中药逆转药物耐药性的研究进展

薄毅文 ,  宋礼国 ,  刁修冰 ,  张海东 ,  于慧 ,  孔祥图 ,  倪海雯

药学进展 ›› 2026, Vol. 50 ›› Issue (5) : 412 -421.

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药学进展 ›› 2026, Vol. 50 ›› Issue (5) : 412 -421. DOI: 10.20053/j.issn1001-5094.202511120889
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中药逆转药物耐药性的研究进展

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Research Progress on Reversal of Drug Resistance by Traditional Chinese Medicine

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摘要

药物耐药性已成为当前公共卫生领域的严峻挑战,耐药所致死亡人数逐年攀升,社会经济负担持续加重,亟需探寻有效防控策略。中医药底蕴深厚、临床经验丰富,在逆转抗感染、抗肿瘤药物耐药方面具备独特优势与应用潜力。对中药逆转抗感染及抗肿瘤药物耐药的作用机制及临床应用进行综述,总结中医药干预耐药的优势和局限性,旨在为中医药攻克耐药性难题提供理论依据与研究新思路。

Abstract

Drug resistance has become a severe challenge in the field of public health. The death toll caused by drug resistance increases year by year, and the socioeconomic burden continues to escalate. It is imperative to explore effective prevention and control strategies. With a profound theoretical foundation and extensive clinical experience, traditional Chinese medicine possesses unique advantages and application potential in reversing anti-infective and anti-tumor drug resistance. This paper reviews the mechanisms and clinical application of traditional Chinese medicine in reversing anti-infective and anti-tumor drug resistance, and summarizes its advantages and limitations, aiming to provide a theoretical basis and new research directions for tackling drug resistance via traditional Chinese medicine.

关键词

中药 / 抗生素耐药性 / 肿瘤耐药 / 天然产物

Key words

traditional Chinese medicine / antibiotic resistance / tumor drug resistance / natural products

引用本文

引用格式 ▾
薄毅文,宋礼国,刁修冰,张海东,于慧,孔祥图,倪海雯. 中药逆转药物耐药性的研究进展[J]. 药学进展, 2026, 50(5): 412-421 DOI:10.20053/j.issn1001-5094.202511120889

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参考文献

[1]

Bukowski K, Kciuk M, Kontek R. Mechanisms of multidrug resistance in cancer chemotherapy[J].Int J Mol Sci, 2020, 21(9): 3233.

[2]

Xiao G, Li J, Sun Z. The combination of antibiotic and non—antibiotic compounds improves antibiotic efficacy against multidrug—resistant bacteria[J].Int J Mol Sci, 2023, 24(20): 15493.

[3]

Wagenlehner F M E, Dittmar F. Re: global burden of bacterial antimicrobial resistance in 2019: a systematic analysis[J].Eur Urol, 2022, 82(6): 658.

[4]

Zou J Y, Chen Q L, Luo X C,et al. Natural products reverse cancer multidrug resistance[J].Front Pharmacol, 2024, 15: 1348076.

[5]

Smith W P J, Wucher B R, Nadell C D,et al. Bacterial defences: mechanisms, evolution and antimicrobial resistance[J].Nat Rev Microbiol, 2023, 21(8): 519-534.

[6]

Ferreira C, Abrantes P, Costa S S,et al. Occurrence and variability of the efflux pump gene norAacross the Staphylococcusgenus[J].Int J Mol Sci, 2022, 23(23): 15306.

[7]

Tintino S R, Wilairatana P, de Souza V C A,et al. Inhibition of the norA gene expression and the NorA efflux pump by the tannic acid[J].Sci Rep, 2023, 13(1): 17394.

[8]

Maurya A, Dwivedi G R, Darokar M P,et al. Antibacterial and synergy of clavine alkaloid lysergol and its derivatives against nalidixic acid—resistant Escherichia coli[J].Chem Biol Drug Des, 2013, 81(4): 484-490.

[9]

Rowaiye A, Ibeanu G C, Bur D,et al. Phyto—molecules show potentials to combat drug—resistance in bacterial cell membranes[J].Microb Pathog, 2025, 205: 107723.

[10]

Fu Y, Liu W, Liu M,et al. In vitroanti—biofilm efficacy of sanguinarine against carbapenem—resistant Serratia marcescens[J].Biofouling, 2021, 37(3): 341-351.

