Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat <italic style="font-style: italic">Bi </italic>（痹）-Marrow Deficiency-Bone Damage"

SUN Tiantian; LIU Hongxiao

doi:10.13288/j.11-2166/r.2026.14.008

您当前的位置：

首页 >

文章列表页 >

Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat Bi （痹）-Marrow Deficiency-Bone Damage"

更新时间：2026-07-17

- Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat Bi （痹）-Marrow Deficiency-Bone Damage"
- Journal of Traditional Chinese Medicine Vol. 67, Issue 14, Pages: 1509-1513(2026)
- 作者机构：
  
  1.中国中医科学院广安门医院，北京市西城区北线阁5号，100053
  2.北京中医药大学研究生院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2026.14.008
  CLC：
- Received：21 April 2026，
  
  Revised：2026-05-28，
  
  Accepted：25 May 2026，
  
  Online First：15 July 2026，
  
  Published：17 July 2026
- 稿件说明：
移动端阅览
孙田田,刘宏潇.基于“热痹-髓亏-骨损”动态病机论治强直性脊柱炎[J].中医杂志,2026,67(14):1509-1513.

SUN Tiantian,LIU Hongxiao.Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat Bi （痹）-Marrow Deficiency-Bone Damage"[J].Journal of Traditional Chinese Medicine,2026,67(14):1509-1513.
孙田田,刘宏潇.基于“热痹-髓亏-骨损”动态病机论治强直性脊柱炎[J].中医杂志,2026,67(14):1509-1513. DOI： 10.13288/j.11-2166/r.2026.14.008.

SUN Tiantian,LIU Hongxiao.Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat Bi （痹）-Marrow Deficiency-Bone Damage"[J].Journal of Traditional Chinese Medicine,2026,67(14):1509-1513. DOI： 10.13288/j.11-2166/r.2026.14.008.

摘要

立足肾藏精、髓养骨的相关认识，结合强直性脊柱炎（AS）现代医学病理特点，系统阐释强直性脊柱炎“热痹（炎症活动）-髓亏（骨髓水肿）-骨损（骨结构损伤）”的动态病机演变。认为强直性脊柱炎热痹期肾虚邪侵、热壅经络，髓亏期热耗肾精、髓伤络阻，骨损期肾竭髓空、痰瘀凝骨。据此提出强直性脊柱炎分期治疗策略，热痹期以补肾填精、清热通络为主，髓亏期以补肾益髓、通络消肿为要，骨损期以补肾填精、益髓健骨、化痰逐瘀为法。

Abstract

Based on the understanding of "kidney storing essence and marrow nourishing bone"， and in combination with the modern pathological characteristics of ankylosing spondylitis （AS）， this paper systematically elucidates the dynamic pathogenesis evolution of "heat

（inflammatory activity）-marrow deficiency （bone marrow edema）-bone damage （bone structural damage）" in AS. It is proposed that in the heat

stage， there is kidney deficiency with pathogenic invasion and heat congesting the meridians. In the marrow deficiency stage， heat consumes kidney essence， leading to marrow injury and collateral obstruction. In the bone damage stage， kidney exhaustion and marrow emptiness occur， with phlegm-stasis congealing on bone. Accordingly， a stage-specific treatment strategy for AS is established. In the heat

stage， treatment focuses on supplementing the kidney and replenishing essence， clearing heat and unblocking collaterals. In the marrow deficiency stage， the main approach is to supplement the kidney and benefit marrow， unblock collaterals and reduce edema. In the bone damage stage， it is suggested to supplement the kidney and replenish essence， benefit marrow and strengthen bone， resolve phlegm and expel stasis.

关键词

Keywords

references

Ramiro S ， Nikiphorou E ， Sepriano A ， et al . ASAS-EULAR recommendations for the management of axial spondyloarthritis： 2022 update ［J］. Ann Rheum Dis ， 2023 ， 82 （ 1 ）： 19 - 34 .

Parvin A ， Sharma A R ， Hasan M A ， et al . Decoding the inflammatory-osteogenic axis in ankylosing spondylitis： mechanisms， dysregulation， and emerging therapeutic interventions ［J］. Front Immunol ， 2025 ， 16 ： 1633318 . DOI： 10.3389/fimmu.2025.1633318 http://dx.doi.org/10.3389/fimmu.2025.1633318 .

Sieper J ， Braun J ， Rudwaleit M ， et al . Ankylosing spondylitis： an overview ［J］. Ann Rheum Dis ， 2002 ， 61 （ Suppl 3 ）： iii8-iii18.

阮志磊，李卫卫 . 中医对强直性脊柱炎病位病因病机之浅析［J］. 中医临床研究， 2014 ， 6 （ 14 ）： 57 - 58 .

