2026 年第 9 期 第 21 卷

基于“虚气留滞”理论探讨铁死亡对类风湿关节炎的调控机制

Exploration on the regulatory mechanism of ferroptosis in rheumatoid arthritis based on the theory of "deficiency of Qi and lingering stagnation"

作者：邵俊莉1楚朝宇1徐荣漪2许静2付杨阳2祁燕1徐莹1

英文作者：Shao Junli1 Chu Zhaoyu1 Xu Rongyi2 Xu Jing2 Fu Yangyang2 Qi Yan1 Xu Ying1

单位：1云南中医药大学第一附属医院云南中医药大学第一临床医学院，昆明650011；2云南中医药大学中药学院，昆明650500

英文单位：1The First Clinical Medical College Yunnan University of Chinese Medicine the First Affiliated Hospital of Yunnan University of Chinese Medicine Kunming 650011 China; 2School of Chinese Materia Medica Yunnan University of Chinese Medicine Kunming 650500 China

关键词：类风湿关节炎；虚气留滞；铁死亡；气虚血瘀

英文关键词：Rheumatoidarthritis;DeficiencyofQiandlingeringstagnation;Ferroptosis;Qideficiencyandbloodstasis

• 摘要：

• 类风湿关节炎(RA)作为一种以慢性侵袭性滑膜炎和进行性关节破坏为特征的常见系统性自身免疫性疾病，其病程迁延反复、致残率高，严重损害患者身心健康与生活质量。中医“虚气留滞”为阐释RA缠绵难愈病机的重要理论之一，其内涵为“虚为本，滞为标”。铁死亡作为一种新型程序性细胞死亡模式，在调控炎症反应、滑膜细胞增殖及关节组织破坏中发挥关键作用，逐渐成为RA发病机制研究热点。研究表明铁死亡异常激活与“虚气留滞”介导的代谢紊乱、微环境失衡密切相关。本文综述铁死亡生物学特征，深入解析“虚气留滞”理论与铁死亡的关联性，探讨其作为潜在治疗靶点的应用前景，旨在丰富“虚气留滞”理论现代医学内涵，为基于中医理论的RA防治提供新的思路与实验依据。

• Rheumatoid arthritis (RA) is a common systemic autoimmune disease characterized by chronic invasive synovitis and progressive joint destruction. It presents with a protracted and recurrent disease course and a high disability rate, which seriously endangers the physical and mental health as well as the quality of life of patients. The traditional Chinese medicine theory of "deficiency of Qi and lingering stagnation" is one of the core theories interpreting the intractable pathogenesis of RA, which embodies the connotation of "deficiency as the root and stagnation as the branch". As a newly identified pattern of programmed cell death, ferroptosis plays a pivotal role in regulating inflammatory responses, synoviocyte proliferation and joint tissue destruction, and has gradually become a research hotspot in the pathogenesis of RA. Accumulating studies have demonstrated that abnormal activation of ferroptosis is closely correlated with metabolic disorders and microenvironmental imbalance mediated by "deficiency of Qi and lingering stagnation". This article summarizes the biological characteristics of ferroptosis, further analyzes the correlation between the theory of "deficiency of Qi and lingering stagnation" and ferroptosis, and explores its application prospects as a potential therapeutic target, aiming to enrich the modern connotation of the theory and provide novel ideas and experimental evidence for the prevention and treatment of RA guided by traditional Chinese medicine theories.