膝关节骨性关节炎的铁死亡机制及其中医药干预进展

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关键词：膝关节骨性关节炎；铁死亡；软骨细胞；中医药；骨碎补；独活寄生汤中图分类号：R274.9 文献标志码：A 文章编号：1007-3213（2025）05-1290-07DOI：10.13359/j.cnki.gzxbtcm.2025.05.037

Ferroptosis Mechanism of Knee Osteoarthritis and Its Progress in Traditional Chinese Medicine Intervention

HANFeiyu'，CAO Yujing²，LIN Zihan³，WANG Yinlong'，TONG Wuyue'（1.SchoolofOrthopedicsandTraumatology，Henan UniversityofChinese Medicine，Zhengzhou450o Henan，China；2.HenanProvince HospitalofTraditional ChineseMedicine，Zhengzhou45ooo3Henan，China；3.Luoyang CentralTunnelHospital，Luoyang 471099 Henan，China）

Abstract：Knee osteoarthritis （KOA）is a common musculoskeletal disease，and ferroptosis is a new type of programmed cell death involving iron ions.This paper summarized the relationship between the pathological changes of ferroptosis and the onset of KOA，and reviewed the progress of traditional Chinese medicine（TCM） intervention in KOA based on the pathological changes of ferroptosis.The pathological changes of ferroptosis are mainlyrelated to the imbalance of aminoacid antioxidant system，iron metabolism disorder and lipid peroxide accumulation. The cystine/glutamate antiporter （System XO ），glutathione （GSH）and glutathione peroxidase 4 （GPX4）arethe core targets for regulating ferroptosis，involving the main signaling pathways for studying the TCM intervention of KOAvia ferroptosis.Single herbs such as Drynariae Rhizoma，Scutelariae Barbatae Herba， Epimedii Folium，Astragali Radix，Ligustri Lucidi Fructus，and Achyranthis Bidentatae Radix，and multi-herb formulae such as Duhuo Jisheng Decoction and Yougui Pills，can inhibit the ferrptosis of chondrocytes through multiple targets and multiple pathways，thus treating KOA.The research of the TCM intervention on the ferroptosis of chondrocytes and its associated signaling pathways can provides a novel approach for expanding the TCMtherapy of KOA.

Keywords：knee osteoarthritis； ferroptosis；chondrocytes；traditional Chinese medicine；Drynariae Rhizoma; Duhuo Jisheng Decoction

膝关节骨性关节炎（kneeosteoarthritis，KOA）是常见的进行性肌肉骨骼疾病，可影响关节，但主要影响髋关节和膝关节，其病变特点是关节软骨的退行性变和关节周围继发性骨质增生[1。（剩余15037字）