中医药防治结直肠腺瘤的表观遗传机制研究 进展

Research Progress on the Epigenetic Mechanism of Traditional Chinese Medicine in the Prevention and Treatment of Colorectal Adenomas

摘要: 结直肠腺瘤作为结直肠癌明确的癌前病变，其防治是降低结直肠癌发病率的關鍵环节。中医药基于“治未病”思想，认为“脾虚”是其核心病机，“健脾固本”是重要的干预原则。近年来，表观遗传学研究揭示，在腺瘤向癌演变过程中，由DNA甲基化、组蛋白修饰等异常构成的“表观遗传微环境”紊乱起着关键的驱动作用，这为阐释“健脾固本”的生物学内涵提供了全新的分子视角。本综述系统梳理了中医药通过“健脾固本”干预结直肠腺瘤的研究现状，重点聚焦于健脾类中药复方及单体成分通过调控DNA甲基化、组蛋白修饰、非编码RNA等表观遗传机制，重塑肿瘤微环境、逆转细胞恶性潜能、从而抑制腺瘤发生发展的最新进展。同时，探讨了类器官等前沿模型在“病证结合”机制研究中的应用，并分析了当前面临的挑战与未来发展方向，旨在为中医药现代化防治结直肠腺瘤提供理论参考与研究思路。

Abstract: Colorectal adenomas, as definite precancerous lesions of colorectal cancer, are crucial for the prevention and treatment of colorectal cancer. Based on the concept of “preventing disease before it occurs”, traditional Chinese medicine believes that “spleen deficiency” is the core pathogenesis, and “strengthening the spleen and consolidating the foundation” is an important intervention principle. In recent years, epigenetic research has revealed that during the transformation from adenomas to cancer, the disorder of the “epigenetic microenvironment” composed of abnormal DNA methylation, histone modifications, etc., plays a key driving role. This provides a new molecular perspective for explaining the biological connotation of “strengthening the spleen and consolidating the foundation”. This review systematically summarizes the current research status of traditional Chinese medicine’s intervention on colorectal adenomas through “strengthening the spleen and consolidating the foundation”, focusing on the latest progress of strengthening-treating-type Chinese medicine compound prescriptions and single components that regulate epigenetic mechanisms such as DNA methylation, histone modification, and non-coding RNA to reshape the tumor microenvironment, reverse the malignant potential of cells, and thereby inhibit the occurrence and development of adenomas. At the same time, it discusses the application of advanced models such as organoids in the study of the “disease-syndrome combination” mechanism, and analyzes the current challenges and future development directions, aiming to provide theoretical references and research ideas for the modernization of traditional Chinese medicine in the prevention and treatment of colorectal adenomas.