Article(id=1322168921705263294, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168583854080893, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.08.025, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750262400000, receivedDateStr=2025-06-19, revisedDate=1775145600000, revisedDateStr=2026-04-03, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159235645, onlineDateStr=2026-10-28, pubDate=1777046400000, pubDateStr=2026-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159235645, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159235645, creator=13701087609, updateTime=1793159235645, updator=13701087609, issue=Issue{id=1322168583854080893, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='8', pageStart='1241', pageEnd='1424', issueExtLink='null', onlineDate='null', pubDate='1777046400000', pubDateStr='2026-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159155095, creator='13701087609', updateTime=1793159155095, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1420, endPage=1424, ext={EN=ArticleExt(id=1322168922011447487, articleId=1322168921705263294, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application progress of anti-inflammatory diet in patients with knee osteoarthritis, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This paper reviewed the concept,mechanism of action,and application effect of anti-inflammatory diet in patients with knee osteoarthritis.It analyzed the challenges of applying anti-inflammatory diet in patients with knee osteoarthritis and proposed some corresponding suggestions, so as to provide reference for the disease management of patients with knee osteoarthritis.

, authors=Man ZHENG1, Yan ZHAI2, Wenting LI1, Yanan LIU1, Xinying CHE1, authorsList=Man ZHENG, Yan ZHAI, Wenting LI, Yanan LIU, Xinying CHE, authorCompany=null, correspAuthors=Yan ZHAI, authorNote=null, correspAuthorsNote=
ZHAI Yan, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168922414100672, articleId=1322168921705263294, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=抗炎饮食在膝骨关节炎病人中的应用进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

综述抗炎饮食的概念、作用机制及在膝骨关节炎病人中的应用效果,分析抗炎饮食在膝骨关节炎病人中应用的挑战,并提出相应的建议,以期为膝骨关节炎病人的疾病管理提供参考。

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郑蔓,本科

, correspAuthorsNote=
翟燕,E-mail:
ZHAI Yan, E-mail:
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抗炎饮食在膝骨关节炎病人中的应用进展
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郑蔓 1 , 翟燕 2, *, * , 李文婷 1 , 刘亚楠 1 , 车鑫滢 1
护理研究 | 科研综述 2026,40(8): 1420-1424
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护理研究 |科研综述 2026 , 40 (8) : 1420 -1424
抗炎饮食在膝骨关节炎病人中的应用进展
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郑蔓1, 翟燕2, *, * , 李文婷1, 刘亚楠1, 车鑫滢1
作者信息
  • 1山东中医药大学,山东 250014
  • 2山东省中医院
通讯作者:
翟燕,E-mail:
ZHAI Yan, E-mail:
作者简介:

郑蔓,本科

Application progress of anti-inflammatory diet in patients with knee osteoarthritis
Man ZHENG1, Yan ZHAI2 , Wenting LI1, Yanan LIU1, Xinying CHE1
Affiliations
  • 1Shandong University of Traditional Chinese Medicine, Shandong 250014 China
  • 2Shandong Provincial Hospital of Traditional Chinese Medicine
  • Corresponding Author:
    ZHAI Yan, E-mail:
出版时间: 2026-04-25 doi: 10.12102/j.issn.1009-6493.2026.08.025
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综述抗炎饮食的概念、作用机制及在膝骨关节炎病人中的应用效果,分析抗炎饮食在膝骨关节炎病人中应用的挑战,并提出相应的建议,以期为膝骨关节炎病人的疾病管理提供参考。

抗炎饮食  /  膝骨关节炎  /  综述

This paper reviewed the concept,mechanism of action,and application effect of anti-inflammatory diet in patients with knee osteoarthritis.It analyzed the challenges of applying anti-inflammatory diet in patients with knee osteoarthritis and proposed some corresponding suggestions, so as to provide reference for the disease management of patients with knee osteoarthritis.

