胃癌是最常見的消化道腫瘤之一，其高發(fā)病率和致死率已嚴(yán)重危害人類身心健康。細(xì)胞凋亡是機(jī)體細(xì)胞維持自身穩(wěn)態(tài)環(huán)境的一種自發(fā)性死亡方式，在胃癌的發(fā)生、發(fā)展過程中被廣泛關(guān)注，始終影響著胃癌的轉(zhuǎn)歸和預(yù)后。中醫(yī)藥治療胃癌在改善患者癥狀、提高生活質(zhì)量、延長(zhǎng)生存期等方面具有不可替代的優(yōu)勢(shì)。研究發(fā)現(xiàn)，中藥活性成分如多糖類、皂苷類、黃酮類、生物堿類以及內(nèi)酯類等可通過調(diào)控胃癌相關(guān)信號(hào)通路，提高促凋亡蛋白Bax、Bad、Bim的表達(dá)，降低抗凋亡蛋白Bcl-2、Bcl-xL、Bcl-W的表達(dá)，破壞胃癌細(xì)胞線粒體結(jié)構(gòu)，降低線粒體膜電位水平，激活Caspase級(jí)聯(lián)反應(yīng)，最終誘導(dǎo)胃癌細(xì)胞線粒體凋亡，抑制胃癌的進(jìn)展。通過對(duì)近年來中藥活性成治療胃癌的相關(guān)研究進(jìn)行歸納總結(jié)，從中藥活性成分調(diào)控線粒體凋亡抗胃癌的作用機(jī)制方面進(jìn)行詳細(xì)綜述，以期為臨床治療胃癌新藥研發(fā)提供思路和參考。

Gastric carcinoma (GC) is one of the most common malignant tumors of the digestive system with high incidence and mortality, posing a significant risk to human physical and mental health. Apoptosis is a spontaneous death mode of body cells to maintain their homeostasis environment, which is widely described in the occurrence and development of GC, and always affects the outcome and prognosis of GC. Traditional Chinese medicine (TCM) treatment of GC has irreplaceable advantages in improving symptoms, improving quality of life and prolonging survival. Research has demonstrated that the active constituents of traditional Chinese medicine, including polysaccharides, saponins, flavonoids, alkaloids, and lactones, can modulate the expression of pro-apoptotic proteins such as Bax, Bad, and Bim, while concurrently downregulating the expression of anti-apoptotic proteins Bcl-2, Bcl-xL, and Bcl-W. This modulation disrupts the mitochondrial architecture of GC cells by influencing GC-related signaling pathways. Additionally, these active ingredients decrease mitochondrial membrane potential, activate the caspase cascade, and ultimately induce mitochondrial apoptosis in GC cells, thereby inhibiting the progression of gastric cancer. This paper provides a comprehensive summary of recent studies on the treatment of GC using active components of TCM. Additionally, it offers an in-depth review of the anti-GC mechanisms, specifically focusing on the regulation of mitochondrial apoptosis by these active components. The objective is to furnish insights and references that could facilitate the development of novel therapeutic agents for the clinical management of GC.

R285.5

河南省重點(diǎn)研發(fā)與推廣專項(xiàng)（科技攻關(guān)）項(xiàng)目（232102310280）；張仲景經(jīng)方合方的臨床應(yīng)用及其作用機(jī)制研究項(xiàng)目（GZY-KJS-2022-041）；河南中醫(yī)藥學(xué)科領(lǐng)軍人才項(xiàng)目（豫衛(wèi)中醫(yī)函[2021]8號(hào)）；河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（2023ZY2071）；河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（2021JDZX2003）