中药多糖抗妇科恶性肿瘤作用的研究进展

doi:10.12280/gjfckx.20250700

摘要/Abstract

摘要：

妇科恶性肿瘤的发病率和病死率逐年升高，严重威胁女性生命健康。中医药在妇科恶性肿瘤综合治疗中应用广泛，作为最常见的中药活性成分，中药多糖抗妇科恶性肿瘤的作用机制包括调控肿瘤相关信号通路，阻滞肿瘤细胞周期，抑制肿瘤细胞转移和侵袭，促进肿瘤细胞凋亡、自噬和铁死亡，抑制肿瘤细胞免疫逃逸和上皮-间质转化，调节癌基因和抑癌基因表达，以及作为高效的药物载体发挥减毒增效作用等。但中药多糖的临床应用仍然面临生物利用度低、分离提取复杂等挑战，未来有必要进行进一步的基础研究和临床试验，以期为中药创新药的开发提供参考，促进中西医结合治疗妇科恶性肿瘤在临床中的广泛应用。

关键词: 多糖类, 中药化学成分, 宫颈肿瘤, 卵巢肿瘤, 子宫内膜肿瘤

Abstract:

The incidence and mortality rates of gynecological malignancies are increasing year by year, posing a serious threat to women′s health. Traditional Chinese medicine is widely used in the comprehensive treatment of gynecological malignancies. As the most common active components of traditional Chinese medicine, the mechanisms of Chinese herbal polysaccharides against gynecological malignancies include regulating tumor-related signaling pathways, arresting the tumor cell cycle, inhibiting tumor cell metastasis and invasion, promoting tumor cell apoptosis, autophagy and ferroptosis, suppressing tumor cell immune escape and epithelial-mesenchymal transition, regulating the expression of oncogenes and tumor suppressor genes, and serving as efficient drug carriers to reduce toxicity and enhance efficacy. However, the clinical application of traditional Chinese medicine polysaccharides still faces challenges such as low bioavailability and complex separation and extraction. In the future, it is necessary to conduct further basic research and clinical trials to provide references for the development of innovative traditional Chinese medicine and promote the wide clinical application of the combination of traditional Chinese and Western medicine in the treatment of gynecological malignancies.

Key words: Polysaccharides, Chemical compositions (TCD), Uterine cervical neoplasms, Ovarian neoplasms, Endometrial neoplasms

高越, 石百超, 余健楠, 张丽倩, 王宇, 吴效科. 中药多糖抗妇科恶性肿瘤作用的研究进展[J]. 国际妇产科学杂志, 2025, 52(6): 685-689.

GAO Yue, SHI Bai-chao, YU Jian-nan, ZHANG Li-qian, WANG Yu, WU Xiao-ke. Research Progress on the Anti-Gynecological Malignancy Effects of Chinese Herbal Polysaccharides[J]. Journal of International Obstetrics and Gynecology, 2025, 52(6): 685-689.

