风湿免疫性疾病诊疗中的动态平衡策略

永红 魏(山西医科大学第二医院，中国)

摘要

风湿免疫性疾病（rheumatic diseases, RDs）是一类以免疫系统功能紊乱、自身组织遭受攻击为特征的慢性疾病。本文基于动态平衡（Dynamic Equilibrium, DE）理念，探讨其在RDs诊疗过程中的理论价值与实践意义。本文首先剖析RDs的免疫失衡本质，继而系统阐述DE策略在疾病治疗目标设定、精准干预实施、患者日常管理及长期健康维护等方面的应用。通过融合医学科学与人文关怀视角，本文指出RDs的治疗模式正由传统的“免疫抑制”到“免疫调节”转型，医患协同、整体照护和生命质量优化已成为临床实践的核心目标。最后，本文展望精准医疗、人工智能（Artificial Intelligence, AI）与新型治疗策略在实现个体化平衡调节的潜在作用与发展前景。

关键词

风湿免疫性疾病；动态平衡；免疫稳态；阴平阳秘

参考

Zisa D, Goodman SM. Perioperative Management of Rheumatic Disease and Therapies. Rheum Dis Clin North Am. 2022 May;48(2):455-466. doi: 10.1016/j.rdc.2022.02.005. PMID: 35400371.

Feng Y, Li B, Li XY, Wu ZB. The Role of Autophagy in Rheumatic Disease. Curr Drug Targets. 2018;19(9):1009-1017. doi: 10.2174/1389450117666160819155028. PMID: 27550202.

Tian, Jingru et al. Global epidemiology of systemic lupus erythematosus: a comprehensive systematic analysis and modelling study. Annals of the Rheumatic Diseases, Volume 82, Issue 3, 351-356

Billman, G.E. (2013). Homeostasis: The Dynamic Self-Regulatory Process that Maintains Health and Buffers Against Disease. In: Sturmberg, J., Martin, C. (eds) Handbook of Systems and Complexity in Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4998-0_10

Wissel C. A universal law of the characteristic return time near thresholds. Oecologia. 1984 Dec;65(1):101-107. doi: 10.1007/BF00384470. PMID: 28312117.

冯琳晶,于洋,杜红伟.FoxO1在胰岛β细胞代谢灵活性受损及失代偿进程中的作用[J].中国生物工程杂志,2018,38(06):70-76.DOI:10.13523/j.cb.20180610.

Hopf U, Ramadori G. Physiologie und Pathophysiologie des retikuloendothelialen Systems der Leber [Physiology and pathophysiology of the reticuloendothelial system of the liver (author’s transl)]. Leber Magen Darm. 1980 Oct;10(5):277-83. German. PMID: 7464416.

廖玲玲,彭明松,刘根延,杨婧文.彭明松运用自拟鳖甲化结饮加减治疗痰湿型肺结节经验[J].国医论坛,2024,39(2):59-61

Julian MK. Autoimmune disease: cost-effective care. Nurs Manage. 2014 Nov;45(11):24-9; quiz 30. doi: 10.1097/01.NUMA.0000455740.32485.9c. PMID: 25304753.

陈建仁.基于结构主义的医易阴阳学说特色辨析[J].福建中医药,2025,56(05):18-21.DOI:10.13260/j.cnki.jfjtcm.2025.05005.

都紫微,都广礼.阴平阳秘与格阴格阳[J].河南中医,2024,44(04):517-520.DOI:10.16367/j.issn.1003-5028.2024.04.0097.

Kerpel-Fronius E. Origin and clinical significance of some common disturbances in body fluid homeostasis. I. Basic principles of the regulation of body fluid homeostasis. Acta Morphol Acad Sci Hung. 1966;14(3):301-7. PMID: 5967221.

郑炜贞,陆燕,王旭东,等.试论阴阳平衡与原发性干燥综合征Th17/Treg免疫稳态的相关性[J/OL].中医学报,1-7[2025-10-17].https://link.cnki.net/urlid/41.1411.R.20240826.1421.088.

蔡愈,胡欢.中医免疫阴阳平衡抗风疗法治疗类风湿性关节炎的疗效分析[J].大医生,2023,8(18):116-118.DOI:CNKI:SUN:DYIS.0.2023-18-039.

侯艺涵,季云润,王晓旭,等.浅析用阴阳平衡理论解释银屑病细胞调控及免疫反应[J].环球中医药,2022,15(07):1180-1184.DOI:CNKI:SUN:HQZY.0.2022-07-012.

祁冬冬.探讨类风湿性关节炎采用免疫阴阳平衡抗风疗法的治疗效果[J].临床检验杂志(电子版),2017,6(04):790-791.DOI:CNKI:SUN:LNJI.0.2017-04-107.

陈飞.基于阴阳平衡的类风湿性关节炎中医疗法研究[J].光明中医,2016,31(13):1842-1843.DOI:CNKI:SUN:GMZY.0.2016-13-002.

Weyand, C.M., Goronzy, J.J. The immunology of rheumatoid arthritis. Nat Immunol 22, 10–18 (2021). https://doi.org/10.1038/s41590-020-00816-x

刘健,程华威,郭雯,等.类风湿性关节炎生活质量调查[J].中国临床保健杂志,2006,(02):106-108.DOI:CNKI:SUN:LZBJ.0.2006-02-004.

Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016 Jan;75(1):3-15. doi: 10.1136/annrheumdis-2015-207524. Epub 2015 May 12. PMID: 25969430; PMCID: PMC4717393.

Oray M, Abu Samra K, Ebrahimiadib N, Meese H, Foster CS. Long-term side effects of glucocorticoids. Expert Opin Drug Saf. 2016;15(4):457-65. doi: 10.1517/14740338.2016.1140743. Epub 2016 Feb 6. PMID: 26789102.

Abedi, M., Alavi-Moghadam, S., Payab, M. et al. Mesenchymal stem cell as a novel approach to systemic sclerosis; current status and future perspectives. Cell Regen 9, 20 (2020). https://doi.org/10.1186/s13619-020-00058-0

Bluestone JA, Buckner JH, Fitch M, et al. Type 1 diabetes immunotherapy using polyclonal regulatory T cells. Sci Transl Med. 2015 Nov 25;7(315):315ra189. doi: 10.1126/scitranslmed.aad4134. PMID: 26606968; PMCID: PMC4729454.

Giles, Ian et al.The autoimmune rheumatic diseases-an introduction. Medicine, Volume 46, Issue 2, 77

Guan, Yuanfang et al. “Machine Learning to Predict Anti-Tumor Necrosis Factor Drug Responses of Rheumatoid Arthritis Patients by Integrating Clinical and Genetic Markers.” Arthritis & rheumatology (Hoboken, N.J.) vol. 71,12 (2019): 1987-1996. doi:10.1002/art.41056

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v8i11.34540