肿瘤相关中性粒细胞（tumor-associated neutrophils，TANs）是肿瘤微环境（tumor microenvironment，TME）中功能可塑性极强的免疫细胞，其浸润活化、极化平衡及中性粒细胞胞外诱捕网（neutrophil extracellular traps，NETs）形成深刻影响肿瘤发生、发展及免疫应答。TANs极化失衡与NETs过度形成是肿瘤免疫逃逸的关键机制。中医“虚瘀毒”核心病机与TANs功能异常密切相关：正气亏虚是TANs功能异常的根本前提，痰瘀互结为TANs介导的促肿瘤微环境奠定病理基础，热毒内蕴驱动TANs异常活化及炎症放大。中医药凭借多靶点、多途径优势，通过扶正祛邪、化痰祛瘀、清热解毒等治法，靶向调控C-X-C基序趋化因子配体1（C-X-C motif chemokine ligand 1，CXCL1）/C-X-C基序趋化因子受体2（C-X-C motif chemokine receptor 2，CXCR2）、磷脂酰肌醇3-激酶（phosphatidylinositol 3-kinase，PI3K）/蛋白激酶B（protein kinase B，AKT）、核因子-κB（nuclear factor-κB，NF-κB）、信号转导及转录激活因子3（signal transducer and activator of transcription 3，STAT3）等信号通路，抑制TANs异常募集与活化、调节N1/N2极化平衡、减少NETs生成，进而改善TME免疫抑制状态、阻断肿瘤进展。立足中西医理论融合视角，系统阐释TANs的肿瘤调控机制及其与中医“虚瘀毒”核心病机的内在关联，结合现有研究解析中医药调控TANs的作用逻辑，为揭示中医药抗肿瘤的科学内涵筑牢理论根基，更为构建TANs靶向治疗的中西医结合新策略提供核心理论支撑。

Tumor-associated neutrophils (TANs) are immune cells with strong functional plasticity in the tumor microenvironment (TME). Their infiltration, activation, polarization balance, and formation of neutrophil extracellular traps (NETs) profoundly affect tumor occurrence, development, and immune responses. Polarization imbalance of TANs and excessive formation of NETs are key mechanisms underlying tumor immune evasion. The core pathogenesis of “deficiency-stasis-toxin” in traditional Chinese medicine (TCM) is closely related to the abnormal function of TANs: deficiency of healthy qi is the fundamental prerequisite for the abnormal function of TANs; intertwining of phlegm and stasis provides a pathological basis for the pro-tumor microenvironment of TANs; and internal accumulation of heat-toxin drives abnormal activation of TANs and amplification of inflammation. With the advantages of multi-target and multi-pathway effects, TCM regulates signaling pathways such as C-X-C motif chemokine ligand 1 (CXCL1)/C-X-C motif chemokine receptor 2 (CXCR2), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT), nuclear factor-κB (NF-κB), signal transducer and activator of transcription 3 (STAT3) through therapeutic methods including reinforcing healthy qi and eliminating pathogens; resolving phlegm and removing stasis; clearing heat and resolving toxin. These methods can inhibit the abnormal recruitment and activation of TANs, regulate the N1/N2 polarization balance, and reduce NETs production, thereby improving the immunosuppressive state of TME and blocking tumor progression. From the perspective of integrated TCM and Western medical theories, this article systematically explains the tumor regulatory mechanism of TANs and its intrinsic correlation with the core pathogenesis of “deficiency-stasis-toxin” in TCM. It also analyzes the functional mechanism of TCM in regulating TANs based on existing research, which not only lays a theoretical foundation for revealing the scientific connotation of TCM in anti-tumor therapy but also provides core theoretical support for constructing a new integrated TCM and Western medicine strategy for TANs-targeted antitumor therapy.

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国家自然科学基金资助项目（82305329）；国家自然科学基金资助项目（82405496）；国家自然科学基金资助项目（82505683）；湖南省卫生健康高层次人才重大专项（R2023111）；湖南省自然科学基金资助项目（2023JJ40500，2024JJ6343，2025JJ90022）