多系统萎缩（multiple system atrophy，MSA）是一种散在的进行性神经退行性疾病，主要分为帕金森型和小脑型，其核心临床特征包括快速进展的自主神经衰竭和运动功能障碍。目前MSA病因未明，涉及多种致病机制，因此治疗手段仅限于有限的对症处理，尚缺乏有效的疾病修饰疗法以延缓疾病进展。当前研究聚焦于探索靶向α-突触核蛋白病理、调节神经炎症以及增强神经营养支持等中西医诊疗策略，基础研究和早期临床试验正在评估各治疗方案的潜力。本综述旨在概述MSA的生物学机制以及最新研究进展，以推动临床对MSA针对性治疗策略的认识。

Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disease that is mainly categorized into Parkinsonism (MSA-P) and cerebellar (MSA-C) types. Its core clinical features include rapidly progressive autonomic failure and motor dysfunction. Currently, the etiology of MSA is unknown and involves multiple pathogenic mechanisms, therefore, treatment is limited to symptomatic management, and there is a lack of effective disease-modifying therapy (DMT) to slow down disease progression. Current research focuses on exploring diagnostic and therapeutic strategies combining traditional Chinese and western medicine, such as targeting α‍-synuclein pathology, regulating neuroinflammation, and enhancing neurotrophic support. Basic research and early clinical trials are evaluating the potential of various treatment options. This review aims to summarize the biological mechanisms of MSA and the latest research advancements, in order to facilitate clinical understanding of targeted treatment strategies for MSA.