基于“经筋–生物力学–炎症反应轴”探讨膝骨关节炎的发病机制

The Pathogenesis of Knee Osteoarthritis Was Explored Based on the “Meridian-Biomechanics-Inflammatory Response Axis”

摘要: 膝骨关节炎(KOA)是一种慢性退行性关节疾病，其发病机制涉及多系统间的复杂交互作用。本研究基于“经筋–生物力学–炎症反应轴”理论框架，将中医经筋学说与现代生物力学及分子病理学相结合，系统性地阐述了KOA的跨学科发病机制。研究发现，经筋系统功能紊乱(特别是足三阳经筋的张力异常)会直接引发下肢力线偏移和关节应力分布异常，力学失衡通过激活MAPK/NF-κB等关键信号通路，触发IL-1β和TNF-α等促炎因子的级联释放，炎症微环境通过痛觉敏化和神经血管新生等途径加重经筋系统功能失调，由此形成“筋结形成–力学失稳–炎症扩散”的恶性循环。本研究提出的理论为理解膝骨关节炎的发病机制和制定早期防治策略提供了跨学科研究框架。

Abstract: Knee osteoarthritis (KOA) is a chronic degenerative joint disease, whose pathogenesis involves complex interactions among multiple systems. This study, based on the theoretical framework of the “meridian-mechanobiology-inflammation axis”, combines traditional Chinese medicine meridian theory with modern biomechanics and molecular pathology to systematically expound the interdisciplinary pathogenesis of KOA. The research found that dysfunction of the meridian system (especially abnormal tension of the three yang meridians of the foot) directly leads to lower limb force line deviation and abnormal joint stress distribution. Mechanical imbalance activates key signaling pathways such as MAPK/NF-κB, triggering a cascade release of pro-inflammatory factors such as IL-1β and TNF-α. The inflammatory microenvironment aggravates meridian system dysfunction through pathways such as pain sensitization and neurovascular neogenesis, thereby forming a vicious cycle of “meridian knot formation-mechanical instability-inflammation spread”. The theory proposed in this study provides an interdisciplinary research framework for understanding the pathogenesis of knee osteoarthritis and formulating early prevention and treatment strategies.