基于“骨痹–痿证”同源论探讨骨–肌轴介导的骨关节炎与肌少症共病机制
Mechanisms Underlying Osteoarthritis and Sarcopenia Comorbidity through the Bone-Muscle Axis: A Perspective from the Traditional Chinese Medicine Theory of “Bone Impediment and Flaccidity Syndrome Sharing the Same Origin”
DOI: 10.12677/tcm.2026.159483, PDF,   
作者: 蒋佳灵*：成都中医药大学临床医学院，四川 成都；张 怡#：成都中医药大学附属医院老年病科，四川 成都
关键词: 骨–肌轴；骨关节炎；肌少症；补肾健脾；共病机制；Bone-Muscle Axis； Osteoarthritis； Sarcopenia； Tonifying Kidney and Strengthening Spleen； Comorbidity Mechanism
摘要: 骨关节炎(Osteoarthritis, OA)与肌少症(Sarcopenia)是中老年人群常见的骨肌退行性疾病，二者并非独立发生，而是通过骨–肌轴形成相互作用的病理网络。文章基于中医“骨痹–痿证”同源理论与现代骨–肌轴学说，系统探讨OA与肌少症共病机制及干预策略。研究认为，骨–肌轴失衡是连接关节退变与肌肉衰减的关键环节，力学异常、慢性低度炎症及代谢紊乱共同推动疾病进展，并与中医“肾主骨生髓”、“脾主肌肉四肢”及“虚–痰–瘀–痹”病机相契合。补肾健脾、活血通痹类中医药联合运动及营养干预可发挥骨肌保护作用，为OA合并肌少症的中西医防治提供新思路。
Abstract: Osteoarthritis (OA) and sarcopenia are common age-related musculoskeletal degenerative disorders in middle-aged and older adults. Rather than occurring as independent pathological conditions, these two disorders interact through a complex pathological network mediated by the bone-muscle axis. Based on the traditional Chinese medicine (TCM) theory of the shared origin of “bone impediment-atrophy syndrome” and the modern concept of the bone-muscle axis, this study systematically explores the potential mechanisms underlying OA and sarcopenia comorbidity and discusses corresponding intervention strategies. Current evidence suggests that dysfunction of the bone-muscle axis serves as a critical link connecting joint degeneration and muscle deterioration. Mechanical abnormalities, chronic low-grade inflammation, and metabolic disturbances collectively contribute to disease progression, showing considerable consistency with the TCM pathological concepts of “the kidney governing bones and generating marrow”, “the spleen governing muscles and limbs”, and the pathological pattern of “deficiency, phlegm accumulation, blood stasis, and obstruction”. Integrated interventions combining kidney-tonifying, spleen-strengthening, and blood-activating therapies with exercise and nutritional support may exert protective effects on both bone and skeletal muscle. These findings provide a novel perspective and potential therapeutic strategy for the prevention and management of OA complicated with sarcopenia through an integrated approach combining traditional Chinese and Western medicine.
文章引用：蒋佳灵, 张怡. 基于“骨痹–痿证”同源论探讨骨–肌轴介导的骨关节炎与肌少症共病机制[J]. 中医学, 2026, 15(9): 56-64. https://doi.org/10.12677/tcm.2026.159483

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