By analyzing the effects of various meteorological factors such as air temperature, air pressure and humidity and the combined meteorological factors on patients with rheumatoid arthritis, it is tentatively concluded that the effects of low air temperature, high air pressure and high humidity on patients’ joint pain are more pronounced. Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease characterized by synovial lesions. Its pathogenesis is complex and there are many predisposing factors, but it is mostly thought to be caused by a combination of genetic and environmental factors. According to statistics, about 90% of RA patients are sensitive to climate change. The prevalence of rheumatoid arthritis has been reported to be high in areas with large changes in climate and humidity; some rheumatic patients often complain of increased symptoms when weather change fronts (fronts are the interface between cold air masses and warm air masses) pass by, especially when the pain increases before rain and decreases after rain. Studies have shown that changes in meteorological factors are closely related to RA. 1. The “Heavenly Man Corresponding to Nature” theory in Chinese medicine There are necessary conditions in nature for human survival, and the human body must respond to the various changes in nature to produce corresponding physiological changes in order to carry out normal physiological activities. More than two thousand years ago, the Yellow Emperor’s Classic of Internal Medicine [1] discussed the relationship between human beings and nature, such as “The Spiritual Pivot? The Evil Guest”[1] says: “Man corresponds to heaven and earth”; “The Ling Shu? The Dew of the Ages” says: “Man and the heavens and the earth are also in sympathy with each other and with the sun and the moon”. Chinese medicine has formed a relatively independent and complete theory of meteorological medicine by focusing on the six qi of the four seasons and fully reflecting the influence of climate and weather changes on human life activities in various aspects such as physiopathology, diagnosis and treatment, and health and rehabilitation. Moriwa et al. used 17-KS (adrenocorticotropic hormone) excretion as a representative indicator of internal qi (kidney qi), and used seasonal and meteorological elements to reflect external environmental changes. The results confirmed that the annual cycle of 17-KS corresponds to the cycle of the four seasons, and found the pattern of high summer and low winter, and that the unpleasant index (a composite index representing temperature and humidity) and the cycle of temperature change are the same as the 17-KS discharge. Zhou discussed and analyzed the consistency between the Wei Qi and the heat metabolism of human body in Chinese medicine in terms of physiological functions and pathological characteristics from the aspect of meteorological medicine theory, which embodies the essence of the theory of the correspondence between heaven and man in Chinese medicine. Likewise, climate change has a certain influence on the occurrence, development and regression of human diseases. Li et al. analyzed the relationship between the pain onset rate and the Taiyin lunar cycle in 822 patients with rheumatism, and found that there was an approximate lunar rhythm with a Lorentz linear pattern of variation in the onset date of the Taiyin lunar cycle, followed by periodic changes in the lunar phase of the onset of birth, gradual gain, hope, gradual loss, and emptiness, and the pain onset rate also showed highly significant or significant differences at each stage simultaneously. The theory of “Heaven and Man correspond to each other” in Chinese medicine allows people to further understand the relationship between environment – people – health, and to grasp health and disease from a holistic, dynamic and discriminatory point of view, which is more in line with the laws of movement of the human body. This is in line with the laws of movement and change of the human body, which is the strength of Chinese medicine. Rheumatoid arthritis belongs to the category of “paralysis” in Chinese medicine, and its causes are mainly twofold: one is the deficiency of positive energy; the other is the external attack of wind, cold and dampness. For example, Su Wen? Paralysis” [1] points out that “the wind, cold, and damp are mixed and combined to form paralysis. The wind is a paralysis of movement, the cold is a paralysis of pain, and the damp is a paralysis of adhesion”, and “if it is not combined with wind, cold, and damp, it is not a paralysis”. The “Commentary on fever” cloud: “where the evil comes together, its qi must be deficient”. This shows that people have long recognized the importance of internal and external combination of evil in the pathogenesis of paralysis. Ge Linbao et al. used guinea pigs to model wind-cold and damp paralysis, and confirmed the paralytic effect of wind-cold and damp environment by observing the nerve histology, nerve conduction velocity, transmission velocity, motor endplate diameter length and submicroscopic structure of gastrocnemius muscle. Wang Xuhui was the first in China to use a homemade paralysis modeling kit to cause partial inflammatory changes locally in rabbit joints. Wang An-Min et al. observed that external cold and damp factors (swimming in cold water at 15°C to 17°C for 5 min to 7 min once a day for 7 d) could aggravate the local lesions in the joints of collagen-induced arthritis (CIA) in rats, but the use of the above-mentioned cold and damp factors alone did not cause any lesions in the animals. From the perspective of external pathogenesis, Xiao Changhong et al. successfully developed a combined TCM model of wind-cold-damp paralysis and wind-damp-heat paralysis RA in accordance with TCM etiology and pathogenesis by giving two different conditioned stimuli, wind-cold-damp and wind-damp-heat, on top of staphylococcal enterotoxin