Rheumatoid arthritis, also known as rheumatoid, is an inflammatory disease of rheumatoid joints that may be related to differences in endocrine, nutritional, geographic, occupational, psychological and social environments, bacterial and viral infections, and genetic factors. The disease occurs in small joints of the hands, wrists, and feet, with recurrent episodes and symmetrical distribution. In the early stage, there is redness, swelling, pain and dysfunction of the joints, and in the late stage, the joints may have different degrees of stiffness and deformity, accompanied by atrophy of the bones and skeletal muscles, which can easily lead to disability. In Chinese medicine, it is considered as wind and bone joint paralysis, mostly caused by the loss of qi and blood in the meridians, external attack of wind and cold condensation. Diagnostic criteria: 1. Morning stiffness of the joints and surrounding joints for at least 1 hour (≥ 6 weeks). 2. Arthralgias in 3 or more joint areas (≥ 6 weeks). 3, arthrosis in at least one joint area of the wrist, metacarpophalangeal joint, or proximal interphalangeal joint (≥ 6 weeks). 4. Symmetrical arthritis (≥ 6 weeks). Rheumatoid nodules 5, rheumatoid nodules extensor surfaces or subcutaneous nodules in the proximal joint area. 6, check rheumatoid 3: positive rheumatoid factor (<5% positive rate in normal population). 7, hand X-ray image changes after the anterior hand, wrist X-ray shows bone invasion or clear bone decalcification typical of rheumatoid arthritis changes. The diagnosis can be confirmed by meeting 4 of the above 7 items. Rheumatoid arthritis treatment mainly includes the following methods: 1, the main western drug treatment: DMARDs, methotrexate (MTX), salbutamol, leflunomide, injectable gold preparations, hormones, tumor necrosis factor (TNF) antagonists, etc. 2, Chinese herbal medicine treatment, for symptom relief, reduce the toxic side effects of western drugs have a certain effect. 3.For those who have obvious joint deformity and affect their life, they can choose surgery to improve the function of joint movement. Recently, the European League Against Rheumatism has made several recommendations: 1 Once rheumatoid arthritis is diagnosed, traditional DMARDs should be used as much as possible. 2 The goal of treatment is to achieve remission or low disease activity as early as possible, with follow-up every 1 to 3 months and treatment regimen adjustment. 3 Methotrexate (MTX) is one of the drugs of choice in active RA. 4 If MTX is contraindicated or not tolerated, it can be replaced with salazosulfapyridine, leflunomide, and injectable gold preparations. 5 Patients who have not used DMARDs, with or without hormones, may be considered for DMARDs monotherapy: 6 For patients on DMARDs monotherapy or combination therapy, small to moderate doses of hormones may be used for a short period of time if necessary, but tapered as early and as soon as possible. 7 After failure of treatment with the preferred conventional DMARDs, patients may be considered for addition of biologic DMARDs if poor prognostic factors are present, and patients may be switched to other conventional DMARDs if no poor prognostic factors are present. 8 Patients with poor outcome on MTX or other conventional DMARDs may be considered for MTX combined with biologic DMARDs with or without combined hormones, and tumor necrosis TNF antagonists such as adalimumab, etanercept, golimumab, infliximab, and certolizumab are recommended. 9 Patients who have failed their first treatment with TNF antagonists may be considered for other TNF antagonists or biologics such as abciximab, rituximab, and tocillzumah. 10 Patients with refractory RA or with contraindications to biologics and traditional DMARDs may be treated with azathioprine, cyclosporine A (or cyclophosphamide in exceptional cases), alone or in combination. 1 1 All patients with RA should be considered for intensive therapy, with patients with poor prognostic factors benefiting most from intensive therapy. 1 2 If a patient is in sustained remission, consider tapering, starting with a reduction or discontinuation of hormones, or when biologics are combined with other traditional DMARDs. 1 3 Patients in long-term sustained remission may be cautiously tapered from traditional DMARDs after joint physician-patient discussion. 14 Patients who have not used traditional DMARDs but have poor prognostic factors may be considered for MTX plus biologic combination therapy. 15 Treatment regimens should be adjusted based on disease activity, bone destruction, complications, and safety factors.