Warburg效应、抑制脂肪酸从头合成、干预氨基酸代谢等，从而抑制结直肠癌进展的作用机制，为中医药防治结直肠癌提供新的研究思路和理论依据。

Colorectal cancer (CRC) is a highly prevalent malignant tumor of the digestive tract globally, ranking among the top in terms of incidence worldwide. Metabolic reprogramming is a key hallmark of CRC, involving the abnormal remodeling of glucose, lipid, and amino acid metabolism, which is precisely regulated by signaling pathways such as phosphatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin, hypoxia inducible factor-1α, and c-Myc. In recent years, targeting metabolic reprogramming has emerged as a novel strategy for CRC treatment. However, single-target chemical inhibitors face challenges like drug resistance. Traditional Chinese medicine (TCM) demonstrates unique advantages in intervening in CRC metabolic reprogramming through its multi-component and multi-target characteristics. Based on a brief overview of the core mechanisms of metabolic reprogramming in CRC, this review systematically summarizes the mechanisms by which active TCM components (berberine, ginsenosides, wogonin, etc.) and TCM formulas (Huangqin Decoction, Wumei Wan, etc.) inhibit CRC progression by regulating key metabolic enzymes and signaling pathways, thereby reversing the Warburg effect, inhibiting de novo fatty acid synthesis, and intervening in amino acid metabolism. This article aims to offer new research ideas and a theoretical basis for the prevention and treatment of CRC with TCM.

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国家自然科学青年基金资助项目（82304835）；中央级公益性科研院所基本科研业务费专项资金资助（ZZ19-XRZ-092）；中国中医科学院科技创新工程重点协同攻关项目（CI2023C054YLL）；国家自然科学基金面上项目（82074328）；山东省自然科学基金青年面上专项类别（ZR2025QC938）