| [Background]Rheumatoid Arthritis (RA) is a chronic multisystem disease of unknown etiology, characterized by persistent inflammatory etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric fashion. Although cartilaginous destruction, bony erosions, and joint deformity are hallmarks, the course of RA can be variable. Modern treatment of RA is "treating rheumatoid arthritis to target", which means treatment targeting remission or low disease activity. Drug program of RA bases on Disease-modifying antirheumatic drugs (DMARDs), but also nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GCs) and biological agents will be concerned when necessary. As the research of treating rheumatoid diseases with Traditional Chinese Medicine (TCM) goes in depth, the advantage TCM attracts clinical doctors’ attention. My mentor, Professor Dong Zhenhua, has worked on treating rheumatic diseases by integrating TCM and Western Medicine over 30 years large amount of experience, especially in the area of treating RA by combination therapy with TCM and Western Medicine.[Objective]Based on the treatment of 98 RA cases of Professor Dong Zhenhua, this study is trying to summarize the professor’s idea about pathogenesis, law of syndrome differentiation and characteristic of treatment. That will improve the clinical efficacy, find out advantages of treating RA by TCM, as well as lay the foundation of further research and clarify TCM innovative research RA therapeutic mechanism. [Method]Collect 98 cases of RA form outpatient clinic of Peking Union Medical College Hospital. Then review all cases, analyze distribution of syndrome types and its characteristic, combine with my mentor’s inspiration in the teaching and learning process and his articles published on this study recent period. Finally, sum up the experience of Professor Dong Zhenhua in treating RA, including the essence of etiology and pathogenesis of RA, his law of syndrome differentiation, his unique treatment characteristics. [Results] 1. Among all cases, those patients with syndromes combined excess and deficiency take the most part, especially wind-dampness resisting collateral with Qi-Yin deficiency, and dampness-heat arthralgia spasm with Qi-Yin deficiency, each accounts for 14.29% and 13.27% of total. The excess syndrome distribution (arranging in descending order):wind-dampness resisting collateral>dampness-heat arthralgia spasm>phlegm and blood stasis>others (pure deficiency syndromes)> dampness-cold resisting col lateral>wind-dampness resisting collateral with phlegm and blood stasis, dampness-cold resisting collateral with phlegm and blood stasis, dampness-heat arthralgia spasm with phlegm and blood stasis. The deficiency syndrome distribution (arranging in descending order):deficiency of Qi and Yin>others (pure excess syndromes) >deficiency of liver and kidney>deficiency of Qi and blood>Qi deficiency of spleen and stomach, deficiency of liver and kidney with Qi-Yin deficiency.2. The incidence of female patients is far more than male, while there is no statistical difference of syndrome distribution between female and male.3. There is no statistical difference of syndrome distribution among groups of different course.4. Whether RA patients complicated with SS or not, their syndrome distributions have no statistical difference except the syndrome of dampness-heat,which is far more in the RA group.[Conclusion]1. Pathogenesis features:Both deficiency and excess exist together, while phlegm and blood stasis complicated disease condition.2. Differential treatment characteristics: ①Main syndrome of active period is excess, while main syndrome of remission period is deficiency. ②Main syndrome may change between excess and deficiency, as RA turns in to active or not. ③RA turns from active period to remission period, main syndrome may change from excess to deficiency.3. TCM syndromes analysis:①Syndromes combined excess and deficiency take the most part, especially wind-dampness resisting collateral with Qi-Yin deficiency, and dampness-heat arthralgia spasm with Qi-Yin deficiency. ②The most excess syndrome is wind-dampness resisting collateral, while the most deficiency syndrome is deficiency of Qi and Yin. ③There is no statistical difference of syndrome distribution between female and male.④There is no statistical difference of syndrome distribution among groups of different course. ⑤Whether RA patients complicated with SS or not, their syndrome distributions have no statistical difference except the syndrome of dampness-heat.4. Treating characteristics:Maximize curative effect by early diagnosis and early treatment. Insist treating RA with therapy combing TCM and Western Medicine together. Insist differentiating TCM syndrome, with differentiating disease combined organically.
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