强直性脊柱炎（Ankylosing spondylitis，AS）是以炎性背痛为主要临床特点的慢性炎症性自身免疫性疾病， 其病理特征主要包括炎症、骨破坏和病理性新骨形成。AS 病因错综复杂，主要与遗传、感染、环境及肠道菌 群等因素相关，其病机暂未明确。近年来，骨免疫学作为研究炎症性关节炎的新主题，其在 AS 发病机制及发 生发展中扮演着重要角色，主要体现在炎症反应和骨代谢失衡等方面。中医药具有多途径、多组分、多靶点、 多层次的特点，可以通过调节骨骼系统的骨细胞及免疫系统的相关因子，改善 AS 炎症反应及骨代谢失衡，以 达到防治 AS 的目的。基于此，该文总结了骨免疫学在 AS 发病机制中的作用，并综述了中医药通过干预骨免 疫治疗 AS 的研究现状，以期为 AS 的治疗提供参考。

Ankylosing spondylitis （AS）is a chronic inflammatory autoimmune disease characterized by inflammatory back pain. Its pathological features mainly include inflammation， bone destruction， and pathologic new bone formation. The etiology of AS is complex， and it may be related to genetics， infections， the environment， and intestinal flora. Its pathogenesis has not yet been clarified. In recent years，osteoimmunology，as a new theme in the study of inflammatory arthritis， plays an important role in the pathogenesis and development of AS， which was embodied in the inflammatory response and imbalance of bone metabolism. Traditional Chinese medicine （TCM） has the characteristics of multiple pathways，multiple components，multiple targets and multiple levels. TCM can improve the inflammatory response and bone metabolism imbalance of AS by regulating the osteoblasts of the skeletal system and the related factors of the immune system，thus to prevent and control AS. For this reason，the paper summarizes the role of bone immunology in the pathogenesis of AS，and reviews the current status of research on the intervention of TCM in bone immunology for the treatment of AS，with a view to providing certain references for the future clinical application of TCM in the prevention and treatment of AS.

R285.5

甘肃省名中医王海东传承工作室项目（国中医药规财函［2021］242号）；甘肃省科技计划资助项目（23JRRA1535）；国家中医药管理局高 水平中医药重点学科建设项目（国中医药人教函[2023]85号）