逆转细菌耐药性中药及其作用机制研究进展

The escalating challenge of bacterial drug resistance has emerged as a critical global public health concern. Traditional Chinese Medicine (TCM), characterized by its multi-target mechanisms of action and low toxicity profile, has progressively become a pivotal research direction for reversing antibiotic resistance. This paper systematically reviews recent advances in molecular mechanisms underlying TCM-mediated regulation of drug-resistant bacteria, with emphasis on six key pathways: 1) suppression of resistance gene mutations through regulation of RecA protein activity; 2) inhibition of horizontal transfer of resistance genes via interference with plasmid conjugation and transformation; 3) enhancement of bacterial outer membrane permeability; 4) functional inhibition of efflux pumps exemplified by the AcrAB-TolC system; 5) elimination of resistance plasmids via activation of the Hok/Sok system; and 6) inhibition of extended-spectrum β-lactamase activity, particularly targeting CTX-M-15 enzymes. Clinical evidence supporting the synergistic effects of TCM-antibiotic combination therapies is critically analyzed, along with discussion of their clinical potential and limitations. Current research gaps are identified, including standardization deficiencies in TCM components, insufficient elucidation of multi-target mechanisms, and potential hepatotoxicity risks. Future directions are proposed, encompassing nanotechnology-enhanced drug delivery systems, multi-omics analysis to elucidate interaction networks, and international standardization initiatives. This study provides both theoretical foundations and practical references for advancing TCM development and clinical translation in antimicrobial resistance management.