[11]

Upadhyay A, Jaiswal N, Kumar A. Biofilm battle: new transformative tactics to tackle the bacterial biofilm infections[J].Microb Pathog, 2025, 199: 107277.

[12]

Kincses A, Ghazal T S A, Veres K,et al. Phenolic compounds from Origanum majoranawith biofilm—inhibitory activity against methicillin—resistant Staphylococcus aureusand Escherichia colistrains[J].Pharm Biol, 2025, 63(1): 402-410.

[13]

Ding Y, Li Z, Xu C,et al. Fluorogenic probes/inhibitors of β—lactamase and their applications in drug—resistant bacteria[J].Angew Chem Int Ed, 2021, 60(1): 24-40.

[14]

Dharmaratne M P J, Manoraj A, Thevanesam V,et al. Terminalia belliricafruit extracts: in—vitroantibacterial activity against selected multidrug—resistant bacteria, radical scavenging activity and cytotoxicity study on BHK—21 cells[J].BMC Complement Altern Med, 2018, 18(1): 325.

[15]

Zhao X, Yu Z, Ding T. Quorum—sensing regulation of antimicrobial resistance in bacteria[J].Microorganisms, 2020, 8(3): 425.

[16]

El—Sawy E R, Abdel—Aziz M S, Abdelmegeed H,et al. Coumarins: quorum sensing and biofilm formation inhibition[J].Molecules, 2024, 29(19): 4534.

[17]

Yang J, Liu Z, Hu B,et al. Transcriptional modifications enhance the persistence of resistant plasmids in the presence of tetracycline in an environmentally relevant concentration[J].Sci Total Environ, 2023, 885: 163602.

[18]

Latha C, Shriram V D, Jahagirdar S S,et al. Antiplasmid activity of 1'—acetoxychavicol acetate from Alpinia galangaagainst multi—drug resistant bacteria[J].J Ethnopharmacol, 2009, 123(3): 522-525.

[19]

Zeng Q, Wang Z J, Chen S,et al. Phytochemical and anti—MRSA constituents of Zanthoxylum nitidum[J].Biomed Pharmacother, 2022, 148: 112758.

[20]

Li T, Wang Z, Zhang X,et al. Natural product usnic acid as an antibacterial therapeutic agent: current achievements and further prospects[J].ACS Infect Dis, 2025, 11(6): 1403-1415.

[21]

Zhang S, Hu B, Xu J,et al. Baicalin suppress growth and virulence—related factors of methicillin—resistant Staphylococcus aureus in vitroand vivo[J].Microb Pathog, 2020, 139: 103899.

[22]

Swetha T K, Pooranachithra M, Subramenium G A,et al. Umbelliferone impedes biofilm formation and virulence of methicillin—resistant Staphylococcus epidermidis viaimpairment of initial attachment and intercellular adhesion[J].Front Cell Infect Microbiol, 2019, 9: 357.

[23]

Qin X, Wu Y, Zhao Y,et al. Revealing active constituents within traditional Chinese medicine used for treating bacterial pneumonia, with emphasis on the mechanism of baicalein against multi—drug resistant Klebsiella pneumoniae[J].J Ethnopharmacol, 2024, 321: 117488.

[24]

Wang G, Li L, Wang X,et al. Hypericin enhances β—lactam antibiotics activity by inhibiting sarA expression in methicillin—resistant Staphylococcus aureus[J].Acta Pharm Sin B, 2019, 9(6): 1174-1182.

[25]

Bajire S K, Jain S, Johnson R P,et al. 6—Methylcoumarin attenuates quorum sensing and biofilm formation in Pseudomonas aeruginosaPAO1 and its applications on solid surface coatings with polyurethane[J].Appl Microbiol Biotechnol, 2021, 105(23): 8647-8661.

[26]

Sun D, Bo L, Jiang C,et al. Beyond the boundary: the emerging roles of ATP—binding cassette transporters in multidrug resistance (MDR) and therapeutic targeting in cancer[J].Drug Resist Updat, 2026, 84: 101310.

[27]

Zhou X, Jin N, Chen B. Tetrandrine overcomes drug resistance mediated by bone marrow microenvironment by regulating the expression of P—glycoprotein in acute leukemia[J].Hematology, 2022, 27(1): 274-279.

[28]

Zeng R, Yang X M, Li H W,et al. Simplified derivatives of tetrandrine as potent and specific P—gp inhibitors to reverse multidrug resistance in cancer chemotherapy[J].J Med Chem, 2023, 66(6): 4086-4105.