谢国倩，何晓瑾，金实，等 . 从肾-脾轴论治强直性脊柱炎［J］. 南京中医药大学学报， 2020 ， 36 （ 1 ）： 11 - 13 .

王拥军 . “肾主骨”藏象理论与实践［M］. 北京：人民卫生出版社， 2023 ： 500 .

李晴晴，金艳，周定华 . 孟河医派周定华教授基于“肾督亏虚”理论治疗强直性脊柱炎的经验［J］. 中国医药导报， 2024 ， 21 （ 6 ）： 127 - 131 .

Spoorenberg A ， Van Der Heijde D ， De Klerk E ， et al . Relative value of erythrocyte sedimentation rate and C-reactive protein in assessment of disease activity in ankylosing spondylitis ［J］. J Rheumatol ， 1999 ， 26 （ 4 ）： 980 - 984 .

Muench D E ， Sun Z ， Sharma A ， et al . A pathogenic Th17/CD38 + macrophage feedback loop drives inflammatory arthritis through TNF-α ［J］. J Immunol ， 2022 ， 208 （ 6 ）： 1315 - 1328 .

Maksymowych W P ， Inman R D ， Salonen D ， et al . Spondyloarthritis Research Consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis ［J］. Arthritis Rheum ， 2005 ， 53 （ 5 ）： 703 - 709 .

Renson T ， Carron P ， De Craemer A S ， et al . Axial involvement in patients with early peripheral spondyloarthritis： a prospective MRI study of sacroiliac joints and spine ［J］. Ann Rheum Dis ， 2021 ， 80 （ 1 ）： 103 - 108 .

Kotsis K ， Voulgari P V ， Drosos A A ， et al . Health-related quality of life in patients with ankylosing spondylitis： a comprehensive review ［J］. Expert Rev Pharmacoecon Outcomes Res ， 2014 ， 14 （ 6 ）： 857 - 872 .

Lee S H ， Lee K H ， Kim D ， et al . Targeting osteoclast-derived DPP4 alleviates inflammation-mediated ectopic bone formation in ankylosing spondylitis ［J］. Arthritis Res Ther ， 2025 ， 27 （ 1 ）： 40 .

杨静，田雪梅，王海东，等 . “肾主骨”理论辨治强直性脊柱炎继发骨质疏松症［J］. 中国骨质疏松杂志， 2024 ， 30 （ 4 ）： 556 - 559 .

吴娟，杨悦，李月，等 . 男性强直性脊柱炎患者骶髂关节骨髓水肿与中医证候的相关性研究［J］. 北京中医药， 2022 ， 41 （ 8 ）： 833 - 837 .

Machado P ， Landewé R ， Braun J ， et al . Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis ［J］. Ann Rheum Dis ， 2010 ， 69 （ 8 ）： 1465 - 1470 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

The Effect of Bone Immune Microenvironment and Bone Mesenchymal Stem Cells on the Heterotopic Ossification of Ankylosing Spondylitis Based on the Theory of "Bone Sweat Pore-Kidney Visceral Manifestation"

A Retrospective Clinical Study on the Correlation between the Theory of Five Movements and Six Climates， and Kidney Deficiency with Governor Vessel Cold Syndrome and Kidney Deficiency Damp-Heat Syndrome in Ankylosing Spondylitis

A Multicenter Cross-sectional Survey on the Clinical Characteristics of Patients of Ankylosing Spondylitis with Kidney Deficiency and Stasis Obstruction Syndrome and Damp-heat Stasis Obstruction Syndrome

Survey on the Differences in Disease Activity between Kidney Deficiency Obstruction Syndrome and Damp-heat Obstruction Syndrome of Ankylosing Spondylitis Patients

A Multicentered,Double-Blind,Randomize-Controlled Trial of Tonifying Kidney and Fortifying Du Meridian in Treating Ankylosing Spondylitis

Related Author

CHEN Yuening

WU Juan

LI Yue

YAN Xiaoping

KONG Weiping

MA Xiaoxia

FENG Xinghua

JIANG Quan

Related Institution

Japan Friendship Hospital

Graduate School of Beijing University of Chinese Medicine

National Data Center of Traditional Chinese Medicine，China Academy of Chinese Medical Sciences

National Digital Center of Traditional Chinese Medicine，China Academy of Chinese Medical Sciences

Beijing University of Chinese Medicine

Address：No.16, Nanxiao street, Dongzhimen, Dongcheng District, Beijing Postal code：100700
Tel：010-64035632 Email：jtcmcn@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010102007558号
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰

Treatment of Ankylosing Spondylitis Based on the Dynamic Pathogenesis of "Heat Bi （痹）-Marrow Deficiency-Bone Damage"

DOI：10.13288/j.11-2166/r.2026.14.008

摘要

Abstract

关键词

Keywords

references