在过去的十年中，结直肠癌在年轻成年人中的发病率较高，死亡率较低。近年来，肠道菌群对结直肠癌的发生、进展和治疗的影响已经得到广泛研究，以及其对炎症和癌症微环境的积极治疗影响。从历史上看，中药在结直肠癌的治疗中被广泛应用，通过促进癌细胞凋亡，抑制癌转移并减少药物抗性和副作用。本研究主要关注中药或肠道菌群对结直肠癌的影响。中药和肠道菌群之间的相互作用是双向的，不应忽视中药和肠道菌群在结直肠癌治疗中的联合影响。因此，本综述讨论了肠道细菌在结直肠癌的发展和治疗中的作用，包括抑制癌变、参与治疗和协助伤口愈合。然后，分别总结了不同种类中药单体、中药药对以及中药方剂在凋亡、转移、免疫抑制和药物抗性方面的复杂抗结直肠癌效应。此外，分析了中药和肠道菌群之间的相互作用以及对癌症治疗的联合效应。本综述为中药和肠道菌群在结直肠癌临床治疗中的应用提供了机制参考，并为肠道菌群和中药的联合开发和应用铺平了道路。© 2023 Wiley Periodicals LLC.

Over the past decade, colorectal cancer has reported a higher incidence in younger adults and a lower mortality rate. Recently, the influence of the intestinal flora in the initiation, progression, and treatment of colorectal cancer has been extensively studied, as well as their positive therapeutic impact on inflammation and the cancer microenvironment. Historically, traditional Chinese medicine (TCM) has been widely used in the treatment of colorectal cancer via promoted cancer cell apoptosis, inhibited cancer metastasis, and reduced drug resistance and side effects. The present research is more on the effect of either herbal medicine or intestinal flora on colorectal cancer. The interactions between TCM and intestinal flora are bidirectional and the combined impacts of TCM and gut microbiota in the treatment of colon cancer should not be neglected. Therefore, this review discusses the role of intestinal bacteria in the progression and treatment of colorectal cancer by inhibiting carcinogenesis, participating in therapy, and assisting in healing. Then the complex anticolon cancer effects of different kinds of TCM monomers, TCM drug pairs, and traditional Chinese prescriptions embodied in apoptosis, metastasis, immune suppression, and drug resistance are summarized separately. In addition, the interaction between TCM and intestinal flora and the combined effect on cancer treatment were analyzed. This review provides a mechanistic reference for the application of TCM and intestinal flora in the clinical treatment of colorectal cancer and paves the way for the combined development and application of microbiome and TCM.© 2023 Wiley Periodicals LLC.