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Restoring Homeostatic Balance: Advances in Traditional Chinese Medicine for Rheumatoid Arthritis
Yuhong Xiang1,2, Aihong Yang2, Cong Guo1
1State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China.
The American Journal of Chinese Medicine
|April 30, 2026
Summary
Traditional Chinese Medicine (TCM) offers a holistic approach to rheumatoid arthritis (RA), targeting multiple imbalances. Recent studies show TCM effectively rebalances immune, inflammatory, and metabolic pathways for RA treatment.
Area of Science:
- Integrative medicine and immunology
- Pharmacology of Traditional Chinese Medicine
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation-mediated joint damage.
- RA pathogenesis involves dysregulation of immune cells, inflammation, oxidative stress, angiogenesis, bone homeostasis, and gut microbiota.
- Conventional RA therapies can be costly and induce adverse effects.
Purpose of the Study:
- To review in vitro and in vivo studies on anti-rheumatoid arthritis Traditional Chinese Medicine (TCM) published between 2020 and 2025.
- To elucidate the multi-target, network-based therapeutic mechanisms of TCM in rheumatoid arthritis.
Main Methods:
- Systematic review of in vitro and in vivo research on anti-RA TCM from 2020-2025.
- Analysis of studies focusing on TCM's effects on immune cell polarization, inflammation, oxidative stress, angiogenesis, bone metabolism, and gut microbiota.
Main Results:
- TCM exhibits multi-target, network-based regulation for rheumatoid arthritis.
- Key mechanisms include modulating immune cell polarization, rebalancing inflammatory factors, scavenging reactive oxygen species (ROS), inhibiting angiogenesis, regulating osteoblast-osteoclast crosstalk, and reshaping gut microbiota.
- Evidence-based TCM examples include Tripterygium wilfordii, Wutou Decoction, and Toddalia asiatica extract.
Conclusions:
- Traditional Chinese Medicine offers a unique advantage in rheumatoid arthritis treatment by reestablishing dynamic homeostasis through interconnected pathological balance.
- TCM agents demonstrate complex pharmacological properties by acting on multiple balance networks simultaneously.
- Further research is required to clarify the synergistic regulatory mechanisms of TCM components and facilitate clinical translation.
