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河南中医药大学,郑州 450046
Received:07 September 2025,
Revised:2025-11-04,
Accepted:10 November 2025,
Online First:13 November 2025,
Published:05 June 2026
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周恩慧,车志英,王振亮等.当归拈痛汤治疗类风湿关节炎的研究进展[J].中国实验方剂学杂志,2026,32(11):343-349.
ZHOU Enhui,CHE Zhiying,WANG Zhenliang,et al.Danggui Niantongtang in Treatment of Rheumatoid Arthritis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(11):343-349.
周恩慧,车志英,王振亮等.当归拈痛汤治疗类风湿关节炎的研究进展[J].中国实验方剂学杂志,2026,32(11):343-349. DOI: 10.13422/j.cnki.syfjx.20252403.
ZHOU Enhui,CHE Zhiying,WANG Zhenliang,et al.Danggui Niantongtang in Treatment of Rheumatoid Arthritis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(11):343-349. DOI: 10.13422/j.cnki.syfjx.20252403.
类风湿关节炎(RA)是一种以对称性多关节炎为典型表现的慢性系统性自身免疫性疾病,长期可致关节畸形、功能丧失,严重降低患者生活质量。当归拈痛汤出自金代张元素《医学启源》,具有清热利湿、祛风止痛之效,是治疗RA湿热痹阻证的经典方剂。笔者通过检索知网、万方、PubMed等数据库,对当归拈痛汤治疗RA的临床疗效和实验研究进行整合与梳理,阐述其作用机制,以期为今后开展当归拈痛汤在RA领域的临床和基础研究提供有益参考。临床研究表明,当归拈痛汤可改善湿热痹阻型RA患者关节肿痛、晨僵、活动受限等核心症状,降低C反应蛋白、血沉等炎症活动指标,促进RA患者膝关节置换术后康复;与甲氨蝶呤等西药联用时,能增强抗炎效果并减轻西药胃肠道刺激、肝损伤等不良反应。实验研究揭示,该方具有调控炎症因子网络、促进滑膜细胞凋亡、抑制滑膜细胞异常自噬、抑制滑膜血管新生、调节肠道菌群稳态等作用。然而当前研究尚存在临床质量不足、机制网络交互关系不明确、剂型优化欠缺等问题,未来需开展高质量临床研究、多组学机制探索及剂型改良,为其临床推广与深入研究提供科学依据。
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by symmetrical polyarthritis, which may lead to joint deformity and loss of joint function in the long term, severely impairing patients' quality of life. Danggui Niantongtang, originated from
Medical Revelations
by Zhang Yuansu in the Jin Dynasty, has the effects of clearing heat and draining dampness, dispelling wind and alleviating pain, and serves as a classic formula for treating RA damp-heat stagnation syndrome. By searching CNKI, Wanfang, PubMed and other databases, the author systematically reviewed the clinical efficacy and experimental research of Danggui Niantongtang
in the treatment of RA, and elucidated its mechanisms of action, so as to provide a valuable reference for future clinical and basic research of Danggui Niantongtang in the field of RA. Clinical studies demonstrated that Danggui Niantongtang can improve core symptoms in RA patients with the damp-heat stagnation syndrome, including joint swelling and pain, morning stiffness and limited joint mobility, decrease inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and facilitate postoperative rehabilitation in RA patients undergoing total knee arthroplasty (TKA). When combined with Western medicines such as methotrexate, it can enhance the anti-inflammatory efficacy and mitigate adverse reactions, including gastrointestinal discomfort and hepatic injury. Experimental studies revealed that this formula can modulate the inflammatory cytokine network, promote synoviocyte apoptosis, inhibit abnormal synoviocyte autophagy, suppress synovial angiogenesis, and maintain intestinal flora homeostasis. However, several limitations exist in current research, such as insufficient clinical quality, unclear interaction between mechanisms and networks, and insufficient research on dosage form optimization. In the future, high-quality clinical research, multi-omics mechanistic studies, and dosage form improvement are needed to provide scientific basis for its clinical promotion and in-depth research.
DI MATTEO A , BATHON J M , EMERY P . Rheumatoid arthritis [J]. Lancet , 2023 , 402 ( 10416 ): 2019 - 2033 .
BEHL T , MEHTA K , SEHGAL A , et al . Exploring the role of polyphenols in rheumatoid arthritis [J]. Crit Rev Food Sci Nutr , 2021 , 62 ( 19 ): 21 - 22 .
