Expert consensus on research paradigms and technological layout for clinical priority diseases in traditional Chinese medicine: Rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic, highly disabling autoimmune disease. Although modern medical treatments have made progress, challenges such as suboptimal efficacy, relapse, difficulties in comorbidity management, and side effects persist. Traditional Chinese medicine (TCM) demonstrates unique advantages in the treatment of RA throughout the entire course of the disease, particularly in early intervention, consolidation during remission, reducing the side effects of Western medicines, and preventing relapse. Based on this, the article explores the research paradigm and scientific and technological strategic approaches for RA, which is recognized as a disease with clinical advantages in TCM. It proposes a three-pronged approach: optimizing the integrated traditional Chinese and Western medicine diagnostic and treatment system, strengthening comprehensive prevention and control of RA-related complications and comorbidities, and establishing a chronic disease management system for RA based on TCM theories. Through the synergy of clinical and basic research, the aim is to clarify the advantageous aspects of TCM in RA diagnosis and treatment, develop effective treatment protocols, enhance RA prevention and management, and underscore the value of TCM.

Keywords

Integrated TCM-Western Medicine / priority disease / rheumatoid arthritis / technological layout / traditional Chinese medicine

References

[1] Prevoo ML , van't Hof MA , Kuper HH , van Leeuwen MA , van de Putte LB , van Riel PL . Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995; 38 (1): 44- 48.

[2] Wang X , Li M , Zhang Y , et al. Clinical observation on 100 cases of early rheumatoid arthritis with knee synovitis treated by TCM minimally invasive needle-knife arthroscopy combined with conventional Western medicine. Rheumatism and Arthritis. 2020; 9 (1): 17- 20.

[3] Zhang H , Zhang X , Ren C , et al. Clinical study on heat- reinforcing acupuncture combined with methotrexate in the treatment of early rheumatoid arthritis. Journal of Clinical Acupuncture and Moxibustion. 2023; 39 (10): 38- 42.

[4] Xie Z , Cao W , Huang L , et al. Expert consensus on the diagnosis and treatment of pre-rheumatoid arthritis status. China Journal of Traditional Chinese Medicine and Pharmacy. 2024; 39 (2): 839- 846.

[5] Zhou X , Han M , Xiao H , et al. Treatment of rheumatoid arthritis by combining disease and syndrome differentiation with staged therapy. Beijing Journal of Traditional Chinese Medicine. 2019; 38 (10): 1020- 1023.

[6] Yao C , Jiang Q , Xia C , et al. Real-world study on factors associated with relapse in patients with clinically quiescent rheumatoid arthritis. J Tradit Chin Med. 2023; 64 (13): 1343- 1350.

[7] Tang Z , Liang Z , Huang C , et al. Effects of Chonggu granule on bone metabolism and the Notch pathway in rheumatoid arthritis patients with osteoporosis. Chin J Osteoporos. 2024; 30 (9): 1323- 1328.

[8] Dong P , Yuan P , Kang W , et al. Study on integrated traditional Chinese and Western medicine for rheumatoid arthritis complicated with osteoporosis. Chin J Osteoporos. 2024; 30 (1): 151- 156.

[9] Chen M , Zhou X . Discussion on TCM pathogenesis of secondary osteoporosis in rheumatoid arthritis. Rheumatism and Arthritis. 2013; 2 (4): 42- 43.

[10] Tian J , Wang G , Song M , et al. Research progress on kidney- tonifying and collateral-dredging therapy for rheumatoid arthritis with osteoporosis. Chin J Osteoporos. 2022; 28 (3): 465- 468.

[11] Ma R , Guo Z , Tao Q , et al. Mechanism of Zhi-Wang decoction combined with methotrexate in ameliorating bone destruction in CIA rats via modulation of the RANKL/OPG pathway. Chin J Exp Tradit Med Formulae. 2022; 28 (5): 46- 54.

[12] Duan Y , Zhang H , Yu Y , et al. Analysis of the impact of cardiovascular disease on rheumatoid arthritis in middle-aged and elderly Chinese based on the CHARLS database and exploration of new TCM therapeutic approaches. Chinese Archives of Traditional Chinese Medicine. 2023; 41 (12): 165- 168.

[13] Yu B , Xie H . Clinical study on Wenbi decoction for active rheumatoid arthritis with cold-damp Bi obstruction pattern. Clinical Journal of Chinese Medicine (Zhongyi Linchuang Yanjiu). 2011; 3 (4): 7- 9 (in Chinese).

[14] Liu S . Clinical observation on 100 cases of active rheumatoid arthritis treated by integrated traditional Chinese and Western medicine. J Tradit Chin Med. 2008; 49 (3): 228- 230.

[15] He T , Dai Y , Wu H , et al. Meta-analysis of the efficacy and safety of TCM treatment for refractory rheumatoid arthritis. Hunan Journal of Traditional Chinese Medicine. 2023; 39 (11): 116- 123.

