Intervertebral disc degeneration （IVDD） is the core cause of chronic low back pain， which severely impairs patients’ quality of life and imposes a heavy social and medical burden. The hypoxia-pyroptosis-inflammation cascade mediated by hypoxia-inducible factor-1α （HIF-1α） is the core pathological mechanism driving the initiation and progression of IVDD. Natural active ingredients derived from traditional Chinese medicine （TCM） have become a research hotspot in the field of IVDD prevention and treatment due to their advantages of multi-target effects， favorable efficacy， and low toxicity. This paper systematically reviews the mechanism of HIF-1α-mediated hypoxia-pyroptosis-inflammation cascade in degenerative nucleus pulposus tissue and the intervention of related active ingredients. It is found that natural active ingredients such as baicalein， curcumin and resveratrol can intervene in the HIF-1α-mediated pathological cascade through four core links to delay IVDD progression： targeting the HIF-1α oxygen sensing pathway to block the initiation of pyroptosis cascade， inhibiting NOD-like receptor protein 3 inflammasome activation to cut off the cascade amplification of inflammatory signals， intervening in the Gasdermin D-mediated pyroptosis execution stage to protect cell membrane integrity， and regulating extracellular matrix metabolism to reconstruct intervertebral disc homeostasis.

Low back pain (LBP) is closely related to intervertebral disc degeneration (IDD) , spinal canal stenosis, intervertebral disc herniation, osteoarthritis of intervertebral facet joints, ligament and muscle lesions, among which IDD is the key factor causing low back pain. Emerging evidence suggests that a large number of pro-inflammatory cytokines are produced during IDD, and the inflammatory responses induced by these cytokines aggravate the occurrence and development of degeneration. At the molecular level, the mechanism of regulating intervertebral disc metabolism based on signal pathway has become a research hotspot, but the specific pathway mechanism is still unclear. In this paper, according to the crosstalk of NF-κB, TGF-β, MAPK, Wnt/β-catenin, PI3K/AKT/mTOR and other signal pathways, the positive and negative feedback effects of signal pathways on the inflammatory response during disc degeneration will be discussed. To elucidate the pro-inflammatory effects of NF-κB, anti-inflammatory effects of TGF-β and MAPK as well as the potential mechanisms of other pathways, we analyze the internal relationship between the mechanism of IDD and the signal pathway transduction, in order to provide new ideas for the treatment of IDD.