PAPADOPOULOU D , ROUMELIOTI F , TZAFERIS C , et al . Repurposing antipsychotic drug amisulpride for targeting synovial fibroblast activation in arthritis [J]. JCI Insight , 2023 , 8 ( 9 ): e165024 .
王金平 , 陶庆文 , 莫美 , 等 . 中医药临床优势病种探讨——类风湿关节炎 [J]. 中国实验方剂学杂志 , 2025 , 31 ( 17 ): 202 - 210 .
WANG J P , TAO Q W , MO M , et al . Clinical dominant disease of traditional Chinese medicine:Rheumatoid arthritis [J]. Chin J Exp Tradit Med Form , 2025 , 31 ( 17 ): 202 - 210 .
WANG H , FAN B B , LIU M X , et al . Exploring the mechanism of Danggui Niantong decoction in the treatment of rheumatoid arthritis based on network pharmacology,Mendelian randomization,molecular docking and molecular dynamics simulation [J]. Medicine(Baltimore) , 2025 , 104 ( 37 ): e44266 .
周晔 , 张玉萍 . 当归拈痛汤研究进展 [J]. 广西中医药大学学报 , 2022 , 25 ( 2 ): 61 - 64 .
ZHOU Y , ZHANG Y P . Research progress of Danggui Niantong decoction [J]. J Guangxi Univ Chin Med , 2022 , 25 ( 2 ): 61 - 64 .
中华中医药学会内科分会 . 类风湿性关节炎 : ZYYXH/T 114-2008 [S]. 北京 : 中国中医药出版社 , 2008 .
Internal Medicine Professional Committee of China Association of Chinese Medicine . Rheumatoid arthritis : ZYYXH/T 114-2008 [S]. Beijing : China Press of Traditional Chinese Medicine , 2008 .
姜泉 , 巩勋 , 焦娟 , 等 . 类风湿关节炎病证结合诊疗指南(2025年) [J]. 中医杂志 , 2025 , 66 ( 17 ): 1842 - 1856 .
JIANG Q , GONG X , JIAO J , et al . Guideline for integrated traditional Chinese medicine syndrome and disease diagnosis and treatment of rheumatoid arthritis (2025) [J]. J Tradit Chin Med , 2025 , 66 ( 17 ): 1842 - 1856 .
胡茹英 , 刘效栓 , 刘军刚 , 等 . 当归拈痛汤治疗湿热痹阻型类风湿关节炎的Meta分析 [J]. 甘肃医药 , 2021 , 40 ( 2 ): 133 - 138 .
HU R Y , LIU X S , LIU J G , et al . Meta-analysis of Danggui Niantong decoction in the treatment of rheumatoid arthritis [J]. Gansu Med J , 2021 , 40 ( 2 ): 133 - 138 .
崔占举 . 当归拈痛汤辅助治疗湿热痹阻证活动期类风湿性关节炎的临床疗效分析 [J]. 医学理论与实践 , 2022 , 35 ( 7 ): 1161 - 1163 .
CUI Z J . Analysis of clinical efficacy of Danggui Niantong decoction in adjuvant treatment of active rheumatoid arthritis with damp-heat stagnation syndrome [J]. J Med Theory Pract , 2022 , 35 ( 7 ): 1161 - 1163 .
庄志毅 , 宋维海 , 张文广 , 等 . 当归拈痛汤联合西药治疗活动期类风湿关节炎湿热痹阻证患者的效果分析 [J]. 青海医药杂志 , 2023 , 53 ( 12 ): 50 - 52 .
ZHUANG Z Y , SONG W H , ZHANG W G , et al . Analysis of the effect of Danggui Niantong decoction combined with western medicine on patients with damp-heat stagnation syndrome of active rheumatoid arthritis [J]. Qinghai Med J , 2023 , 53 ( 12 ): 50 - 52 .
乔娜 . 当归拈痛汤在类风湿关节炎湿热痹阻证患者中的应用效果 [J]. 内蒙古中医药 , 2024 , 43 ( 7 ): 7 - 9 .
QIAO N . Danggui Niantong decoction in rheumatoid arthritis patients with damp-heat stagnation syndrome [J]. Inner Mongolia J Tradit Chin Med , 2024 , 43 ( 7 ): 7 - 9 .
