Rheumatoid Arthritis
Rheumatoid arthritis is a common autoimmune disease whose main clinical presentation is symmetrical polyarthritis. It is characterized by chronic inflammation of the joint synovium and progressive joint damage. Its primary pathological changes are chronic synovitis and pannus formation, which can erode cartilage and bone and lead to joint destruction.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Joint pain and heaviness, with pain that shifts from place to place; pale-red tongue; white, greasy coating; soggy or slippery pulse.
In plain language:
- The joints may hurt and feel heavy, making movement feel cumbersome.
- The location of the pain may shift from one place to another, making it difficult to pinpoint.
- The tongue may appear pale red, with a relatively light, dull color.
- The tongue coating may look white and greasy.
- On palpation, the pulse may feel soft or slippery, flowing smoothly rather than feeling firm.
|Treatment Approach
Clinical description:
Dispel wind, eliminate dampness, unblock the collaterals, and relieve pain.
In plain language:
- Dispel wind: In TCM terms, disperse “wind” affecting the body to ease discomfort.
- Eliminate dampness: Address excess dampness in the body to reduce feelings of heaviness and stickiness.
- Unblock the collaterals: Promote the flow of qi and blood through the channels and collaterals.
- Relieve pain: Ease pain and reduce discomfort.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Cold, painful, heavy-feeling joints in the limbs, with localized sensitivity to cold. Pain worsens with cold and eases with warmth; swollen tongue with a pale, dusky body; white, greasy or white, slippery coating; wiry and moderate or deep and tight pulse.
In plain language:
- The joints in the arms and legs may feel cold and painful, with a sense of heaviness.
- The affected area may be sensitive to cold and noticeably uncomfortable in cold wind or water.
- Pain may worsen noticeably in cold conditions.
- Pain may ease with warmth or keeping warm; a warm compress may feel soothing.
- The tongue may look enlarged or swollen when extended.
- The tongue may look pale with a slight dusky tinge, rather than bright red.
- The tongue coating may be white, thick, and greasy, or white and slippery-looking.
- On palpation, the pulse may feel wiry and relatively slow, or be more apparent only with deeper pressure and feel tight.
|Treatment Approach
Clinical description:
Warm the channels, dispel cold, eliminate dampness, and unblock the collaterals.
In plain language:
- Warm the channels: Warm the channels to reduce internal cold and ease stiffness and cold-related discomfort.
- Dispel cold: Disperse cold that has accumulated locally or in the body to ease cold pain and symptoms aggravated by cold.
- Eliminate dampness: Address excess dampness in the body to reduce feelings of heaviness, stickiness, and sluggishness.
- Unblock the collaterals: Promote the flow of qi and blood through the channels and collaterals to ease numbness and pain.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Swelling, pain, and heaviness in the joints and muscles, with warmth or a burning sensation to the touch; red tongue; yellow, greasy coating; soggy and rapid or slippery and rapid pulse.
In plain language:
- The joints and muscles may become swollen and painful, with a feeling of heaviness.
- The affected area may feel hot to the touch or noticeably warm.
- The tongue may appear red.
- The tongue coating may be yellow, thick, and greasy.
- On palpation, the pulse may feel soft and relatively fast, or slippery and relatively fast.
|Treatment Approach
Clinical description:
Clear heat, eliminate dampness, free Bi obstruction, and unblock the collaterals.
In plain language:
- Clear heat: Address internal heat to ease redness, swelling, burning sensations, and feelings such as restlessness and thirst.
- Eliminate dampness: Address accumulated dampness to ease heaviness, stickiness, and swelling.
- Free Bi obstruction: Disperse obstruction to help promote movement in the joints and channels.
- Unblock the collaterals: Promote the flow of qi and blood to ease numbness, aching pain, and tightness.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Painful, swollen joints, morning stiffness, and nodules around the joints or under the skin; dusky-purple tongue; white, thick or thick, greasy coating; deep, thin, choppy or deep, slippery pulse.
In plain language:
- The joints may be painful and swollen, with discomfort and reduced ease of movement.
- Joints may feel stiff upon waking in the morning, gradually easing after some movement.
- Small nodules may appear around the joints or beneath the skin and may feel like small hard lumps.
- The tongue may look dusky or purplish.
- The tongue coating may be white and thick, or white, thick, and greasy.
- On palpation, the pulse may be apparent only with deeper pressure and feel thin and uneven, or feel slippery under deeper pressure.
|Treatment Approach
Clinical description:
Invigorate blood, resolve stasis, transform phlegm, and unblock the collaterals.
In plain language:
- Invigorate blood → Promote local blood flow to ease pain, stiffness, and numbness.
- Move stasis → Address stagnant blood to ease sharp or localized pain and swelling.
- Transform phlegm → Address phlegm and pathological fluids in TCM terms to ease chest oppression, excess phlegm, and a heavy feeling.
- Unblock the collaterals → Promote the flow of qi and blood to improve mobility and ease numbness and aching pain.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Aching or dull joint pain accompanied by fatigue and weakness, a dull complexion, pale tongue, thin coating, and a thin, weak or deep, thin, weak pulse.
In plain language:
- The joints may ache or have a dull pain, causing discomfort during everyday activities.
- Fatigue and weakness may also occur, with low energy and easy tiring.
- The complexion may look dull and lack a healthy glow.
- The tongue may appear pale.
- The tongue coating may be thin, with little coverage, and not thick or greasy.
- On palpation, the pulse may feel thin and weak, or be apparent only with deeper pressure and feel thin and weak.
|Treatment Approach
Clinical description:
Supplement qi and nourish blood, unblock the channels, and invigorate the collaterals.
In plain language:
- Supplement qi → Support vitality and bodily function, helping address shortness of breath, weakness, and reluctance to speak.