[29]

Dong J, Yuan L, Hu C,et al. Strategies to overcome cancer multidrug resistance (MDR) through targeting P—glycoprotein (ABCB1): an updated review[J].Pharmacol Ther, 2023, 249: 108488.

[30]

Wang C, Zeng C, Wang A,et al. Lycorine exerts antitumor effects on the osimertinib—resistant non—small cell lung cancer by inhibiting NOTCH3/HES1 signaling[J].J Biochem Mol Toxicol, 2025, 39(9): e70501.

[31]

Jiang Z B, Xu C, Xu P,et al. Lycorine suppresses non—small—cell lung cancer progression through activating STING pathway and stimulating an antitumor immune response[J].Chem Biol Drug Des, 2024, 104(6): e70036.

[32]

Sancha S A R, Szemerédi N, Spengler G,et al. Lycorine carbamate derivatives for reversing P—glycoprotein—mediated multidrug resistance in human colon adenocarcinoma cells[J].Int J Mol Sci, 2023, 24(3): 2061.

[33]

Liu Y, Liang J, Zhang Y,et al. Drug resistance and tumor immune microenvironment: an overview of current understandings (Review)[J].Int J Oncol, 2024, 65(4): 96.

[34]

Chen Y, Zhang J, Zhang M,et al. Baicalein resensitizes tamoxifen—resistant breast cancer cells by reducing aerobic glycolysis and reversing mitochondrial dysfunctionviainhibition of hypoxia—inducible factor—1α[J].Clin Transl Med, 2021, 11(11): e577.

[35]

Ibáñez Gaspar V, McMorrow T. The curcuminoid EF24 in combination with TRAIL reduces human renal cancer cell migration by decreasing MMP—2/MMP—9 activity through a reduction in H2O2 [J].Int J Mol Sci, 2023, 24(2): 1043.

[36]

Liu T, Chen Q, Liu R,et al. DMGAT: predicting ncRNA—drug resistance associations based on diffusion map and heterogeneous graph attention network[J].Brief Bioinform, 2025, 26(2): bbaf179.

[37]

Wu H, Du J E, Li C,et al. Kaempferol can reverse the 5—Fu resistance of colorectal cancer cells by inhibiting PKM2—mediated glycolysis[J].Int J Mol Sci, 2022, 23(7): 3544.

[38]

Groelly F J, Fawkes M, Dagg R A,et al. Targeting DNA damage response pathways in cancer[J].Nat Rev Cancer, 2023, 23(2): 78-94.

[39]

Choi C Y, Lim S C, Lee T B,et al. Molecular basis of resveratrol—induced resensitization of acquired drug—resistant cancer cells[J].Nutrients, 2022, 14(3): 699.

[40]

Wang Z, Sun X, Feng Y,et al. Corrigendum to Dihydromyricetin reverses MRP2—induced multidrug resistance by preventing NF—κB—Nrf2 signaling in colorectal cancer cell Phytomedicine 82(2021) PHYMED 153414[J].Phytomedicine, 2022, 100: 153732.

[41]

Zhang N, Tian X, Liu F,et al. Reversal of sorafenib resistance in hepatocellular carcinoma by curcumol: insights from network pharmacology, molecular docking, and experimental validation[J].Front Pharmacol, 2025, 16: 1514997.

[42]

Azizi E, Fouladdel S, Komeili Movahhed T,et al. Quercetin effects on cell cycle arrest and apoptosis and doxorubicin activity in T47D cancer stem cells[J].Asian Pac J Cancer Prev, 2022, 23(12): 4145-4154.

[43]

Tang Z, Tian X. Astragalus membranaceus: a traditional Chinese medicine with multifaceted impacts on breast cancer treatment[J].Biomolecules, 2024, 14(10): 1339.

[44]

Ji X, Liu K, Li Q,et al. A mini—review of flavone isomers apigenin and genistein in prostate cancer treatment[J].Front Pharmacol, 2022, 13: 851589.

[45]

Xu W, Ding J, Kuang S,et al. Icariin—Curcumol promotes docetaxel sensitivity in prostate cancer through modulation of the PI3K—Akt signaling pathway and the Warburg effect[J].Cancer Cell Int, 2023, 23(1): 190.

[46]

Vakhrusheva O, Erb H H H, Bräunig V,et al. Artesunate inhibits the growth behavior of docetaxel—resistant prostate cancer cells[J].Front Oncol, 2022, 12: 789284.

