基于"柔筋正骨"理论从机械力学视角探讨强直性脊柱炎中医非药物疗法OA

Ankylosing spondylitis(AS)is a chronic rheumatic autoimmune disease primarily affecting the axial skeleton,particularly the spine and sacroiliac joints,with an insidious onset and a high risk of long-term disability.Non-pharmaco-logical therapies in traditional Chinese medicine(TCM)have attracted increasing attention for symptom relief and func-tional improvement in AS.TCM theory attributes the pathogenesis of AS to"muscle-bone imbalance",while growing evi-dence highlights the role of mechanical factors in disease progression.This study explores the relationship between the muscle-bone imbalance theory and biomechanical mechanisms,and systematically reviews the available literature.A differ-entiated evidence synthesis strategy was applied based on study design hierarchy,methodological quality,and consistency of outcomes to evaluate the strength of evidence supporting acupuncture,needle-knife therapy,moxibustion,tuina,and traditional therapeutic exercises.In addition,adverse events,risk factors,and considerations for special populations were summarized to provide a comprehensive safety perspective.The findings indicate high-level evidence for acupuncture,moderate-level evidence for needle-knife therapy and moxi-bustion,and limited evidence for tuina and traditional exerci-ses.Overall,when performed under standardized protocols and appropriate patient selection,TCM non-pharmacological therapies demonstrate a favorable safety profile.