肿瘤微环境（TME）在肿瘤的发展中起着重要作用。免疫调节性细胞和细胞因子促使癌细胞避免免疫监视。细胞毒性T淋巴细胞相关抗原-4（CTLA-4）和程序性死亡受体-1/程序性死亡受体配体-1（PD-1/PD-L1）等免疫检查点分子的过度表达抑制了免疫功能，使癌细胞得以避免被免疫系统清除。因此，减少肿瘤免疫抑制可能是癌症治疗的重要策略。目前，许多免疫检查点靶向药物，如PD-1/PD-L1抑制剂已经获得上市批准，并在临床癌症治疗中显示出独特的优势。中医药学中“扶正祛邪”的概念与肿瘤免疫治疗是一致的。根据以往的研究，中医药在肿瘤免疫治疗中的作用主要与天然杀伤细胞、CD8/CD4 T细胞、树突状细胞、M2巨噬细胞、白细胞介素-2、肿瘤坏死因子；以及T调节细胞、髓源性抑制细胞、癌组织相关成纤维细胞、PD-1/PD-L1、转化生长因子以及肿瘤坏死因子的负调控有关。本文总结了中医药靶向TME的研究进展，并进一步介绍了中医药对免疫检查点的作用研究进展。现代药理学研究已经证明，中医药可以通过抑制免疫检查点分子的过度表达和增强肿瘤免疫治疗的疗效直接或间接地影响TME。具有免疫调节刺激作用的中医药可能是实现非炎症性或“冷”肿瘤患者从免疫治疗中获益的关键因素。

The tumor microenvironment (TME) plays an important role in the development of tumors. Immunoregulatory cells and cytokines facilitate cancer cells to avoid immune surveillance. Overexpression of immune checkpoint molecules such as CTLA-4 and PD-1/PD-L1 inhibits immune function and enables cancer cells to avoid clearance by the immune system. Thus, minimizing tumor immunosuppression could be an important strategy for cancer therapy. Currently, many immune checkpoint-targeted drugs, such as PD-1/PD-L1 inhibitors, have been approved for marketing and have shown unique advantages in the clinical treatment of cancers. The concept of "strengthening resistance to eliminate pathogenic factors" in traditional Chinese medicine (TCM) is consistent with the immunotherapy of cancer. According to previous studies, the role of TCM in tumor immunotherapy is mainly associated with the positive regulation of natural killer cells, CD8/CD4 T cells, dendritic cells, M2 macrophages, interleukin-2, tumor necrosis factor-[Formula: see text], and IFN-[Formula: see text], as well as with the negative regulation of Tregs, myeloid-derived suppressor cells, cancer-associated fibroblasts, PD-1/PD-L1, transforming growth factor-[Formula: see text], and tumor necrosis factor-[Formula: see text]. This paper summarizes the current research on the effect of TCM targeting the TME, and further introduces the research progress on studying the effects of TCM on immune checkpoints. Modern pharmacological studies have demonstrated that TCM can directly or indirectly affect the TME by inhibiting the overexpression of immune checkpoint molecules and enhancing the efficacy of tumor immunotherapy. TCM with immunomodulatory stimulation could be the key factor to achieve benefits from immunotherapy for patients with non-inflammatory, or "cold", tumors.