To explore the effect of Guizhi Shaoyao Zhimu Decoction（桂枝芍药知母汤）combined with adalimumab on inflammatory response and blood viscosity in rheumatoid arthritis（RA）.

Seventy-two patients with RA of windcold-dampness type admitted to Shandong Wendeng Orthopedic Hospital from January 2021 to December 2023 were enrolled for the research and randomly divided into the control group（adalimumab treatment, 36 cases）and the experimental group（Modified Guizhi Shaoyao Zhimu Decoction combined with adalimumab treatment, 36 cases）. The blood levels of inflammatory indicators[tumor necrosis factor-α（TNF-α）, C-reactive protein（CRP）, interleukin-6（IL-6）, nod-like receptor protein3（NLRP3）], blood viscosity related indicators[whole blood viscosity-high shear, whole blood viscosity-low shear, plasma viscosity, fibrinogen（Fib）], traditional Chinese medicine syndrome scores, disease activity scale-28（DAS-28）, World Health Organization Quality of Life Test-Bref（WHOQOL-BREF）scores were compared between the experimental group and the control group before and 12 weeks after treatment.

There were no statistically significant differences in the general information and various indicators between the experimental group and the control group of RA patients before treatment（P>0.05）. Compared with those before treatment within the group, the blood levels of TNF-α, CRP, IL-6, NLRP3, whole blood viscosity-high shear, whole blood viscosity-low shear, plasma viscosity and Fib, traditional Chinese medicine syndrome score and DAS-28 score in two groups were significantly reduced, while the WHOQOL-BREF total score was significantly increased（P<0.05）. The blood levels of TNF-α, CRP, IL-6, NLRP3, whole blood viscosity-high shear, whole blood viscosity-low shear, plasma viscosity, Fib, Traditional Chinese Medicine syndrome score and DAS-28 score after treatment in experimental group were all significantly lower than those in the control group, while the total score of WHOQOL-BREF was significantly higher than that in the control group（P<0.05）.

Guizhi Shaoyao Zhimu Decoction combined with adalimumab treatment could significantly alleviate the inflammation and blood viscosity in RA patients with wind-cold-dampness type, improve traditional Chinese medicine syndromes, reduce the disease activity and improve the quality of life, which is worthy of promoting and applying.