免疫检查点抑制剂（ICIs）改变了肿瘤免疫治疗的格局，在手术、化疗和放疗的同时提供了新的治疗方法，并显着提高了生存效益。然而，它们的临床疗效在某些患者中有限，并且它们的使用可能会导致免疫相关不良事件（irAE）。中药 (TCM) 与 ICI 的结合已被证明具有增强致敏性和降低毒性的潜力。临床试验和实验探索已证实中药及其有效成分协同增强ICIs的疗效。本文总结了中药提高ICIs临床疗效、减少irAE的实践。本文还总结了中药汤剂、中药制剂、中药有效成分协同作用的实验研究机制。中药联合ICIs的研究大多是基础实验。我们探讨了中药增强ICIs的作用机制，为中药辅助免疫治疗的研发提供参考。我们利用PubMed和中国国家知识基础设施数据库进行了文献检索，重点关注中药汤剂、中药制剂以及有效成分。提高 ICI 的有效性并减少 irAE。搜索关键词为“ICIs与中药”、“PD-1与中药”、“PD-L1与中药”、“CTLA-4与中药”、“IDO1与中药”、 《Tim-3与中医》、《TIGIT与中医》、《irAEs与中医》。检索时间为2014年5月至2024年5月。筛选涉及中药或其成分与ICIs联合使用并研究其潜在机制的文章。最终获得了30个与ICIs联合使用的中药来探索其作用机制。在除PD-1以外的免疫检查点分子部分，中药联合应用的研究较少，因此纳入了中药调控免疫检查点分子的研究。中药已被证明可以增强ICIs的有效性，并减少免疫检查点分子的作用。 irAE。研究人员表示，中药及其活性成分可以与ICIs协同作用，通过调节免疫检查点PD-1、PD-L1、CTLA-4、IDO1，调节肠道菌群，改善肿瘤微环境等，中药与ICIs结合可以发挥更好的作用。抗肿瘤作用，但需要更大的样本和高质量的临床试验来证实这一点。许多中药及其成分在实验研究中已被证明具有ICIs增敏作用，这为ICI增强剂的后续开发提供了丰富的选择。版权所有©2024。Elsevier B.V.出版。

Immune checkpoint inhibitors (ICIs) have altered the landscape of tumor immunotherapy, offering novel therapeutic approaches alongside surgery, chemotherapy, and radiotherapy and significantly improving survival benefits. However, their clinical efficacy is limited in some patients, and their use may cause immune-related adverse events (irAEs). Integrating traditional Chinese medicine (TCM) with ICIs has demonstrated the potential to boost sensitization and reduce toxicity. Clinical trials and experimental explorations have confirmed that TCM and its active components synergistically enhance the effectiveness of ICIs.This narrative review summarizes the TCM practices that enhance the clinical efficacy and reduce irAEs of ICIs. This paper also summarizes the mechanism of experimental studies on the synergies of Chinese herbal decoctions, Chinese herbal preparation, and Chinese herbal active ingredients. Most of the studies on TCM combined with ICIs are basic experiments. We discussed the mechanism of TCM enhanced ICIs to provide reference for the research and development of TCM adjuvant immunotherapy.We conducted a literature search using PubMed and Chinese National Knowledge Infrastructure databases, with a focus on herbal decoction, Chinese medicine preparations, and active ingredients that boost the effectiveness of ICIs and reduce irAEs. The search keywords were "ICIs and traditional Chinese medicine", "PD-1 and traditional Chinese medicine", "PD-L1 and traditional Chinese medicine", "CTLA-4 and traditional Chinese medicine", "IDO1 and traditional Chinese medicine", "Tim-3 and traditional Chinese medicine", "TIGIT and traditional Chinese medicine", "irAEs and traditional Chinese medicine". The search period was from May 2014 to May 2024. Articles involving the use of TCM or its components in combination with ICIs and investigating the underlying mechanisms were screened. Finally, 30 Chinese medicines used in combination with ICIs were obtained to explore the mechanism. In the part of immune checkpoint molecules other than PD-1, there were few studies on the combined application of TCM, so studies involving the regulation of immune checkpoint molecules by TCM were included.TCM has been shown to boost the effectiveness of ICIs and reduce irAEs. Researchers indicate that TCM and its active components can work synergistically with ICIs by regulating immune checkpoints PD-1, PD-L1, CTLA-4, and IDO1, regulating intestinal flora, improving tumor microenvironment and more.Combining TCM with ICIs can play a better anti-tumor role, but larger samples and high-quality clinical trials are necessary to confirm this. Many Chinese medicines and their ingredients have been shown to sensitize ICIs in experimental studies, which provides a rich choice for the subsequent development of ICI enhancers.Copyright © 2024. Published by Elsevier B.V.