anti-inflammatory diet  /  knee osteoarthritis  /  review
郑蔓, 翟燕, 李文婷, 刘亚楠, 车鑫滢. 抗炎饮食在膝骨关节炎病人中的应用进展. 护理研究, 2026 , 40 (8) : 1420 -1424 . DOI: 10.12102/j.issn.1009-6493.2026.08.025
Man ZHENG, Yan ZHAI, Wenting LI, Yanan LIU, Xinying CHE. Application progress of anti-inflammatory diet in patients with knee osteoarthritis[J]. Chinese Nursing Research, 2026 , 40 (8) : 1420 -1424 . DOI: 10.12102/j.issn.1009-6493.2026.08.025
膝骨关节炎(knee osteoarthritis,KOA)是一种以关节软骨进行性破坏为主的慢性退行性疾病,以关节疼痛、僵硬、功能障碍为主要表现,严重影响病人的生活质量,也是导致残疾的最主要原因[1-2]。我国膝骨关节炎发病率与致残率逐渐增加,截至2020年,我国40岁及以上人群膝骨关节炎发病率超过35%,预计2030年会有近4亿人患有膝骨关节炎[3]。研究表明,膝骨关节炎所导致的疼痛和活动受限,可进一步增加心血管疾病的发生率,并导致全因死亡率增加近1倍,已成为世界范围内亟待解决的重要健康问题[4]。近年来,在慢性病的预防和管理方面,具有抗炎特性的饮食引起了人们的极大兴趣[5]。炎症在膝骨关节炎的发病机制和疾病进展中起着关键作用[6-7],研究表明,抗炎饮食在膝骨关节炎病人中有诸多益处,并可缓解疾病的进展[8]。因此,本研究主要对抗炎饮食的概述、重要性、应用及现存挑战进行综述,以期为膝骨关节炎病人的疾病管理提供参考依据。
抗炎饮食是指一种饮食模式,其通过摄入特定的营养素降低或调节体内炎症水平。这种饮食模式与白细胞介素、肿瘤坏死因子和C反应蛋白等炎症生物标志物水平密切相关[9-10]。此外,抗炎饮食的特点是大量食用水果、蔬菜、全谷物、豆类、肥鱼、坚果、橄榄油和植物化学物质,同时限制摄入具有潜在促炎特性的食物,如红肉、精制糖类[11-12]。抗炎饮食的概念由Sears[13]最先提出,其强调降低Omega-6脂肪酸和饱和脂肪的水平,饮食中的大部分脂肪来自非炎症性单不饱和脂肪。2006年,Giugliano等[14]将抗炎饮食的概念引入慢性病,探讨了饮食与炎症的关系,为抗炎饮食干预奠定了基础。此外,有学者将抗炎饮食的类型主要归纳为地中海饮食、冲绳饮食和北欧饮食[15]。此后,抗炎饮食模式逐渐发展完善,作为一种治疗方法广泛应用于心血管疾病、糖尿病以及自身免疫性疾病[16-17],其作为一种护理干预措施应用于膝骨关节炎疾病领域,可有效减轻膝骨关节炎的炎症反应,改善病人的功能状态,从而提高病人的生活质量。
目前,关于抗炎饮食在膝骨关节炎病人中作用机制的研究尚未形成统一结论。然而,大多数学者倾向认为其主要涉及两种机制:调节炎症和抗氧化应激机制。抗炎饮食中的营养成分通过多种机制发挥显著的抗炎作用:促炎基因表达的调控、花生四烯酸代谢途径的调节以及对免疫系统功能的影响。抗炎饮食成分通过调节类花生酸的合成,降低花生四烯酸代谢产物的促炎作用,从而减轻组织中的炎症反应[18]。氧化应激是活性氧的产生与其被抗氧化防御系统清除之间不平衡的结果,在骨关节炎软骨中含量很高,是慢性炎症的主要原因。食用富含多酚的食物,如水果、蔬菜、草药、香料和橄榄油,可中和自由基和其他活性氧,从而通过抗氧化和抗炎特性减少炎症[19]。
