To investigate the clinical efficacy of modified Baihu Guizhi Decoction combined with methotrexate (MTX) in the treatment of rheumatoid arthritis (RA)

A randomized controlled trial was conducted. A total of 120 RA patients admitted to the outpatient and inpatient departments of Rheumatology and Immunology at Xinyang Central Hospital from January 2022 to April 2024 were randomly divided into a control group and an observation group, with 60 cases in each group. The control group received standard-dose MTX, while the observation group received modified Baihu Guizhi Decoction in addition to the MTX regimen. The treatment duration was 12 weeks. Traditional Chinese medicine (TCM) syndrome scores, Visual Analog Scale (VAS) scores, joint swelling degree, morning stiffness duration, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) titer, C-reactive protein (CRP), and macrophage migration inhibitory factor (MIF) levels were compared between the two groups before and after treatment to evaluate efficacy and safety.

After treatment, TCM syndrome scores, VAS scores, morning stiffness duration, and joint swelling degree improved in both groups, and ESR, RF, CRP, and MIF levels decreased (P < 0.05). The observation group showed significantly greater improvements compared to the control group (P <0.05). The proportion of patients achieving ACR50/70 improvement criteria was higher (P < 0.05), and the incidence of adverse reactions was lower (P < 0.05) in the observation group.

Modified Baihu Guizhi Decoction combined with MTX demonstrates significant efficacy in treating RA with Wind-Damp-Heat obstruction syndrome. Its mechanism of action may be related to the regulation of CRP and MIF expression.