[16] Gong X , Ma X , Jiang Q . Review of clinical research hotspots in TCM treatment of rheumatoid arthritis. Chinese Journal of Basic Medicine in Traditional Chinese Medicine. 2024; 30 (6): 953- 958.

[17] Yao C , Xu C , Zhang Y , et al. Clinical observation on Bushen Zhi- Wang decoction in delaying bone erosion progression in rheumatoid arthritis. Chinese Journal of Basic Medicine in Traditional Chinese Medicine. 2023; 29 (6): 976- 981.

[18] Liu J , Guo J , Wang Y , et al. Clinical efficacy and association rule analysis of external application of Furong Ointment combined with internal TCM medicine for active rheumatoid arthritis. Rheumatism and Arthritis. 2017; 6 (3): 15- 21.

[19] Huang X , Lin H , Huang Z . Efficacy observation of internal and external application of Chinese herbal medicine in treating rheumatoid arthritis. Chinese Archives of Traditional Chinese Medicine. 2010; 28 (8): 1786- 1788.

[20] Fang Y . Clinical study on needle-knife therapy combined with internal and external TCM medicine for refractory swelling and pain in rheumatoid arthritis. Chinese Archives of Traditional Chinese Medicine. 2016; 34 (3): 724- 727.

[21] Li R , Niu Y . TCM syndrome differentiation and treatment of rheumatoid arthritis in remission stage. Clinical Journal of Chinese Medicine (Zhongyi Linchuang Yanjiu). 2014; 6 (30): 82- 83 (in Chinese).

[22] Gu Z , Zhou G , Zhang X , Liang G , Xiao X , Dou Y . Research progress of plant medicine and Chinese herbal compounds in the treatment of rheumatoid arthritis combined with osteoporosis. Front Med. 2023; 10: 1288591.

[23] Lu W . Analysis of the therapeutic effect of TCM in treating rheumatoid arthritis. Clinical Journal of Chinese Medicine (Zhongyi Linchuang Yanjiu). 2015; 7 (29): 56- 58 (in Chinese).

[24] Lu HL , Chang CM , Hsieh PC , Wang JC , Kung YY . The effects of acupuncture and related techniques on patients with rheumatoid arthritis:a systematic review and meta-analysis. J Chin Med Assoc. 2022; 85 (3): 388- 400.

[25] National Administration of Traditional Chinese Medicine Regional TCM Rheumatology Diagnosis and Treatment Center . Guangzhou national regional integrated traditional Chinese and Western medicine rheumatology alliance. Expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of rheumatoid arthritis (2025 edition). Chinese Journal of Rheumatology. 2025; 29 (3): 177- 188.

[26] Xu X , Li QJ , Xia S , Wang MM , Ji W . Tripterygium glycosides for treating late-onset rheumatoid arthritis:a systematic review and meta-analysis. Altern Ther Health Med. 2016; 22 (6): 32- 39.

[27] Lu P , Li L , Liu B , et al. Efficacy and safety of integrated traditional Chinese and Western medicine for rheumatoid arthritis-interstitial lung disease:a systematic review and meta-analysis. Heliyon. 2024; 10 (21): e38771.

[28] Tang X , Liu Z , Yang Z , et al. The effect of Chinese medicine compound in the treatment of rheumatoid arthritis on the level of rheumatoid factor and anti-cyclic citrullinated peptide antibodies:a systematic review and meta-analysis. Front Pharmacol. 2021; 12: 686360.

[29] Cai X , Chen XM , Xia X , et al. The bone-protecting efficiency of Chinese medicines compared with Western medicines in rheumatoid arthritis:a systematic review and meta-analysis of comparative studies. Front Pharmacol. 2018; 9: 914.

[30] Shu H , Chen XY , Zhao J , Li P , Sun Z . Efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases. World J Clin Cases. 2025; 13 (6): 95513.

[31] Zhang Y . Efficacy of Tripterygium wilfordii glycosides tablets combined with methotrexate tablets in treating rheumatoid arthritis and its influence on disease activity and inflammatory factors. Chinese Journal of Modern Drug Application (Zhongguo Xiandai Yaowu Yingyong). 2023; 17 (21): 31- 35 (in Chinese).

[32] Tao S , Wang X , Liao C , et al. The efficacy of moxibustion on the serum levels of CXCL1 and β-EP in patients with rheumatoid arthritis. Pain Res Manag. 2021; 2021 (1): 7466313- 10.

[33] Seca S , Miranda D , Cardoso D , et al. Effectiveness of acupuncture on pain, physical function and health-related quality of life in patients with rheumatoid arthritis:a systematic review of quantitative evidence. Chin J Integr Med. 2019; 25 (9): 704- 709.

[34] Lan T , Wang Z , Yan Z , et al. Observation on the delaying effect of Bushen Zhi-Wang decoction on bone destruction in rheumatoid arthritis with liver-kidney deficiency syndrome based on modified sharp score. Journal of Beijing University of Traditional Chinese Medicine. 2023; 46 (4): 557- 563.

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The Author(s). Advanced Chinese Medicine published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.