Modern Research on Traditional Chinese Ethnomedicines for Rheumatoid Arthritis: Acting Through Signaling Pathways

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis and multi-joint destruction. The disease course is prolonged, recurrent, and associated with high disability rates. Patients often experience significant physical and mental suffering due to persistent pain, joint deformities, and multisystem complications. Clinical treatment faces dual challenges of controlling inflammation and delaying structural damage. Although current mainstream chemical drugs, such as disease-modifying antirheumatic drugs (DMARDs), can relieve symptoms, their long-term use can easily cause adverse reactions, including lung involvement and cardiovascular disease. Although biological agents exhibit strong targeting capabilities, they are costly and immunosuppressive, thus increasing the risk of infection and other complications. These limitations highlight the urgent need for developing new therapeutic agents with improved safety and efficacy profiles. In this context, traditional Chinese ethnomedicines, rooted in the medical systems of China's ethnic minorities, have gradually attracted attention due to their potential for multicomponent synergy, favorable safety profiles, and low cost. They have thus become a research hotspot for complementary and alternative RA therapies in recent years. A comprehensive literature review reveals that existing anti-RA studies of traditional Chinese ethnomedicines mainly focus on regulating inflammation-related signaling pathways. However, issues such as fragmented target verification and unclear active ingredients remain. Therefore, this study comprehensively reviews the research progress on the molecular mechanisms by which traditional Chinese ethnomedicines regulate RA-related signaling pathways. It also examines the regulatory effects of certain ethnomedicines on crosstalk among multiple pathways and identifies active components in selected ethnomedicines. Acknowledging that the current evidence base is predominantly preclinical, this review highlights the critical need for rigorous clinical trials and comprehensive safety assessments to validate these findings. Ultimately, this work aims to provide new insights into clarifying the mechanisms of action of traditional Chinese ethnomedicines and to guide future targeted research for developing potential anti-RA drugs.