AHN J , KIM A , LEE Y J , et al . A Multi-biomarker panel for predicting tocilizumab response in rheumatoid arthritis patients [J]. Transl Res , 2024 , 273 : 23 - 31 .
潘翠琦 , 范舜华 , 潘碧琦 , 等 . 当归拈痛汤对类风湿性关节炎患者RF和抗CCP抗体的影响 [J]. 按摩与康复医学 , 2014 , 5 ( 7 ): 70 - 71 .
PAN C Q , FAN S H , PAN B Q , et al . Effect of Danggui Niantong decoction on RF and anti-CCP antibody in patients with rheumatoid arthritis [J]. Tradit Chin Med Rehabil , 2014 , 5 ( 7 ): 70 - 71 .
胡南松 , 胡志彦 , 夏臣杰 . 当归拈痛汤加减联合洛索洛芬钠对类风湿性关节炎(湿热痹阻型)患者关节疼痛及MMP-3、ESR的影响 [J]. 健康研究 , 2020 , 40 ( 6 ): 668 - 672 .
HU N S , HU Z Y , XIA C J . Effects of modified Danggui Niantong decoction combined with loxoprofen sodium on joint pain,MMP-3 and ESR in patients with rheumatoid arthritis ( damp-heat stagnation type) [J]. Health Res , 2020 , 40 ( 6 ): 668 - 672 .
蒋华 , 张艳萍 . 当归拈痛汤加减方联合甲氨蝶呤治疗类风湿关节炎的疗效探讨 [J]. 当代医药论丛 , 2020 , 18 ( 2 ): 200 - 201 .
JIANG H , ZHANG Y P . Discussion on the therapeutic effect of Danggui Niantong decoction combined with methotrexate on rheumatoid arthritis [J]. Contemp Med Symp , 2020 , 18 ( 2 ): 200 - 201 .
任金晴 , 徐照 , 赵晶晶 , 等 . 当归拈痛汤治疗类风湿关节炎活动期临床效果研究 [J]. 临床军医杂志 , 2023 , 51 ( 2 ): 166 - 169 .
REN J Q , XU Z , ZHAO J J , et al . Study on the clinical effect of Danggui Niantong decoction in the treatment of active rheumatoid arthritis [J]. Clin J Med Off , 2023 , 51 ( 2 ): 166 - 169 .
葛林 , 石志敏 . 不同剂型当归拈痛汤治疗类风湿关节炎的临床疗效比较 [J]. 山东中医杂志 , 2017 , 36 ( 1 ): 17 - 19 .
GE L , SHI Z M . Comparison of clinical efficacy of Danggui Niantong decoction of different dosage form in treatment of rheumatoid arthritis [J]. Shandong J Tradit Chin Med , 2017 , 36 ( 1 ): 17 - 19 .
RIDDLE D L , DUMENCI L . Using two predictive models captures two types of poor outcomes in knee arthroplasty:A multisite longitudinal cohort study [J]. Arthritis Rheumatol , 2024 , 76 ( 7 ): 1036 - 1046 .
马济川 . 当归拈痛汤加减用于类风湿关节炎膝关节置换术后疗效分析 [J]. 河南外科学杂志 , 2023 , 29 ( 6 ): 142 - 144 .
MA J C . Curative effect analysis of Danggui Niantong decoction after knee replacement for rheumatoid arthritis [J]. Henan J Surg , 2023 , 29 ( 6 ): 142 - 144 .
LI X Y , ZHANG S X , ZHANG M M , et al . A multifunctional nano-delivery system against rheumatoid arthritis by combined phototherapy,hypoxia-activated chemotherapy,and RNA interference [J]. Int J Nanomed , 2022 , 17 : 6257 - 6273 .
GUO R Q , WANG L , HUANG J B , et al . Ultrasound-targeted microbubble destruction-mediated cell-mimetic nanodrugs for treating rheumatoid arthritis [J]. ACS Biomater Sci Eng , 2023 , 9 ( 6 ): 3670 - 3679 .
周振强 , 翁雅芳 . 当归拈痛汤联合西药治疗类风湿关节炎30例临床观察 [J]. 北方药学 , 2023 , 20 ( 5 ): 154 - 157 .
