類風(fēng)濕關(guān)節(jié)炎（RA）是一類以全身性自身免疫異常為核心特征的慢性疾病，其發(fā)病機制尚不十分明確，臨床治療仍面臨難以徹底根治的困境，患者的關(guān)節(jié)功能與日常生活質(zhì)量常受嚴(yán)重影響。現(xiàn)代醫(yī)學(xué)治療RA存在一定的臨床局限性，因此探索更高效、安全的治療策略已成為領(lǐng)域內(nèi)的迫切需求。腺苷酸活化蛋白激酶（AMPK）作為調(diào)控細(xì)胞能量代謝穩(wěn)態(tài)的關(guān)鍵信號分子，近年來被證實其介導(dǎo)的信號通路廣泛參與RA的病理進(jìn)程，已成為當(dāng)前抗RA機制研究與藥物研發(fā)的核心靶點通路之一。中醫(yī)藥在RA治療中具有多靶點、多通路、多環(huán)節(jié)的獨特優(yōu)勢，研究發(fā)現(xiàn)，生物堿類、醌類、萜類等中藥活性成分可直接或間接調(diào)控AMPK信號通路，經(jīng)典中藥復(fù)方如桂枝芍藥知母湯和中藥制劑如黃芩清熱除痹膠囊同樣能通過該通路發(fā)揮抗RA作用，具體機制涵蓋促進(jìn)細(xì)胞凋亡、誘導(dǎo)細(xì)胞自噬、改善免疫微環(huán)境、減輕炎癥反應(yīng)、抑制氧化應(yīng)激、阻斷細(xì)胞焦亡6大維度。對近年來中醫(yī)藥通過AMPK信號通路干預(yù)RA的相關(guān)研究進(jìn)行總結(jié)分析，為RA治療與臨床方案優(yōu)化提供新的思路和參考。

Rheumatoid arthritis（RA） is a chronic disease characterized by systemic autoimmune abnormalities. The underlying mechanism of RA remains unclear, and clinical treatment still faces the challenge of being unable to achieve a complete cure. The joint function and quality of life of patients are often severely affected. Modern medical treatment for RA has certain clinical limitations, so exploring more efficient and safe treatment strategies has become an urgent need in the field. Adenosine monophosphate-activated protein kinase（AMPK） is a key signaling molecule that regulates the homeostasis of cellular energy metabolism. In recent years, it has been confirmed that the signaling pathways mediated by AMPK are widely involved in the pathological process of RA and have become one of the core target pathways in the current research on anti-RA mechanisms and drug development. Traditional Chinese medicine has unique advantages in treating RA, such as multiple targets, multiple pathways, and multiple links. Studies have found that bioactive components of traditional Chinese medicine, such as alkaloids, quinones, and terpenoids, can directly or indirectly regulate the AMPK signaling pathway. Classic traditional Chinese medicine formulas, such as Guizhi Shaoyao Zhimu Decoction, and traditional Chinese medicine preparations, such as Huangqin Qingre Chubi Capsules, can also exert anti-RA effects through this pathway. The specific mechanisms include promoting cell apoptosis, inducing autophagy, improving the immune microenvironment, reducing inflammatory responses, inhibiting oxidative stress, and blocking pyroptosis. By summarizing and analyzing the relevant research on the intervention of RA by traditional Chinese medicine through the AMPK signaling pathway in recent years, new ideas and references for RA treatment and clinical protocol optimization are provided.

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國家自然科學(xué)基金面上項目(81874465);國家自然科學(xué)基金青年項目(82405297); 中國博士后科學(xué)基金第71/76批面上項目(2022M711083/2024M763850); 中原醫(yī)療衛(wèi)生領(lǐng)軍人才項目(豫組通[2017]44號); 河南省中醫(yī)藥拔尖人才項目(2022ZYBJ10); 河南省自然科學(xué)基金資助項目(222300420228); 河南省科技研發(fā)計劃聯(lián)合基金項目(222301420089);河南省科技研發(fā)計劃聯(lián)合基金資助項目(232301420069); 河南省科技攻關(guān)項目(222102310392、252102311247); 河南省高等學(xué)校青年骨干教師培養(yǎng)計劃資助項目(2024GGJS069)