膝骨关节炎的发病机制与慢性炎症密切相关,炎症不仅影响疾病的发生和进展,还会加重膝骨关节炎病人的症状负担[20]。抗炎饮食富含未精制和最低限度加工的食物、富含多酚的食物、富含Omega-3脂肪酸的食物等,这些营养物质可减轻炎症反应,从而改善膝骨关节炎病人的关节功能,进一步提升病人的生活质量[19,21]。世界卫生组织建议,饮食干预作为常规疗法的辅助治疗在缓解膝骨关节炎相关症状方面具有巨大的潜力,并且其重要性正日益凸显[22]。Omega-3脂肪酸,特别是鱼油中的脂肪酸,已被证明具有抗炎作用并减少骨关节炎病人的软骨降解[23-24]。同样,多酚已被证明在减少氧化应激、关节疼痛和炎症方面具有巨大的潜力[25]。综上所述,抗炎饮食作为一种辅助干预方式,可给膝骨关节炎病人带来诸多益处。因此,抗炎饮食为膝骨关节炎的疾病管理提供了新的思路和方法,具有重要的临床意义和应用价值。
膝骨关节炎最突出的问题是疼痛,膝骨关节炎病人长期经历慢性疼痛,严重限制病人的活动能力和自理能力,并降低病人的生活质量。因此,缓解疼痛是医护人员长期的主要目标。临床指南指出,非药物干预是适合大多数膝骨关节炎病人的核心治疗[26]。有研究表明,抗炎饮食能缓解疼痛,从而提高膝骨关节炎病人的生活质量[27]。有研究对73例膝骨关节炎病人进行了一项为期9周的可行性研究,所有参与者都接受了远程医疗提供的抗炎饮食教育干预,该饮食强调营养丰富的全食物和最低限度加工的抗炎食品,不鼓励食用被认为具有促炎作用的加工食品,结果表明,抗炎饮食干预对膝骨关节炎有效性的试验是可行的;同时,凸显远程医疗提供的抗炎饮食干预的潜力,可有效减轻疼痛、改善功能和生活质量[8]。Strath等[28]对21例膝骨关节炎病人开展随机对照试验,为期12周,干预组食用抗炎饮食,对照组常规饮食,结果显示,干预组在椅子起立、行走等动作中疼痛评分降低,生活质量优于对照组;由此可见,在12周内,抗炎饮食组干预后膝骨关节炎病人的自我报告和功能性疼痛有所改善,这可能与抗炎饮食的氧化应激减少有关。Du等[29]对63例膝骨关节炎病人进行了一项随机双盲试验,45~79岁患有症状性膝骨关节炎病人被随机分配每天食用40 g冻干蓝莓粉或安慰剂粉,持续4个月,在基线、2个月和4个月时进行疼痛和步态评估,结果表明,食用冻干全蓝莓粉4个月可减轻疼痛、僵硬和进行日常活动的困难,改善步态表现,并对某些炎症和抗炎生物标志物产生有利影响。未来医护人员应向病人传递疼痛自我管理知识,借助非药物干预方法延缓疾病的发展,向家庭、社区推广抗炎饮食在膝骨关节炎中的应用优势。
膝骨关节炎病人常患有抑郁症和焦虑症。有研究发现,高达49.3%的膝骨关节炎病人患有抑郁症[30]。这提示医护人员在膝骨关节炎治疗过程中,应关注病人心理健康、积极干预抑郁情绪。抗炎疗法已被证明可以减少炎症相关疾病(如关节炎和癌症)中的抑郁症状[31]。此外,研究发现,饮食可以调节炎症因子,且特定的饮食营养素具有一系列抗炎特性[32]。Dolatkhah等[33]以60例患有轻度至中度膝骨关节炎的超重和肥胖女性为研究对象,进行了一项为期2个月的随机平行临床试验,以1∶1的比例随机分配到低热量饮食组和抗炎饮食组,低热量饮食组比个人所需能量少500 kcal(1 kcal=4.184 kJ),是在计算总能量并考虑体力活动量后确定的,抗炎饮食组依赖于新鲜水果和蔬菜作为饮食的最大部分,每餐应大量食用(饮食中三分之二的热量);结果显示,与低热量饮食组相比,抗炎饮食搭配低热量饮食组在体重减轻、疼痛强度、功能状态、抑郁、焦虑以及生活质量的某些维度方面均有更显著的改善。Li等[34]研究显示,与接受抗炎饮食的人相比,促炎饮食的人患抑郁症的可能性高45%,患焦虑症的可能性高66%。分析中发现的促炎饮食模式与抑郁和焦虑之间的相关性可用于探索预防和治疗抑郁和焦虑的策略。鉴于抑郁症和焦虑症在膝骨关节炎病人中较为常见,且抗炎饮食可改善病人的不良心理状态。未来可进一步研究抗炎饮食在缓解膝骨关节炎病人不良心理的作用机制,从而促进膝骨关节炎病人的心理健康。此外,Miki等[35]进行的一项横断面研究发现,蔬菜和水果膳食纤维摄入量与抑郁症状呈负相关。
综上所述,抗炎饮食不仅能够通过减轻炎症反应改善膝骨关节炎病人的生理症状,还可缓解病人的不良心理状态。未来研究人员应进一步探索抗炎饮食在缓解膝骨关节炎病人不良心理的作用机制。此外,医护人员在临床实践中应重视病人的饮食习惯,积极推广抗炎饮食,以促进膝骨关节炎病人的心理健康和整体生活质量的提升。