ZHOU Z Q , WENG Y F . Clinical observation on 30 cases of rheumatoid arthritis treated by Danggui Niantong decoction combined with western medicine [J]. J North Pharm , 2023 , 20 ( 5 ): 154 - 157 .
阮丽萍 , 张金山 , 王青松 . 蠲痹汤合当归拈痛汤对类风湿关节炎活动期患者血清类风湿因子、抗环瓜氨酸肽抗体和C反应蛋白水平的影响 [J]. 中国临床医生杂志 , 2024 , 52 ( 9 ): 1119 - 1122 .
RUAN L P , ZHANG J S , WANG Q S . Effects of Juanbi decoction and Danggui Niantong decoction on serum levels of rheumatoid factor,anti-cyclic citrullinated peptide antibody and C-reactive protein in patients with active rheumatoid arthritis [J]. Chin J Clin , 2024 , 52 ( 9 ): 1119 - 1122 .
MENG Q L , WEI K , SHAN Y . E3 ubiquitin ligase gene BIRC3 modulates TNF-induced cell death pathways and promotes aberrant proliferation in rheumatoid arthritis fibroblast-like synoviocytes [J]. Front Immunol , 2024 , 15 : 1433898 .
ZHENG Y X , WEI K , JIANG P , et al . Macrophage polarization in rheumatoid arthritis:Signaling pathways,metabolic reprogramming,and crosstalk with synovial fibroblasts [J]. Front Immunol , 2024 , 15 : 1394108 .
袁立霞 , 刘亚伟 . 当归拈痛汤及其拆方对类风湿性关节炎大鼠炎症因子谱的调控作用研究 [J]. 时珍国医国药 , 2015 , 26 ( 6 ): 1284 - 1287 .
YUAN L X , LIU Y W . Study on the regulatory effect of Danggui Niantong decoction and its disassembled prescriptions on inflammatory factor spectrum in rats with rheumatoid arthritis [J]. Lishizhen Med Mater Med Res , 2015 , 26 ( 6 ): 1284 - 1287 .
梁智超 . 当归拈痛汤对关节炎炎症和骨破坏影响的实验研究 [D]. 上海 : 上海中医药大学 , 2020 .
LIANG Z C . Experimental study on the effect of Danggui Niantong decoction on arthritis inflammation and bone destruction [D]. Shanghai : Shanghai University of Traditional Chinese Medicine , 2020 .
杨灿 , 陈涛 , 马梦娇 , 等 . 当归拈痛汤改善TNF-Tg小鼠关节炎症合并心肺损伤(英文) [J]. Acupuncture and Herbal Medicine , 2023 , 3 ( 4 ): 333 - 342 .
YANG C , CHEN T , MA M J , et al . Danggui Niantong decoction ameliorates joint inflammation and cardiopulmonary injury in TNF-Tg mice [J]. Acupunct Herb Med , 2023 , 3 ( 4 ): 333 - 342 .
PENG H , LIANG R F , YANG S L X , et al . Microneedle-assisted dual delivery of PUMA gene and celastrol for synergistic therapy of rheumatoid arthritis through restoring synovial homeostasis [J] Bioact Mater , 2024 , 36 : 83 - 95 .
尚延春 , 申晟 , 柴巍巍 , 等 . 当归拈痛汤对类风湿关节炎大鼠滑膜细胞凋亡通路的影响 [J]. 世界中医药 , 2018 , 13 ( 7 ): 1718 - 1722 .
SHANG Y C , SHEN S , CHAI W W , et al . Experimental study on Danggui Niantong decoction in treating rheumatoid arthritis rats based on the apoptotic pathway of synovial cells [J]. World Chin Med , 2018 , 13 ( 7 ): 1718 - 1722 .
蔡义思 , 李佳钰 , 陆麒瑾 , 等 . 基于定量蛋白质组学研究当归拈痛汤对风湿热痹佐剂性关节炎大鼠的作用机制 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 13 ): 62 - 70 .
CAI Y S , LI J Y , LU Q J , et al . Mechanism of Danggui Niantongtang on adjuvant arthritis rats with wind-dampness-heat arthralgia based on quantitative proteomics [J]. Chin J Exp Tradit Med Form , 2022 , 28 ( 13 ): 62 - 70 .
赵帆 . 当归拈痛汤对类风湿关节炎成纤维样滑膜细胞凋亡的影响和机制研究 [D]. 广州 : 南方医科大学 , 2020 .
