基于"脾肾相关"理论探讨类风湿关节炎相关肌少症的发病机制与防治策略OA

Sarcopenia is a common complication of rheumatoid arthritis(RA),with a prevalence of up to 66%among RA patients,significantly impacting their functional status and quality of life(including risks of disability and falls).While the exact pathogenesis of sarcopenia in RA remains incompletely understood in modern medicine,it is generally attributed to factors such as inflammatory cytokines,imbalances in protein metabolism,and the effects of glucocor-ticoids;current treatment modalities encompassing exercise,diet,and pharmacotherapy offer some benefits but have limitations.This article combines theoretical discussion with a literature review to systematically elucidate the Tradi-tional Chinese Medicine(TCM)pathogenesis of sarcopenia in RA based on the theory of the"Spleen-Kidney relation-ship".It identifies"deficiency of the Spleen and Kidney"as the core pathogenesis,noting that the condition's onset and progression are closely linked to modern mechanisms such as inflammatory injury,metabolic disorders,declining sex hormone levels,mitochondrial dysfunction,and neuroendocrine dysregulation.The study proposes a TCM prevention and treatment strategy centered on"strengthening the Spleen and Kidney while resolving stasis and unblocking collat-erals".When combined with Western medical therapies,this approach offers the advantages of multi-target action and holistic regulation,providing new insights for clinical practice.