B (SEB) topical application in rats with collagen-induced arthritis. This suggests that the TCM etiology of wind-cold-damp paralysis should not be understood only as abnormal climatic conditions, but may result in a series of pathological changes due to stimulation of the body by certain susceptibility factors and infection sources under abnormal climatic conditions. Shen Hongbo observed that immunization with CCP peptide antigen in a rat model of adjuvant arthritis (AA) induced a series of immune responses in the body, leading to the production of RA-related autoantibodies, while environmental factors (hot and cold environments) enhanced the expression of autoantibodies during the immune response and aggravated the disease. Studies have shown that environmental factors severely affect the expression of Ig, RF, CRP, anti-CCP (anti-cyclic citrullinated polypeptide antibody), APF (antiperinuclear factor), AKA (anti-keratin antibody), VEGF (vascular endothelial growth factor) and IL-1 positive cells, and aggravate synovial hyperplasia and inflammatory cell infiltration, leading to joint osteoporosis and trabecular fracture; humid and hot environment (95%~100% humidity, 30℃~33℃, 1h daily for 9d) had more effects on IgA, IgM, RF, CRP, anti-CCP, APF, AKA, RA33, VEGF positive cells, MOD (mean optical density) value and IL-1 positive cells MOD value than cold and humid environment (95%~100% relative humidity, 7℃~10℃, 1h daily). ℃～10℃, 1h per day,for 9d), and the effect of hot and humid environment on joint pathology was also more serious than that of cold and humid group. 3, the impact of meteorological factors on RA: meteorological factors through the skin, respiratory, sensory system, etc. affect the human body. Yuan Jiali et al. suggested that changes in temperature and humidity in the external environment and toxic biological factors produced by pollution can disrupt the micro-ecological balance in the human body, leading to the onset of disease due to the competition between evil and positive. Modern times have also confirmed that there is a statistically significant relationship between the onset of joint pain and changes in temperature, humidity and air pressure. Temperature: The most comfortable ambient temperature for the human body is 20℃ to 30℃. Yin Xuhui et al. observed the effect of cold on normal human immune function and found that NK activity, IL-2 production capacity, and cell culture supernatant IgG content were significantly lower in the experimental group after 7 d of exposure compared with the control group. after studying the relationship between joint pain and meteorological factors in 29 patients with juvenile rheumatoid arthritis, Tsai et al. concluded that the degree of pain in the joints of patients and meteorological factors such as air temperature, humidity, and There was no significant correlation between meteorological factors such as temperature, humidity, and atmospheric pressure, but when the weather changed drastically (when the average daily temperature dropped sharply by more than 5°C), such as 1 day after the onset of a cold wave, the degree of joint pain in patients was significantly worse compared with the day before and on the day of the cold wave, which was statistically significant, indicating that short-term weather changes have a more direct and significant impact on human health. They also found no significant correlation between the degree of swelling of patients’ joints and weather elements in the study. Similarly high temperature environment can also have adverse effects on human health. According to Pei Guoxian, high temperature can reduce the immune function of human body. Immune cells can be suppressed at 40℃ and irreversible damage can occur at 43℃. Humidity: the human body’s sense of temperature and humidity is very relevant, the body’s optimum humidity: temperature 15 ℃ ~ 20 ℃, relative humidity 45% ~ 55%; temperature 25 ℃, relative humidity 20%. In high humidity, the ambient temperature up to 30 ℃ can make the quiet state of the human body temperature, pulse rate increases, sweat evaporation rate decreases, 35 ℃ when this effect is more significant [15]. If the humidity is as high as 80% to 100%, this is when humid air can have a detrimental effect on the human body, regardless of the temperature conditions [16]. In an experimental study of the effect of external humidity on the immunology of mice with spleen deficiency, Liu Guanghua et al. found that under the abnormal stimulation of high environmental humidity, the cellular and humoral immunity of the organism was at a lower level, as evidenced by a decrease in lymphocyte conversion rate, CD4, IgG, IgM, and an increase in CD8. Patberg et al. proposed a “local microclimate” in their study of RA “(i.e., the effect of purely aerobic factors on the skin includes not only natural meteorological factors, but also factors that prevent the evaporation of sweat, such as clothing and the indoor environment in which one lives. A significant correlation was found between the pain caused by RA and the effect of humidity in the local microclimate on the patient’s skin. While Zhou Huijiong et al. used univariate analysis in their study of RA risk factors and found that humidity in housing and work environment was associated with the onset of RA, but there was no statistical significance in the multifactorial analysis. Xia Lianbo had observed the relationship between the incidence of arthralgia and humidity in a group and found that when the relative humidity varied up and down by more than 10% from day to day, the number of patients with arthralgia increased significantly. Barometric pressure: High-pressure weather makes people feel comfortable, while low-pressure weather tends to induce various diseases. The human body is generally well adapted to changes in air pressure, but if there is a sharp change in air pressure within a short period of time, the body may