[47]

Zhong Y, Le F, Cheng J,et al. Triptolide inhibits JAK2/STAT3 signaling and induces lethal autophagy through ROS generation in cisplatin—resistant SKOV3/DDP ovarian cancer cells[J].Oncol Rep, 2026, 55(3): 43.

[48]

Gao L, Ouyang Y, Li R,et al. Icaritin inhibits migration and invasion of human ovarian cancer cellsviathe Akt/mTOR signaling pathway[J].Front Oncol, 2022, 12: 843489.

[49]

Liang X, Fu W, Peng Y,et al. Lycorine induces apoptosis of acute myeloid leukemia cells and inhibits triglyceride production viabinding and targeting FABP5[J].Ann Hematol, 2023, 102(5): 1073-1086.

[50]

Lee C H, Tsai H Y, Chen C L,et al. Isoliquiritigenin inhibits gastric cancer stemness, modulates tumor microenvironment, and suppresses tumor growth through glucose—regulated protein 78 downregulation[J].Biomedicines, 2022, 10(6): 1350.

[51]

Han J H, Kim M, Kim H J,et al. Targeting lactate dehydrogenase a with catechin resensitizes SNU620/5FU gastric cancer cells to 5—fluorouracil[J].Int J Mol Sci, 2021, 22(10): 5406.

[52]

Lin X, Xu L, Gu M,et al. Gegen Qinlian Decoction reverses oxaliplatin resistance in colorectal cancer by inhibiting YTHDF1—regulated m6A modification of GLS1[J].Phytomedicine, 2024, 133: 155906.

[53]

Chen Y, Lai X, Zhang Y,et al. Huang—Lian—Jie—Du decoction enhances Capecitabine—Oxaliplatin efficacy via Akkermansia muciniphilaand CD8+ T cells in colorectal cancer[J].Phytomedicine, 2025, 148: 157233.

[54]

Huang X, Sun J, Sun J. Combined treatment with JFKD and gefitinib overcomes drug resistance in non—small cell lung cancer[J].Curr Pharm Biotechnol, 2021, 22(3): 389-399.

[55]

Liu Y T, Cai H R, Li H,et al. Buzhong Yiqi decoction improves cisplatin resistance in non—small cell lung cancer by inhibiting PCBP1 to activate the ferritinophagy—mediated ferroptosis pathway[J].J Ethnopharmacol, 2025, 353(Pt A): 120317.

[56]

Cao H, Wang D, Sun P,et al. Zhoushi Qi Ling decoction represses docetaxel resistance and glycolysis of castration—resistant prostate cancer viaregulation of SNHG10/miR—1271—5p/TRIM66 axis[J].Aging, 2021, 13(19): 23096-23107.

[57]

Li Z, Wang J, Wang W,et al. Integrated network pharmacology and RNA sequencing analysis to reveal the mechanisms of Qici Sanling decoction in the treatment of gemcitabine resistant bladder cancer[J].J Pharm Biomed Anal, 2025, 262: 116885.

[58]

Zhai H, Zeng J, Ma X,et al. Baicalein as a potent antifungal agent against Candida albicans: synergy with fluconazole and sustainable production through probiotic—mediated bioconversion[J].Front Microbiol, 2025, 16: 1562103.

[59]

Li N, Zhang J, Yu F,et al. Garlic—derived quorum sensing inhibitors: a novel strategy against fungal resistance[J].Drug Des Devel Ther, 2024, 18: 6413-6426.

[60]

Yang P, Lang J, Li H,et al. TCM—Suite: a comprehensive and holistic platform for Traditional Chinese Medicine component identification and network pharmacology analysis[J].IMeta, 2022, 1(4): e47.

[61]

Xue J, Gao S, You Z,et al. In vitrotechnology and ADMET research in traditional Chinese medicine[J].Front Pharmacol, 2025, 16: 1605330.

[62]

Cong B. Bridging tradition and innovation: phenomics of traditional Chinese medicine 2.0 as a catalyst for the development of integrated holistic precision medicine[J].Digit Chin Med, 2025, 8(3): 279-281.

[63]

Hu Y, Wang Z, Ni K,et al. Challenges in traditional Chinese medicine clinical trials: how to balance personalized treatment and standardized research?[J].Ther Clin Risk Manag, 2025, 21: 1085-1094.

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