参考文献 36

[1]	Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. doi: 10.3322/caac.21660.
[2]	Sancha S, Dobiasová S, Nejedly T, et al. Lycorine and homolycorine derivatives for chemo-sensitizing resistant human ovarian adenocarcinoma cells[J]. Phytomedicine, 2024, 126:155460. doi: 10.1016/j.phymed.2024.155460.
[3]	王子珏, 唐蔚, 宋程. 国医大师潘敏求治疗宫颈癌经验[J]. 湖南中医杂志, 2025, 43(2):48-51. doi: 10.16808/j.cnki.issn1003-7705.2025.02.011.
[4]	蔡梦婷, 唐蔚, 宋程. 国医大师潘敏求以“辨机论治”理论治疗卵巢癌经验[J]. 湖南中医药大学学报, 2025, 45(4):583-587. doi: 10.3969/j.issn.1674-070X.2025.04.001.
[5]	范丹枫, 岳晓青, 王天娇, 等. 战丽彬治疗妇科恶性肿瘤的学术思想及经验总结[J]. 现代中医临床, 2024, 31(6):67-73. doi: 10.3969/j.issn.2095-6606.2024.06.015.
[6]	Slavov A, Chalova V. Physicochemical Characterization of Pectic Polysaccharides from Rose Essential Oil Industry By-Products[J]. Foods, 2024, 13(2):270. doi: 10.3390/foods13020270.
[7]	张玉, 王凯平. 当归多糖的研究进展[J]. 中国药学杂志, 2023, 58(12):1065-1073. doi: 10.11669/cpj.2023.12.002
[8]	Guo R, Chen M, Ding Y, et al. Polysaccharides as Potential Anti-tumor Biomacromolecules -A Review[J]. Front Nutr, 2022, 9:838179. doi: 10.3389/fnut.2022.838179.
[9]	杜维根, 白磊阳, 姜雪峰. 天然多糖的分子结构与生物活性功能[J]. 化学教育(中英文), 2025, 46(10):1-9. doi: 10.13884/j.1003-3807hxjy.2024110227.
[10]	Gao X, Ren C, Li L, et al. Pharmacological action of Hedysarum polysaccharides: a review[J]. Front Pharmacol, 2023, 14:1119224. doi: 10.3389/fphar.2023.1119224.
[11]	王迪, 李钧, 侯兵乔, 等. 中药多糖对肿瘤微环境中免疫细胞调节作用研究进展[J]. 中草药, 2023, 54(13):4346-4358. doi: 10.7501/j.issn.0253-2670.2023.13.028.
[12]	Qin H, Su L, Zhou B, et al. Remote Ischemic Postconditioning Improve Cerebral Ischemia-Reperfusion Injury Induced Cognitive Dysfunction through Suppressing Mitochondrial Apoptosis in Hippocampus via TK/BK/B2R-Mediated PI3K/AKT[J]. Mol Neurobiol, 2025, 62(8):10652-10669. doi: 10.1007/s12035-025-04864-y.
[13]	杨宝芹, 刘高仁, 邵艳社, 等. 白术多糖通过调控线粒体凋亡途径诱导人子宫内膜癌RL95-2细胞凋亡[J]. 中国免疫学杂志, 2022, 38(12):1458-1462. doi: 10.3969/j.issn.1000-484X.2022.12.009.
[14]	张泽敏, 庞岚. 槐耳多糖抑制AEG-1表达对子宫内膜癌细胞生物学行为的影响[J]. 川北医学院学报, 2023, 38(10):1299-1305. doi: 10.3969/j.issn.1005-3697.2023.10.001.
[15]	Lu Q, Shao N, Fang Z, et al. The anti-Alzheimer′s disease effects of ganoderic acid A by inhibiting ferroptosis-lipid peroxidation via activation of the NRF2/SLC7A11/GPX4 signaling pathway[J]. Chem Biol Interact, 2025, 412:111459. doi: 10.1016/j.cbi.2025.111459.
[16]	张永跟, 颜小飞, 刘锋, 等. 黄芪多糖通过Nrf2/SLC7A11/GPX4信号通路诱导卵巢癌细胞铁死亡[J]. 中国中药杂志, 2024, 49(23):6459-6467. doi: 10.19540/j.cnki.cjcmm.20240919.501.
[17]	Guo W, Wang W, Lei F, et al. Angelica sinensis polysaccharide combined with cisplatin reverses cisplatin resistance of ovarian cancer by inducing ferroptosis via regulating GPX4[J]. Biomed Pharmacother, 2024, 175:116680. doi: 10.1016/j.biopha.2024.116680.
[18]	Xia L, Yang M, Liu Y. Portulaca oleracea L. polysaccharide inhibits ovarian cancer via inducing ACSL4-dependent ferroptosis[J]. Aging(Albany NY), 2024, 16(6):5108-5122. doi: 10.18632/aging.205608.
[19]	Shuxia Z, Ping Z, Xiaoyan Z, et al. FB1 causes barrier damage to vascular endothelial cells through ferroptosis by a PINK1/Parkin mediated mitophagy-dependent mechanism[J]. Chem Biol Interact, 2025, 416:111536. doi: 10.1016/j.cbi.2025.111536.
