Abstract: Objective To observe the clinical efficacy of modified Sanbi decoction combined with methotrexate in the treatment of rheumatoid arthritis (RA). Methods A total of 63 patients with RA admitted between September 2021 and September 2023 were selected as the study subjects. They were randomly divided into two groups: the control group (n=31) received oral methotrexate tablets, and the treatment group (n=32) received modified Sanbi decoction in addition to oral methotrexate tablets. Both groups were treated for 4 weeks. Compare the levels of morning stiffness, joint pain, swelling, and grip strength before and after treatment between the two groups. Detect the erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and C-reactive protein (CRP) levels. Additionally, compare the safety indicators such as T lymphocyte helper factor (OKT4), T lymphocyte suppressor factor (OKT8), and OKT4/OKT8 ratios to assess the disease activity before and after treatment in both groups. Results Compared with before treatment, both groups showed a significant reduction in morning stiffness duration, joint pain and swelling scores (P<0.05), and an increase in grip strength (P<0.05) after treatment. ESR, RF, and CRP levels were significantly decreased (P<0.05), while OKT4 levels , OKT8 levels increased, and OKT4/OKT8 ratio decreased significantly (P<0.05). Compared with the control group, the treatment group showed improvements in morning stiffness duration, joint pain, joint swelling, and grip strength levels (P<0.05). The levels of ESR, RF, and CRP were all lower (P<0.05). Additionally, the levels of OKT4 and OKT8 were higher, and the OKT4/OKT8 ratio was lower (P<0.05). Conclusion Modified Sanbi decoction combined with methotrexate is effective in treating RA, improving clinical symptoms, reducing inflammation, inhibiting disease activity, and preventing bone destruction.

Key words: rheumatoid arthritis, clinical studies, Sanbi decoction, methotrexate