With the progress of rheumatoid arthritis, healthy qi gradually declines, and healthy qi and evil qi are in the love stage of deficiency and evil, and the mixture of deficiency and excess. At this time, the liver, spleen and kidney are damaged and the bones and muscles are dystrophy. Yang deficiency of spleen and kidney is the most common, followed by deficiency of liver, blood and kidney essence, and phlegm and blood stasis, which are deeply hidden in meridian joints. Deficiency of zang-fu organs and stagnation of phlegm and blood stasis are the key to the middle-term onset of rheumatoid arthritis, and the stagnation of phlegm and blood stasis is mainly confined to joints and meridians. Therefore, the treatment should focus on warming spleen and kidney, nourishing liver and softening tendons, and focusing on promoting blood circulation and removing blood stasis, resolving phlegm and dredging collaterals. Rheumatoid arthritis is mostly located in the joints of limbs, and drugs such as rattan, twig and giant knotweed can be added as menstruation-dredging drugs, so that the drugs can reach the affected area directly and improve the curative effect. Such as Ramulus Mori, Ramulus Cinnamomi, Sinomenine, Caulis Piperis, Caulis Trachelospermi, Caulis Spatholobi, and Caulis Spatholobi. Moreover, most of these drugs have the function of relaxing meridians and activating collaterals. Combined with the cold and heat properties of drugs, the curative effect can often be significantly improved if they are selected according to syndromes. Rheumatoid arthritis has a long course of disease and requires long-term medication, but most of the drugs used to treat joint pain are pungent heat, which may hurt the stomach. Spleen and stomach are the acquired foundation and the source of qi and blood biochemistry. If the spleen and stomach are damaged, not only can we not continue to take medicine to treat rheumatoid arthritis, but also the five internal organs will be malnourished due to the deficiency of qi and blood biochemistry, which will aggravate the deficiency of liver and kidney, and even make the rheumatoid arthritis change from the middle stage to the late stage, making it difficult to survive. Therefore, we should always pay attention to protecting stomach qi during treatment. When prescribing medicine, you should add products that strengthen the spleen and stomach. If there are symptoms such as epigastric discomfort, pain, anorexia, murmur, etc., you should immediately adjust the prescription, or temporarily stop using drugs harmful to the spleen and stomach, especially insect drugs, and take products that strengthen the spleen and stomach instead, and then continue to take rheumatoid arthritis prescription after the spleen and stomach are coordinated. Take medicine after meals, and pay attention to diet and daily care. 1. Deficiency of liver and kidney, deficiency of qi and blood: This kind of patients have deficiency of liver and kidney, mainly kidney qi. Qi deficiency can not produce blood, but blood stasis, qi deficiency can not promote blood circulation, deficiency of both qi and blood, qi stagnation, impassable veins, and pathogenic factors leaving joints and meridians become stubborn. Symptomatic joint pain of limbs, especially pain, swelling and unfavorable flexion and extension of metacarpophalangeal joints (toes). Emaciation, weakness of limbs, dizziness, palpitation, soreness of waist and knees, pale complexion, polyuria, pale tongue and thready pulse. Syndrome analysis After the invasion of exogenous factors such as wind-cold, damp-heat and so on, due to the lack of positive energy, exogenous factors gradually deepen, lingering in muscles, bones and joints, resulting in stagnation of qi and blood, so the joints are painful and swollen, which is unfavorable for flexion and extension; Due to qi deficiency, in addition to joint swelling and pain, patients gradually develop symptoms such as weakness of limbs, pallor, dizziness, palpitation, emaciation, soreness of waist and knees, and qi deficiency. The treatment method is beneficial to kidney and liver, as well as qi and blood. Prescription drugs are Radix Astragali, Rhizoma Cibotii, Radix Paeoniae Alba, Rhizoma Corydalis, Coicis Semen, Polyporus, Poria, Spatholobus Spatholobus, Rhizoma Curcumae, Radix Angelicae Sinensis, Fructus Psoraleae and Rhizoma Drynariae15g, and Radix Rehmanniae12g. The dosage of Astragalus membranaceus in the prescription is large, which can be 30 ~ 90g. Qi-zu can produce blood, promote blood circulation and relieve arthralgia. Its invigorating qi can not only replenish the spleen and stomach, but also strengthen the exterior. Moreover, Astragalus membranaceus has the function of eliminating pathogenic factors and strengthening the body resistance, which is more effective than ginseng and other drugs, and has no disadvantages of convergence of pathogenic factors. If the joint pain is obvious, 60 grams of Rhizoma Corydalis, 30 grams of sinomenine and Zaocys 15 grams can be used. 30g of Hedyotis diffusa and 30g of honeysuckle. While taking Chinese medicine orally, you can smoke and wash it with Chinese medicine. The prescription is fumigated with rheumatoid arthritis, and 60 grams of raw astragalus root and 60 grams of white peony root are added. You can also warm moxibustion Ganshu, Shenshu and Zusanli. The medical record is Yang XX, female, 23 years old, a farmer. 