not adapt. Xia Lianbo observed the relationship between the incidence of joint pain and barometric pressure in a group and found that when the barometric pressure changed by 10 millibars or more day by day, the number of joint pain patients increased. The sudden change in barometric pressure may affect the balance of body fluids and electrolytes inside and outside the local cells, and the diseased tissues of arthritis patients cannot drain the fluid from the cells in time with the weather change, resulting in higher cellular pressure in the diseased area than the surrounding normal tissues, thus causing pressure and soreness in the diseased area. The influence of weather elements on RA: In 1985, Patberg et al. suggested that joint pain in RA patients was significantly correlated with temperature and air pressure, but not with humidity. Qiu Huxin suggested that paralysis caused by wind, cold, and dampness is a disease mediated by abnormal blood rheology in a population with elevated red blood cell rigidity and elevated plasma viscosity induced by low temperature stress. They found that the microvessels in the low-temperature, high-pressure and low-temperature plus high-pressure groups showed microvascular constriction, and the microcirculation looked like “bald branches” under the microscope, with almost no capillary opening; the high-temperature, high-humidity and high-temperature plus high-pressure groups mainly showed microvascular dilation, capillary opening and blood stasis. Jamison et al. surveyed 558 patients with chronic pain living in four different cities in the United States by questionnaire. 54.2% of the patients were suffering from low back pain and 39% were diagnosed with arthritis. The survey found that 67.9% of patients believed that changes in weather affected their pain, with 52.6% of patients believing that pain began in their joints before the weather changed, and 62.3% of patients claiming that their pain was significant during weather changes. When exploring the effect of specific weather factors on pain, it was found that cold and humidity had the most pronounced effect on patients’ joint pain. Ye Dongqing et al. concluded that the occurrence of RA is associated with dampness and cold in the living and working environment, and suggested that cold and dampness may act as both a systemic stimulus that acts on the immune system of people with certain genetic characteristics, causing functional changes that contribute to the onset of RA, and as an adverse environmental factor that induces or exacerbates the action of certain pathogenic factors that cause RA through autoimmune mechanisms. Chen et al. used an artificial climate chamber to create a wind-cold environment to observe changes in mice, and concluded that one of the main mechanisms of wind-cold pathogenesis may be the suppression of immune function due to the interaction of neuroendocrine-immune regulatory networks, resulting in a decrease in the overall immune function of the body. The patients’ pain was most pronounced under cold, cloudy and overcast weather conditions. Using the Jamison questionnaire, Li [28] investigated the effect of different weather conditions on joint pain in five rheumatic diseases (ankylosing spondylitis, rheumatoid arthritis, osteoarthritis, gouty arthritis, and myofibromyalgia syndrome) and found that 78, 5% of patients complained of joint pain closely related to weather changes, while low temperature, high air pressure, and high humidity were associated with pain in patients with RA. Strusberg et al [29] concluded that patients with rheumatic diseases are sensitive to changes in meteorological factors after studying patients with rheumatic diseases living in an Argentinean city with a Mediterranean climate, where the observation of 82 patients with RA revealed that joint pain was more pronounced in patients with RA at low temperatures, high air pressure and high humidity. In addition, the onset of RA is also seasonally related, with most onset or exacerbation around the vernal and autumn equinoxes each year.Grazio et al [30] found that the onset pattern of RA is seasonally related, with sudden onset mostly in spring and latent onset mostly in autumn, while the number of acute and latent onset is essentially the same in summer and winter. Conclusion: Chinese medicine has an early understanding of the relationship between environment and health and disease, and in recent years, many scholars have done many related studies on the influence of meteorological factors on RA. The influence of meteorological factors on RA is very complex, and is the result of the combined effect of multiple interrelated factors and mutual constraints. Further research is needed on the pathways through which changes in meteorological factors alter human physiology, pathology, endocrine and immune systems. In the future research process, we should focus on the combination of clinical and experimental research, continuously explore the model of RA that is consistent with the combination of Chinese medicine disease and evidence, and explore the influence of meteorological factors on RA from the changes of some objective indicators reflecting disease changes, such as inflammation indicators (CRP, ESR), cytokines, immune regulation, etc.; strengthen multidisciplinary cooperation, introduce different mathematical and statistical methods with the help of modern technology We have introduced different mathematical and statistical methods such as principal component analysis, fuzzy mathematics, lagged cross-correlation and variance spectrum analysis [31] to investigate the correlation between various meteorological factors and the onset of RA. In conclusion, an in-depth study on the influence of meteorological elements and RA may be useful for the rational use of meteorological conditions and the creation of a suitable “artificial microclimate environment” to treat the disease.