肥胖是膝骨关节炎病人的影响因素之一[36]。体重管理作为膝骨关节炎病人的非药物管理之一,与其他饮食模式相比,抗炎饮食作为一种新兴的饮食模式,既可以直接提供抑制炎症反应的营养物质,并且还可以调节身体的新陈代谢过程以对抗慢性炎症,从而可以辅助病人进行体重管理[16]。
Dyer等[37]将99例膝骨关节炎参与者随机分配到饮食干预组(n=50)和对照组(n=49),干预组要求遵循地中海饮食16周,对照组参与者则保持他们正常的饮食,同时,由注册营养师通过电话提供支持,回答问题并指导饮食。所有参与者在研究开始前(干预前)、中期(2个月)和结束时(4个月)被要求完成7 d食物日记(作为食物频率问卷)和关节炎影响测量量表,以评估饮食习惯和症状的变化。研究表明,饮食干预成功地改变了干预组的饮食行为,这与体重减轻有关。此外,坚持地中海式饮食可能对骨关节炎病人有实际和临床益处。未来可延长干预周期,进一步检验抗炎饮食的有效性。
与此同时,体重减轻已被证明可改善膝骨关节炎病人的疼痛和关节功能[38]。Genel等[39]通过一项荟萃分析显示,与常规饮食相比,抗炎饮食不仅可减轻病人体重,同时还可改善膝骨关节炎病人的疼痛和功能状态,从而提高病人的生活质量。一项网络荟萃分析表明,抗炎饮食不仅有助于减少饮食诱导的炎症负荷,还有助于减少与过量脂肪组织相关的炎症负荷[40]。由此可见,抗炎饮食可帮助膝骨关节炎病人进行体重管理,从而更好地帮助病人进行自我管理。未来可通过开展更多大规模、长期的临床研究,进一步验证抗炎饮食在辅助膝骨关节炎病人体重管理的干预方案。
膝骨关节炎的迅速进展会对生活质量造成显著影响,并给医疗保健系统带来压力[41]。因此,迫切需要设计出具有成本效益、副作用小的应用方法,通过提高活动能力以及减轻疼痛症状而改善生活质量。抗炎饮食是一种成本低、安全性高、易操作、可持续性强且具有综合健康益处的干预方式。Law等[20]对一项随机对照试验方案进行评估发现,评估非药物抗炎饮食计划以改善膝骨关节炎病人的疼痛、症状和生活质量可能会产生重要的个人和社会经济效益,减少用于管理膝骨关节炎的医疗保健资金。抗炎饮食还可有效对抗代谢综合征,代谢综合征是慢性病的关键危险因素,治疗膝骨关节炎的优势可进一步扩展到改善其他合并症。此外,抗炎饮食降低了病人需要进行关节置换手术等重大手术的风险。除此之外,手术费用高昂,且术后还可能面临康复训练等一系列费用,因此,避免手术对于病人来说具有显著的经济意义。Ciaffi等[42]在意大利进行了一项干预研究,随机招募了20例有症状的膝骨关节炎病人,结果表明,为期20周的生酮饮食有效改善了膝骨关节炎病人的功能和体重,并提高膝骨关节炎病人的依从性和耐受性。此外,个性化的饮食计划,包括各种膳食选择和根据个人喜好量身定制的简单食谱,可降低病人的医疗成本。虽然抗炎饮食可能需要病人在饮食选择和准备上花费一定的时间和精力,但与药物治疗和手术治疗相比,其成本相对较低,却能够带来显著的生活质量改善效果。此外,Smith等[43]构建相关的经济模型,将非药物治疗方案(饮食和运动项目)纳入分析框架,评估这些方案对于减轻疼痛以及带来的成本效益,研究表明,饮食和运动治疗膝骨关节炎是有效且具有成本效益的干预方案。由此可见,抗炎饮食既能降低病人的经济成本,又可规避长期药物治疗对人体造成的额外负担。
个体对食物的耐受性和过敏反应差异较大,这对抗炎饮食方案的制定构成了挑战。与此同时,为膝骨关节炎病人制定个性化营养策略时,需考虑不同抗炎食物的接受程度、饮食习惯、经济条件、对营养方案的依从性等。研究发现,病人对地中海饮食、生酮饮食等不同抗炎饮食的反应存在较大差异,如部分病人可能难以坚持地中海饮食中较高的植物性食物摄入要求,或因生酮饮食的严格限制而难以长期遵循[44]。因此,由于抗炎饮食的实验性质,未来可为病人提供更频繁和严格的营养咨询,以维持限制糖类的摄入,特别是在较长的干预期间。未来可以建立多学科合作团队,包括营养师、医生、护士、康复治疗师等,共同为膝骨关节炎病人提供个性化的治疗和管理方案,确保饮食干预与其他治疗措施相互配合,提高整体疗效。