ZHAO F . Effect and mechanism of Danggui Niantong decoction on apoptosis of synovial fibroblasts in rheumatoid arthritis [D]. Guangzhou : Southern Medical University , 2020 .
李佳钰 , 赵帆 , 陆麒瑾 , 等 . 当归拈痛汤对佐剂性关节炎大鼠滑膜组织内外凋亡途径关键因子的影响 [J]. 中国实验方剂学杂志 , 2021 , 27 ( 4 ): 1 - 7 .
LI J Y , ZHAO F , LU Q J , et al . Effect of Danggui Niantongtang on key factors of extrinsic and intrinsic apoptotic pathway in synovial tissue of adjuvant arthritis rats [J]. Chin J Exp Tradit Med Form , 2021 , 27 ( 4 ): 1 - 7 .
KELLER C W , ADAMOPOULOS I E , LÜNEMANN J D . Autophagy pathways in autoimmune diseases [J]. J Autoimmun , 2023 , 136 : 103030 .
陆麒瑾 , 李佳钰 , 蔡义思 , 等 . 当归拈痛汤对风湿热痹型佐剂性关节炎大鼠自噬蛋白LC3,Beclin1,p62表达的影响 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 1 ): 41 - 49 .
LU Q J , LI J Y , CAI Y S , et al . Effect of Danggui Niantongtang on Expression of autophagy-related proteins LC3,Beclin1 and p62 in rats with adjuvant arthritis differentiated into wind-damp-heat impediment [J]. Chin J Exp Tradit Med Form , 2022 , 28 ( 1 ): 41 - 49 .
陆麒瑾 , 李佳钰 , 蔡义思 , 等 . 当归拈痛汤对类风湿关节炎成纤维样滑膜细胞自噬与凋亡的影响 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 2 ): 19 - 26 .
LU Q J , LI J Y , CAI Y S , et al . Effect of Danggui Niantongtang on autophagy and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte [J]. Chin J Exp Tradit Med Form , 2022 , 28 ( 2 ): 19 - 26 .
ZHAO F , HU Z Y , LI G J , et al . Angiogenesis in rheumatoid arthritis:Pathological characterization,pathogenic mechanisms,and nano-targeted therapeutic strategies [J]. Bioact Mater , 2025 , 50 : 603 - 639 .
HUANG C C , TSENG T T , LIU S C , et al . S1P increases VEGF production in osteoblasts and facilitates endothelial progenitor cell angiogenesis by inhibiting miR-16-5p expression via the c-Src/FAK signaling pathway in rheumatoid arthritis [J]. Cells , 2021 , 10 ( 8 ): 2168 .
廖江铨 , 田佳星 , 陈俊绵 , 等 . 当归拈痛汤及其拆方对佐剂性关节炎大鼠滑膜组织VEGF表达的影响 [J]. 中国中医基础医学杂志 , 2010 , 16 ( 4 ): 298 - 299 .
LIAO J Q , TIAN J X , CHEN J M , et al . Effects of Danggui Niantong decoction and its separating prescription on VEGF of synovium in rats with adjuvant-induced arthritis [J]. J Basic Chin Med , 2010 , 16 ( 4 ): 298 - 299 .
PENG Q , CHEN X , TIAN J X , et al . The gut homeostasis-immune system axis:Novel insights into rheumatoid arthritis pathogenesis and treatment [J]. Front Immunol , 2024 , 15 : 1482214 .
LU Q J , LI J Y , LIN H X , et al . Danggui Niantong granules ameliorate rheumatoid arthritis by regulating intestinal flora and promoting mitochondrial apoptosis [J]. Pharm Biol , 2022 , 60 ( 1 ): 1606 - 1615 .
梁露莹 , 林鸿鑫 , 蔡义思 , 等 . 基于16S rDNA测序研究当归拈痛汤对风湿热痹佐剂性关节炎大鼠肠道菌群的影响 [J]. 中国实验方剂学杂志 , 2023 , 29 ( 9 ): 18 - 27 .
LIANG L Y , LIN H X , CAI Y S , et al . Effect of Danggui Niantongtang on intestinal flora in adjuvant-induced arthritis rats of wind-dampness-heat arthralgia:Based on 16S rDNA sequencing [J]. Chin J Exp Tradit Med Form , 2023 , 29 ( 9 ): 18 - 27 .
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