[20]	Peng Q, Yu Y, Ye L, et al. Astragalus polysaccharides sensitize ovarian cancer stem cells to PARPi by inhibiting mitophagy via PINK1/Parkin signaling[J]. iScience, 2024, 27(8):110376. doi: 10.1016/j.isci.2024.110376.
[21]	Liu C, Yin Q, Wu Z, et al. Inflammation and Immune Escape in Ovarian Cancer: Pathways and Therapeutic Opportunities[J]. J Inflamm Res, 2025, 18:895-909. doi: 10.2147/JIR.S503479. pmid: 39867950
[22]	蒋鸿晶, 仲国庆, 张洋. 红芪多糖介导STAT3通路抑制卵巢癌小鼠肿瘤细胞免疫逃逸[J]. 免疫学杂志, 2023, 39(3):233-239,247. doi: 10.13431/j.cnki.immunol.j.20230030.
[23]	Yang Y, Xue K, Li Z, et al. c-Myc regulates the CDK1/cyclin B1 dependent-G2/M cell cycle progression by histone H4 acetylation in Raji cells[J]. Int J Mol Med, 2018, 41(6):3366-3378. doi: 10.3892/ijmm.2018.3519. pmid: 29512702
[24]	黄丽金, 李自霖, 杨紫焰, 等. 苦胆草多糖抗氧化及抗人宫颈癌HeLa细胞的作用及机制[J]. 中国实验方剂学杂志, 2024, 30(18):80-88. doi: 10.13422/j.cnki.syfjx.20240821.
[25]	Zhou J, Zhou D, Zhang Q, et al. DCLK1 mediated cooperative acceleration of EMT by avian leukosis virus subgroup J and Marek′s disease virus via the Wnt/β-catenin pathway promotes tumor metastasis[J]. J Virol, 2024, 98(11):e0111224. doi: 10.1128/jvi.01112-24.
[26]	王泯蓉, 张勇, 沈娟. 山慈菇多糖对人卵巢癌细胞增殖和上皮间质转化的影响[J]. 中国临床药理学杂志, 2023, 39(13):1899-1903. doi: 10.13699/j.cnki.1001-6821.2023.13.016.
[27]	Briante R, Zhai Q, Mohanty S, et al. Successful targeting of multidrug-resistant tumors with bispecific antibodies[J]. MAbs, 2025, 17(1):2492238. doi: 10.1080/19420862.2025.2492238.
[28]	闫霜, 王雅莉. 茯苓多糖影响卵巢癌细胞耐药性的机制[J]. 西北药学杂志, 2022, 37(3):94-100. doi: 10.3969/j.issn.1004-2407.2022.03.016.
[29]	Sif S, Al Alawneh M. Aberrant miRNA expression and protein arginine methyltransferase 5 (PRMT5) in cancer: A review[J]. Biochim Biophys Acta Mol Cell Res, 2025, 1872(3):119923. doi: 10.1016/j.bbamcr.2025.119923.
[30]	耿玉娥, 仇春侠, 李卫平, 等. 石见穿多糖通过调控circ-PRMT5/miR-432-5p轴对宫颈癌细胞增殖和凋亡的影响[J]. 中国性科学, 2022, 31(6):27-30. doi: 10.3969/j.issn.1672-1993.2022.06.008.
[31]	Gao Q, Ren Z, Jiao S, et al. HIF-3α-Induced miR-630 Expression Promotes Cancer Hallmarks in Cervical Cancer Cells by Forming a Positive Feedback Loop[J]. J Immunol Res, 2022, 2022:5262963. doi: 10.1155/2022/5262963.
[32]	袁小波, 阳帆, 周丽丽, 等. 马齿苋多糖通过调控微小RNA-630的表达对宫颈癌细胞增殖和凋亡的影响[J]. 中国临床药理学杂志, 2023, 39(12):1718-1722. doi: 10.13699/j.cnki.1001-6821.2023.12.010.
[33]	Choi SH, Do SK, Lee SY, et al. Genetic variants in LKB1/AMPK/mTOR pathway are associated with clinical outcomes of chemotherapy in non-small cell lung cancer[J]. Thorac Cancer, 2022, 13(23):3322-3330. doi: 10.1111/1759-7714.14688. pmid: 36239337
[34]	王彩虹, 尹宁, 王柯静, 等. 基于AMPK通路研究半枝莲多糖对宫颈癌移植瘤小鼠肿瘤组织血管生成的作用机制[J]. 中药药理与临床, 2022, 38(2):74-78. doi: 10.13412/j.cnki.zyyl.2022.02.006.
[35]	Liu Y, Li H, Zheng Z, et al. Rosa rugosa polysaccharide induces autophagy-mediated apoptosis in human cervical cancer cells via the PI3K/AKT/mTOR pathway[J]. Int J Biol Macromol, 2022, 212:257-274. doi: 10.1016/j.ijbiomac.2022.05.023. pmid: 35533849
[36]	袁小波, 唐静. 女贞子多糖通过EGFR/MAPK信号通路对卵巢癌细胞增殖、凋亡的影响[J]. 环球中医药, 2022, 15(12):2375-2380. doi: 10.3969/j.issn.1674-1749.2022.12.017.