病人往往难以长期遵循规定的饮食模式,会受到个人习惯、生活方式、经济因素等多种因素的影响,导致依从性下降。研究发现,通常遵守抗炎饮食的参与者中,有27%的人能够做到每天遵守,68%的人可以大部分时间遵守[8]。由此可见,膝骨关节炎病人在抗炎饮食的长期依从性方面存在问题,尽管有一定的坚持比例,但能够每天严格遵循饮食方案的病人比例仍较低,侧面反映出长期坚持的难度。未来的研究可向病人提供更优质和方便的食谱,或是新的烹饪技术,有助于更长时间地坚持抗炎饮食[45]。未来可充分考虑病人的饮食习惯,将抗炎饮食融入病人的饮食习惯中,从而有助于病人长期坚持抗炎饮食。此外,可充分利用电子健康技术,向病人传授抗炎饮食的相关知识,从而提高他们的自我管理能力和依从性。
国外关于抗炎饮食的研究较多,但缺乏多中心、大样本的随机对照试验[46]。与此同时,国内学者在探索抗炎饮食在膝骨关节炎病人中的应用仍然存在不足,亟待加强随机对照试验的开展。Veronese等[47]在一项关于饮食模式对症状性骨关节炎影响的系统综述表明,支持地中海饮食的证据仍然有限。由此可见,未来需要进一步的研究证实在高证据确定性下的干预效果。此外,有必要进行长期前瞻性研究,以评估采用地中海饮食模式对病人结局的持续益处。鉴于本研究主要纳入英文文献,文化差异不容忽视。因此,在结合我国文化背景的基础上进一步验证抗炎饮食在膝骨关节炎病人中的应用效果显得尤为重要。此外,本研究纳入的研究对象缺乏多样性并且随访期相对较短,这在一定程度上限制了研究结果的广泛性和深度。未来研究可以通过扩大样本量,纳入更多不同年龄、性别、地域等因素的人群,以提高样本的代表性。同时,延长随访时间,有助于更准确地观察抗炎饮食在膝骨关节炎病人中的长期效果,从而为临床实践提供更可靠的参考依据。此外,还可以从多维度、多角度地进行研究设计,进一步探究抗炎饮食在膝骨关节炎病人中的应用效果。
对于膝骨关节炎病人而言,寻找有效、安全且具备吸引力的非药物替代疗法尤为重要,抗炎饮食的应用为膝骨关节炎病人开辟了新的护理路径,有望改善其生活质量和心理健康。抗炎饮食对减轻膝骨关节炎病人疼痛、缓解不良心理、辅助体重管理、减轻经济负担具有巨大的潜力。然而,由于个体化方案制定的复杂性和长期依从性的挑战,其在实际应用中仍受到一定限制。抗炎饮食在膝骨关节炎病人中的应用研究仍然处于探索阶段,未来需要更多高质量的研究进一步验证抗炎饮食的最佳应用模式,以更好地指导临床实践和病人的自我管理。同时,医护人员应加强对病人的营养教育和指导,提高病人对抗炎饮食的认识和依从性,从而促进膝骨关节炎病人的生活质量。

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2026年第40卷第8期
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doi: 10.12102/j.issn.1009-6493.2026.08.025
  • 接收时间:2025-06-19
  • 首发时间:2026-10-28
  • 出版时间:2026-04-25
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  • 收稿日期:2025-06-19
  • 修回日期:2026-04-03
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    1山东中医药大学,山东 250014
    2山东省中医院

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翟燕,E-mail:
ZHAI Yan, E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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