2026 年第 9 期 第 21 卷

中药调控巨噬细胞极化干预痛风性关节炎机制的研究进展

Research progress on the mechanism of traditional Chinese medicine regulating macrophage polarization in intervening gouty arthritis

作者：李如1李泽光2高丽娟2

英文作者：Li Ru1 Li Zeguang2 Gao Lijuan2

单位：1黑龙江中医药大学研究生院，哈尔滨150040；2黑龙江中医药大学附属第一医院风湿病科，哈尔滨150040

英文单位：1Graduate School of Heilongjiang University of Chinese Medicine Harbin 150040 China; 2Department of Rheumatology First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin 150040 China

关键词：痛风性关节炎；巨噬细胞极化；作用机制；中药

英文关键词：Goutyarthritis;Macrophagepolarization;Mechanismofaction;TraditionalChinesemedicine

• 摘要：

• 痛风性关节炎（GA）是一种由体内尿酸代谢失衡导致尿酸钠晶体积聚进行引起疾病发展的炎症性疾病，其发病率持续上升且具有年轻化趋势，已成为严重的公共卫生问题。巨噬细胞极化是GA炎症反应的重要环节，巨噬细胞经不同信号刺激极化为促炎的M1型和抗炎修复的M2型，两种表型间的动态平衡影响GA的发生与转归。中药具有多靶点、多通路的整体调节优势，可通过调控炎症信号枢纽、干预代谢重编程、影响中性粒细胞胞外诱捕网以及调节肠道菌群等多重机制，干预巨噬细胞极化状态，从而抑制炎症、促进组织修复。此外，中药对表观遗传修饰、T细胞亚群交互等机制亦展现出干预潜力。本文对国内外相关研究文献进行汇总，系统综述中药通过上述途径调控巨噬细胞极化的研究进展，以期为GA的治疗提供新思路与科学依据。

• Gouty arthritis (GA) is an inflammatory disease caused by the imbalance of uric acid metabolism in the body leading to the accumulation of sodium urate crystals and disease progression. Its incidence continues to rise with a younger onset trend, and has become a serious public health problem. Macrophage polarization is an important link in the inflammatory response of GA. Macrophages are polarized into pro-inflammatory M1 phenotype and anti-inflammatory reparative M2 phenotype under different signal stimuli, and the dynamic balance between the two phenotypes affects the occurrence and prognosis of GA. Traditional Chinese medicine has the advantages of holistic regulation with multi-target and multi-pathway characteristics. It can intervene in the polarization state of macrophages by regulating inflammatory signal hubs, interfering with metabolic reprogramming, affecting neutrophil extracellular traps, and regulating intestinal flora, thereby inhibiting inflammation and promoting tissue repair. In addition, traditional Chinese medicine also shows intervention potential in mechanisms such as epigenetic modification and T cell subset interaction. This paper summarizes relevant domestic and foreign literatures, systematically reviews the research progress of traditional Chinese medicine in regulating macrophage polarization through the above pathways, so as to provide new ideas and scientific basis for the treatment of GA.