2026 年第 4 期 第 21 卷

“调中复衡”与“肠-关节轴”理论在膝骨关节炎诊疗中的契合性探讨

Exploration on the consistency of the theory of "regulating the middle energizer and restoring balance" and the "gut-joint axis" in the diagnosis and treatment of knee osteoarthritis

作者：蒋锐1何成龙1,2张李成1,2吴鹏1茆军1

英文作者：Jiang Rui1 He Chenglong12 Zhang Licheng12 Wu Peng1 Mao Jun1

单位：1南京中医药大学附属医院骨伤科，南京210023；2南京中医药大学，南京210023

英文单位：1Department of Orthopedics and Traumatology Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210023 China; 2Nanjing University of Chinese Medicine Nanjing 210023 China

关键词：膝骨关节炎；肠-关节轴；动态平衡；全身慢性炎症状态；调中复衡

英文关键词：Kneeosteoarthritis;Gut-jointaxis;Dynamicbalance;Systemicchronicinflammationstate;Regulatingthemiddleenergizerandrestoringbalance

• 摘要：

• 膝骨关节炎是一种以软骨退变、滑膜纤维化为特征的常见慢性疾病，其中医辨证涉及多个脏腑稳态失衡。“调中复衡”理论以调节中焦脾胃为核心，通过调节机体气血阴阳、寒热虚实等因素，从而使人体机能恢复动态平衡。“肠-关节轴”理论主要关注肠道菌群失调释放促炎细胞因子和产生炎症代谢物导致全身慢性炎症状态，进而引发或加重膝骨关节炎。本文旨在讨论两种理论的契合性，为膝骨关节炎的诊治提供新的思路。

• Knee osteoarthritis is a common chronic disease characterized by cartilage degeneration and synovial fibrosis, and its traditional Chinese medicine syndrome differentiation involves homeostasis imbalance of multiple Zang-Fu organs. The theory of "regulating the middle energizer and restoring balance" takes regulating the spleen and stomach of the middle energizer as the core, and restores the dynamic balance of human body functions by regulating Qi, blood, Yin, Yang, cold, heat, deficiency and excess of the body. The "gut-joint axis" theory mainly focuses on the intestinal flora imbalance that releases pro-inflammatory cytokines and produces inflammatory metabolites, leading to a state of systemic chronic inflammation, which in turn induces or aggravates knee osteoarthritis. This paper aims to discuss the consistency of the two theories and provide new ideas for the diagnosis and treatment of knee osteoarthritis.