中药作为治疗前列腺癌的治疗选择:治疗效果及潜在机制。

Chinese medicines as therapeutic options for treating prostate cancer: Therapeutic effects and underlying mechanisms.

作者信息

Li Shenglong, Jing Shuaishuai, Zhou Jiuyun, Li Hui, Yin Pengdong, Zhang Qingwei, Gong Meisheng, Zhao Yongqiang, Lu Ganggang, Jin Guangwei, Li Xixiang, Liang Yonglin, Su Lining

机构信息

College of Integrated Traditional and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, China.

Urology Department, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, China.

出版信息

J Ethnopharmacol. 2025 Aug 27;354:120471. doi: 10.1016/j.jep.2025.120471.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Prostate Cancer (PCa) remains a leading malignancy in males, with significant morbidity and mortality. Despite advancements in treatment, challenges like resistance, recurrence, and metastasis persist. Traditional Chinese Medicine (TCM) offers a promising adjunctive approach, enhancing treatment efficacy, reducing toxicity, delaying progression, and improving quality of life.

AIM OF THE STUDY

This study reviews PCa pathogenesis and evaluates the therapeutic potential of TCM through clinical efficacy data and mechanistic investigations. We further outline TCM's capacity to modulate PCa cellular dynamics through multi-scale biological interactions, establishing a framework for its application in PCa management. Our findings offer insights into TCM-based strategies for overcoming therapeutic limitations in prostate oncology.

MATERIALS AND METHODS

This paper provides a systematic summary of PCa pathogenesis and analyzes the clinical efficacy and molecular mechanisms of TCM in treating PCa. Findings are based on searches using keywords such as 'prostate cancer,' 'pathogenesis,' 'Chinese herbal medicine,' 'herbal medicine,' 'traditional Chinese medicine,' and 'active components of Chinese medicine' in PubMed, Web of Science, EMBASE, Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI).

INCLUSION CRITERIA

① Original clinical studies, observational studies, RCTs, and meta-analyses related to the topic. ② Articles published in the last 10 years on PCa treatment and mechanisms in TCM. ③ Studies investigating the mechanisms, treatment strategies, or efficacy of Chinese medicine in PCa. ④ Research on the molecular mechanisms, therapeutic effects, or potential of Chinese herbs or components for PCa.

EXCLUSION CRITERIA

① Abstracts, conference proceedings, opinion pieces, or non-peer-reviewed articles. ② Studies with low methodological quality (e.g., lacking control groups or detailed drug dosages). ③ Irrelevant studies or those focusing on unrelated diseases.

RESULTS

PCa pathogenesis involves gene mutations, androgen signaling abnormalities, epigenetic changes, inflammation, and metabolic reprogramming. TCM modulates the internal environment to delay progression, extend survival, improve quality of life, enhance immune defense, and alleviate chemotherapy and radiation side effects. TCM also inhibits tumor cell proliferation, metastasis, promotes apoptosis, regulates autophagy and ferroptosis, and reverses chemotherapy resistance, exerting anti-PCa effects through these pathways.

CONCLUSIONS

PCa pathogenesis involves genetics, hormones, inflammation, and metabolism, and remains incompletely understood. TCM significantly inhibits PCa progression by regulating cell behavior, improving symptoms, and reducing adverse effects. However, large-scale, multi-center studies are needed to support its application.

摘要

民族药理学相关性

前列腺癌(PCa)仍然是男性中的主要恶性肿瘤,具有显著的发病率和死亡率。尽管治疗方面取得了进展,但耐药、复发和转移等挑战依然存在。传统中医(TCM)提供了一种有前景的辅助方法,可提高治疗效果、降低毒性、延缓疾病进展并改善生活质量。

研究目的

本研究回顾了PCa的发病机制,并通过临床疗效数据和机制研究评估了中医的治疗潜力。我们进一步概述了中医通过多尺度生物相互作用调节PCa细胞动力学的能力,为其在PCa管理中的应用建立了一个框架。我们的研究结果为基于中医的策略提供了见解,以克服前列腺肿瘤学中的治疗局限性。

材料与方法

本文系统总结了PCa的发病机制,并分析了中医治疗PCa的临床疗效和分子机制。研究结果基于在PubMed、科学网、EMBASE、考克兰图书馆、万方数据库和中国知网中使用“前列腺癌”、“发病机制”、“中草药”、“草药”、“传统中医”和“中药活性成分”等关键词进行的检索。

纳入标准

①与该主题相关的原始临床研究、观察性研究、随机对照试验和荟萃分析。②过去10年发表的关于PCa中医治疗及机制的文章。③研究中医在PCa中的机制、治疗策略或疗效的研究。④关于中药或其成分对PCa的分子机制、治疗效果或潜力的研究。

排除标准

①摘要、会议论文、观点文章或非同行评审文章。②方法学质量低的研究(例如,缺乏对照组或详细的药物剂量)。③无关研究或关注无关疾病的研究。

结果

PCa的发病机制涉及基因突变、雄激素信号异常、表观遗传变化、炎症和代谢重编程。中医调节内环境以延缓疾病进展、延长生存期、改善生活质量、增强免疫防御并减轻化疗和放疗的副作用。中医还抑制肿瘤细胞增殖、转移,促进凋亡,调节自噬和铁死亡,并逆转化疗耐药性,通过这些途径发挥抗PCa作用。

结论

PCa的发病机制涉及遗传学、激素、炎症和代谢,目前仍未完全明确。中医通过调节细胞行为、改善症状和减少不良反应,显著抑制PCa的进展。然而,需要大规模、多中心研究来支持其应用。

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