Psoriatic arthritis, an inflammatory joint disease closely related to psoriasis, has a psoriatic rash and causes inflammation of the joints and surrounding tissues. With psoriatic arthritis, not only does the skin develop erythema and silvery-white scales, which affects personal image, but some patients progress to joint pain, swelling and deformity, which has an impact on the patient’s psychological and physical health. Although most patients with psoriatic arthritis have a slow and mild disease course, a small percentage of patients develop severe, uncontrollable or even disabling arthritis, resulting in joint disability and even loss of work capacity. Follow-up reveals that patients with psoriatic arthritis have a continuously progressive disease, with joint erosion occurring in approximately 47% of patients within 2 years. So, how can psoriatic arthritis be treated to better control its development and reduce its harmful effects? This is a common concern for doctors and patients. The causes and pathogenesis of psoriatic arthritis are not yet completely clear, and it is generally believed that genetic, immune and environmental causes are important factors in the development of psoriatic arthritis. However, although psoriatic arthritis cannot be completely cured, it can be clinically cured and well controlled after active combined Chinese and Western medicine treatment. How to realize the combined Chinese and Western medicine treatment of psoriatic arthritis? Patients with psoriatic arthritis usually have joint pain and other joint inflammation, for such patients can use non-steroidal anti-inflammatory drugs, such as fentanyl and fotarine. However, these drugs can only relieve the symptoms and cannot control the development of the disease. In order to prevent the deterioration of the disease and delay the destruction of joint tissues, slow-acting anti-rheumatic drugs can be selected in a targeted manner. These drugs include methotrexate, cyclosporine A, salazosulfapyridine, leflunomide and gold preparations. If a single slow-acting anti-rheumatic drug is ineffective, it can also be used in combination, with methotrexate as the basic drug for combination therapy, such as methotrexate plus salazosulfapyridine. However, all these must be carried out under the guidance of a specialist physician, and cannot be used indiscriminately, because these drugs have certain toxic side effects. Irregular use of drugs will not only fail to alleviate the condition, but also aggravate it, and even lead to serious complications resulting in death. With the in-depth research on the pathogenesis of psoriatic arthritis and the breakthrough development of bioengineering technology, some new biological agents with target specificity act on various aspects of the immune response and play an important role in the treatment of psoriatic arthritis. For example, TNF-α antagonists (e.g., Ixepro, Classic, and Xumel) are effective in improving joint symptoms and skin lesions and inhibiting the radiological progression of joint lesions. However, because of the complex and diverse pathogenesis of psoriatic arthritis, not all patients respond to TNF-α antagonists. Recent studies have shown that inhibitors of interleukin 12 and interleukin 23 are safe and effective in patients with psoriatic arthritis and help to relieve the signs and symptoms of arthritis in patients with psoriatic arthritis. This is a biological drug with a different mechanism of action from that of TNF-α antagonists for patients with psoriatic arthritis. However, although these drugs mentioned above can provide short-term relief, their side effects are not to be underestimated. Long-term use can lead to abnormal liver and kidney function, gastrointestinal bleeding, etc. Moreover, the disease inevitably recurs, and even surgical treatment cannot finally solve the root of the disease, or even complications that seriously affect the quality of patients’ survival, such as severe infection, carotid intima thickening, muscle disuse wasting and idiopathic wasting. So, how to prevent the emergence of these drug toxicities? How can psoriatic arthritis be best treated? In Chinese medicine, psoriatic arthritis belongs to the category of “Bai H” and “paralysis”. The “white H” image describes the characteristics of psoriasis skin lesions, while the joint symptoms are similar to the category of “paralysis”. Traditional Chinese medicine believes that the causes of this disease are complex, mostly because the body has insufficient positive energy, insufficient qi and blood, and lack of solidity outside the body, so that wind, cold, and dampness and toxicity take advantage of the deficiency and enter, resulting in the stagnation of qi and blood and paralysis of the meridians. The treatment of paralysis in Chinese medicine has a long history, and the main formula of Gui Zhi Shao Yao Zhi Mu Tang has been widely used in clinical practice as the main treatment for paralysis, with remarkable results. The clinical manifestations of psoriatic arthritis are complex and diverse, including cold, heat, actual and deficiency, so specific analysis must be made and treatment must be tailored to each individual in order to achieve success. It is the essence of TCM and the characteristic advantage of TCM, which