雷公藤多苷是从雷公藤Tripterygium wilfordii根部提取出的总苷，其现代制剂雷公藤多苷片在临床上对类风湿性关节炎（rheumatoid arthritis，RA）有确切疗效，雷公藤甲素和雷公藤红素是雷公藤多苷的主要活性成分。现代研究发现雷公藤多苷治疗RA的机制包括抑制血管生成、维持调节性T细胞（regulatory T cells，Treg）和辅助性T细胞17（T helper type 17，Th17）之间的平衡、抑制基质金属蛋白酶表达和促进成纤维样滑膜细胞凋亡等。而其主要活性成分雷公藤甲素和雷公藤红素除了调节Treg和Th17细胞之间的平衡外，还可以通过调节细胞自噬、抑制多条炎症相关信号通路活化等多种途径发挥抑制RA的作用。首先回顾RA的发病机制，并重点对雷公藤多苷及其主要活性成分抑制RA的作用机制进行总结和阐述，以期为有关雷公藤多苷抗RA的研究提供参考。

Tripterygium glycosides (TG) are total glycosides extracted from the roots of Leigongteng (Tripterygium wilfordii). Tripterygium Glycosides Tablet (雷公藤多苷片) is a Chinese patent medicine with definite effect in the treatment of rheumatoid arthritis (RA). Triptolide and celastrol are the main active ingredients in TG. Modern studies have found that the mechanisms of TG against RA include inhibition of angiogenesis, regulation of balance between regulatory T (Treg) and T helper type 17 (Th17) cells, inhibition of matrix metalloproteinase expression and promotion of apoptosis of fibroblast-like synoviocytes. Moreover, as the main active ingredients of TG, triptolide and celastrol can inhibit RA by regulating autophagy, inhibiting the activation of inflammatory signaling pathways. This article firstly reviewed the pathogenesis of RA, and then focused on summarizing and elaborating the mechanisms of TG and its active ingredients against RA, with view to providing reference for the research on TG against RA.

陕西中医药大学学科创新团队项目（2019-YL10）；陕西省教育厅一般专项科研计划项目（22JK0350）