- Nourish blood → Nourish the blood to support qi and blood, addressing a poor complexion, dizziness, palpitations, and numbness in the limbs.
- Unblock the channels → Promote the flow of qi and blood through the channels to ease numbness, aching, distension, and spasms.
- Invigorate the collaterals → Promote blood flow through the collaterals and address obstruction to ease pain, stiffness, and limited movement.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Pain in the joints and muscles, with swollen or stiff, deformed joints; red tongue; thin, white coating; deep, weak pulse.
In plain language:
- The joints and muscles may be painful, causing persistent discomfort.
- Joints may be swollen, stiff, or appear somewhat deformed.
- The tongue may appear red when extended.
- The tongue coating may be thin and white, without a thick or greasy appearance.
- On palpation, the pulse may be apparent only with deeper pressure and feel weak.
|Treatment Approach
Clinical description:
Warm and tonify the liver and kidneys, and strengthen the sinews and bones.
In plain language:
- Warm and tonify the liver and kidneys → Use a warming approach to support the yang qi and essence and blood of the liver and kidneys, addressing symptoms such as sensitivity to cold, soreness and weakness in the lower back and knees, and fatigue.
- Strengthen the sinews and bones → Support the strength and resilience of tendons and bones, easing soreness, weakness, and joint instability and supporting movement.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Joint pain, sometimes worse at night or sharp and stabbing; dusky tongue with stasis spots along the edges or at the tip; thin, white coating; thin, choppy pulse.
In plain language:
- The joints may be painful.
- Pain may be more noticeable at night or feel sharp and stabbing.
- The tongue may look dusky rather than bright red.
- Small purplish spots may be visible along the edge or at the tip of the tongue.
- The tongue coating may be thin and white.
- On palpation, the pulse may feel thin and somewhat rough or uneven.
|Treatment Approach
Clinical description:
Invigorate blood, resolve stasis, relax the sinews, and unblock the collaterals.
In plain language:
- Invigorate blood → Promote local blood flow to ease pain, stiffness, and numbness.
- Resolve stasis → Address stagnant blood to ease sharp or localized pain and swelling.
- Relax the sinews → Relax muscles and sinews to ease tightness, spasms, and pulling sensations and improve range of motion.
- Unblock the collaterals → Promote the flow of qi and blood to improve mobility and ease numbness and aching pain. Invigorate blood → Promote local blood flow to ease pain, stiffness, and numbness.
- Resolve stasis → Address stagnant blood to ease sharp or localized pain and swelling.
- Relax the sinews → Relax muscles and sinews to ease tightness, spasms, and pulling sensations and improve range of motion.
- Unblock the collaterals → Promote the flow of qi and blood to improve mobility and ease numbness and aching pain.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Lv QW，Zhang W，Shi Q，et al. Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis（TRIFRA）：a randomised，controlled clinical trial[J]. Ann Rheum Dis，2015，74(6)：1078-1086.
- Wang HL，Jiang Q，Feng XH，et al. Tripterygium wilfordii Hook F versus conventional synthetic disease-modifying anti-rheumatic drugs as monotherapy for rheumatoid arthritis：a systematic review and network meta-analysis[J]. BMC Complement Altern Med，2016(16)：215.
- Sun Pingping，Zhang Tianjiao，Xu Kejia，et al. Systematic review of randomized controlled trials on the distribution characteristics of clinical adverse reactions to Tripterygium wilfordii and its preparations[J]. World Science and Technology: Modernization of Traditional Chinese Medicine，2015，17(9)：1899-1904.
- Lin Changsong，Yang Xiuyan，Dai Lie. A multicenter clinical study of Kunxian Capsules for rheumatoid arthritis[J]. Chinese Journal of Integrated Traditional and Western Medicine，2011，31(6)：769-774.
- Zhu X，Zhang J，Huo R，et al. Evaluation of the efficacy and safety of different Tripterygium preparations on collagen-induced arthritis in rats[J]. Journal of Ethnopharmacology，2014(158)：283.
- Li Haichang，Wen Chengping，Wang Meijiao，et al. Meta-analysis of total glucosides of paeony combined with methotrexate for the treatment of rheumatoid arthritis[J]. China Journal of Traditional Chinese Medicine and Pharmacy，2012，27(4)：1115.
- Xiang N，Li XM，Zhang MJ，et al. Total glucosides of paeony can reduce the hepatotoxicity caused by Methotrexate and Leflunomide combination treatment of active rheumatoid arthritis[J]. International Immunopharmacology，2015(28)：802.
- Chen Z，Li XP，Li ZJ，et al. Reduced hepatotoxicity by total glucosides of paeony in combination treatment with leflunomide and methotrexate for patients with active rheumatoid arthritis[J]. International Immunopharmacology，2013(15)：474.
- Wang Wenqin. 120 cases of rheumatoid arthritis treated with methotrexate combined with Zhengqing Fengtongning sustained-release tablets[J]. Zhejiang Practical Medicine，2010，15(4)：280-281.
- Chen XM，Huang RY，Huang QC. Systemic Review and Meta-Analysis of the Clinical Efficacy and Adverse Effects of Zhengqing Fengtongning Combined with Methotrexate in Rheumatoid Arthritis[J]. Evidence-Based Complementary and Alternative Medicine，2015，2015：910376.
- Xu M，Liu L，Qi C，et al. Sinomenine Versus NSAIDs for the Treatment of Rheumatoid Arthritis：A Systematic Review and Meta-Analysis[J]. Planta Med，2008(74)：1423.
- Wang Chengde，Shen Pi’an，Hu Yinqi. Practical TCM Rheumatology[M]. Beijing：People’s Medical Publishing House，2009.