has guided the clinical practice of TCM for more than 2000 years. Correct and reasonable diagnosis and treatment can alleviate the symptoms, delay the development, reduce recurrence and improve the quality of survival, and has the characteristics of small side effects and can be used for a long time. According to Professor Lu Chuanjian of the Department of Dermatology of Guangdong Provincial Hospital of Traditional Chinese Medicine, psoriatic arthritis mostly progresses from psoriasis, and the difference in treatment with other types of osteoarthritis is to simultaneously take into account the control of psoriasis and the improvement of joint symptoms. From the perspective of TCM treatment, emphasis is placed on balancing the symptoms with the root cause, and clinical evidence is guided by evidence-based treatment. According to Prof. Lu, most patients with psoriatic arthritis have psoriasis first and arthritis second. At the onset of psoriasis, because of the long-term history of psoriasis, most patients’ symptoms are closely related to blood stasis and Yang deficiency, and treatment is often based on warming Yang and invigorating Blood, and legislating to promote the circulation and relieve pain. In the early stage of these patients, the evidence is mostly that wind-damp heat paralyzes the joints and meridians, and in the later stage, it is often due to the deficiency of liver and kidney, loss of nourishment of joints and stagnation of blood. Therefore, in the early stage of treatment, the main treatment is to dispel wind and dry dampness, clear heat and pass the ligaments, and in the later stage, the treatment should be to nourish the liver and kidneys, harmonize the stasis and pass the ligaments. The treatment of psoriatic arthritis should be a combination of disease identification and evidence identification. Disease identification treatment can grasp the commonality of the disease mechanism, determine the general treatment principles and the basic composition of prescriptions and medicines, and evidence identification treatment can combine the specific conditions of each patient, add and subtract appropriately, and match them flexibly. In the treatment of psoriatic arthritis in TCM, as long as the evidence is accurately identified and the prescriptions and medicines are appropriate, they can be used together with western medicines to increase the effectiveness and reduce the toxicity. However, there are clinical cases where the diagnosis and treatment are basically correct, but the disease does not improve; or the symptoms improve, but the examination indexes do not improve. Why? This is because some Chinese medicines also have clear modern pharmacological effects. If a single Chinese medicine with clear pharmacological effect is added, the physical and chemical indexes will have more obvious improvement. For example, Dangpi can fight against vasculitis, Agaricus can raise red blood cells and hemoglobin, Zedoary can lower lipids, and Sepia is good for the decrease of transaminases, and so on. The use of these herbs on top of the evidence-based treatment can significantly increase the therapeutic effect. The most important symptom of psoriatic arthritis is joint pain. Gentiana macrophylla has better effect on joint swelling and pain and hypothermia; Qingfengtang is a wind dispelling and energizing medicine, which has significant anti-inflammatory and analgesic effect on arthritis and is clinically effective in treating various kinds of joint pain. Psoriatic arthritis is also a kind of immune abnormal disease, so in the clinical use of drugs, Chinese herbal medicines with regulatory and suppressive immune functions can be added appropriately. Therefore, it is the most commonly used herbal medicine in the clinical treatment of immune diseases, especially the Yin deficiency and internal heat type; Bei Sha Shen is a medicine for nourishing Yin and generating fluid and has obvious immunosuppressive activity, so it can be used together with Sheng Di to treat the Yin deficiency and internal heat type of immune diseases; long-term use of glucocorticosteroids will hurt Yin and consume fluid, so Yin nourishing drugs such as Lady’s Mantle, Dry Lotus Grass, Sha Shen and Mai Dong can better antagonize the side effects of hormones. Therefore, traditional Chinese medicine can often control the development of psoriatic arthritis very well. Both TCM and Western medicine have their own advantages and disadvantages in the treatment of psoriatic arthritis. In the treatment of psoriatic arthritis, western medicine has the advantages of fast onset and obvious effect, but it also has the disadvantages of fast relapse, no long-term use, strong toxic side effects and high economic cost; while Chinese medicine has the disadvantage of slow onset, but it has the advantages of relieving symptoms, suitable for long-term use, low toxic side effects, low economic cost and prolonging relapse time. Therefore, the combination of Chinese and Western medicine can achieve the purpose of complementary advantages, better than pure Chinese medicine or Western medicine treatment. The correct and reasonable combination of Chinese and Western medicine in the treatment of psoriatic arthritis can effectively control the disease and slow down its development.