类风湿关节炎（RA）是一类以全身性自身免疫异常为核心特征的慢性疾病，其发病机制尚不十分明确，临床治疗仍面临难以彻底根治的困境，患者的关节功能与日常生活质量常受严重影响。现代医学治疗RA存在一定的临床局限性，因此探索更高效、安全的治疗策略已成为领域内的迫切需求。腺苷酸活化蛋白激酶（AMPK）作为调控细胞能量代谢稳态的关键信号分子，近年来被证实其介导的信号通路广泛参与RA的病理进程，已成为当前抗RA机制研究与药物研发的核心靶点通路之一。中医药在RA治疗中具有多靶点、多通路、多环节的独特优势，研究发现，生物碱类、醌类、萜类等中药活性成分可直接或间接调控AMPK信号通路，经典中药复方如桂枝芍药知母汤和中药制剂如黄芩清热除痹胶囊同样能通过该通路发挥抗RA作用，具体机制涵盖促进细胞凋亡、诱导细胞自噬、改善免疫微环境、减轻炎症反应、抑制氧化应激、阻断细胞焦亡6大维度。对近年来中医药通过AMPK信号通路干预RA的相关研究进行总结分析，为RA治疗与临床方案优化提供新的思路和参考。

Rheumatoid arthritis（RA） is a chronic disease characterized by systemic autoimmune abnormalities. The underlying mechanism of RA remains unclear, and clinical treatment still faces the challenge of being unable to achieve a complete cure. The joint function and quality of life of patients are often severely affected. Modern medical treatment for RA has certain clinical limitations, so exploring more efficient and safe treatment strategies has become an urgent need in the field. Adenosine monophosphate-activated protein kinase（AMPK） is a key signaling molecule that regulates the homeostasis of cellular energy metabolism. In recent years, it has been confirmed that the signaling pathways mediated by AMPK are widely involved in the pathological process of RA and have become one of the core target pathways in the current research on anti-RA mechanisms and drug development. Traditional Chinese medicine has unique advantages in treating RA, such as multiple targets, multiple pathways, and multiple links. Studies have found that bioactive components of traditional Chinese medicine, such as alkaloids, quinones, and terpenoids, can directly or indirectly regulate the AMPK signaling pathway. Classic traditional Chinese medicine formulas, such as Guizhi Shaoyao Zhimu Decoction, and traditional Chinese medicine preparations, such as Huangqin Qingre Chubi Capsules, can also exert anti-RA effects through this pathway. The specific mechanisms include promoting cell apoptosis, inducing autophagy, improving the immune microenvironment, reducing inflammatory responses, inhibiting oxidative stress, and blocking pyroptosis. By summarizing and analyzing the relevant research on the intervention of RA by traditional Chinese medicine through the AMPK signaling pathway in recent years, new ideas and references for RA treatment and clinical protocol optimization are provided.

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国家自然科学基金面上项目(81874465);国家自然科学基金青年项目(82405297); 中国博士后科学基金第71/76批面上项目(2022M711083/2024M763850); 中原医疗卫生领军人才项目(豫组通[2017]44号); 河南省中医药拔尖人才项目(2022ZYBJ10); 河南省自然科学基金资助项目(222300420228); 河南省科技研发计划联合基金项目(222301420089);河南省科技研发计划联合基金资助项目(232301420069); 河南省科技攻关项目(222102310392、252102311247); 河南省高等学校青年骨干教师培养计划资助项目(2024GGJS069)