1993 65438+First visit on February 20th. Pain in small joints of limbs 1 year, 1 month aggravates. Self-report 1 years ago, due to the dull pain in the knee joint after catching cold, it was gradually difficult to squat down, and the small joints were swollen and painful, especially the proximal finger joints, which was unfavorable for flexion and extension. The local hospital diagnosed rheumatoid arthritis. After being treated with anti-rheumatic drugs such as aspirin and ibuprofen, the disease has not been removed, and the neck and hip joints are gradually involved, with soreness of the waist and knees, unbearable pain, poor neck and shoulder movement, palpitation, dizziness, emaciation, pale complexion, polyuria, light and fat tongue, thin and white fur, teeth marks on the edge and heavy pulse. When the erythrocyte sedimentation rate was 74 mm/4, rheumatoid factor 1: 80 was positive. X-ray film showed osteoporosis, cystic destruction of articular surface and narrow joint space. Diagnosed as rheumatoid arthritis (deficiency of liver and kidney, deficiency of both qi and blood). Treatment should benefit kidney and liver, qi and blood, and dredge channels and collaterals. Prescription: Radix Astragali, Rhizoma Cibotii, Radix Paeoniae Alba, Rhizoma Corydalis, Caulis Sinomenii, Caulis Spatholobi, Coicis Semen, Polyporus and Poria each 30g, Radix Angelicae Sinensis, Fructus Psoraleae, Rhizoma Drynariae, Radix Polygoni Multiflori Preparata, Rhizoma Curcumae, Fructus Chaenomelis and Radix Rehmanniae each 65438 02g, decocted in water, with 65438 0 doses per day. At the same time, the traditional Chinese medicine "Sisheng Decoction" is added and subtracted: Radix Aconiti Kusnezoffii, Radix Aconiti, Rhizoma Pinelliae, Rhizoma Arisaematis, Olibanum, Myrrha, Caulis et Folium Gaultheriae Yunnanensis and Radix Angelicae Dahuricae each 65,438 0.5g, Caulis Lonicerae and Caulis Sinomenii each 30g, Radix Clematidis, Radix Astragali and Radix Paeoniae Alba each 60g, and Borneolum Syntheticum 9g (below) are decocted and smoked. The dosage of Astragalus membranaceus in the prescription is large, which can be 30 ~ 90g. Qi-zu can produce blood, promote blood circulation and relieve arthralgia. Its invigorating qi can not only replenish the spleen and stomach, but also strengthen the exterior. Moreover, Astragalus membranaceus has the function of eliminating pathogenic factors and strengthening the body resistance, which is more effective than ginseng and other drugs, and has no disadvantages of convergence of pathogenic factors. If the joint pain is obvious, 60 grams of Rhizoma Corydalis, 30 grams of sinomenine and Zaocys 15 grams can be used. 30g of Hedyotis diffusa and 30g of honeysuckle. While taking Chinese medicine orally, you can smoke and wash it with Chinese medicine. The prescription is fumigated with rheumatoid arthritis, and 60 grams of raw astragalus root and 60 grams of white peony root are added. You can also warm moxibustion Ganshu, Shenshu and Zusanli. The medical record is Yang XX, female, 23 years old, a farmer. 1993 65438+First visit on February 20th. Pain in small joints of limbs 1 year, 1 month aggravates. Self-report 1 years ago, due to the dull pain in the knee joint after catching cold, it was gradually difficult to squat down, and the small joints were swollen and painful, especially the proximal finger joints, which was unfavorable for flexion and extension. The local hospital diagnosed rheumatoid arthritis. After being treated with anti-rheumatic drugs such as aspirin and ibuprofen, the disease has not been removed, and the neck and hip joints are gradually involved, with soreness of the waist and knees, unbearable pain, poor neck and shoulder movement, palpitation, dizziness, emaciation, pale complexion, polyuria, light and fat tongue, thin and white fur, teeth marks on the edge and heavy pulse. When ESR was 74 mm/4, rheumatoid factor 1: 80 was positive. X-ray film showed osteoporosis, cystic destruction of articular surface and narrow joint space. Diagnosed as rheumatoid arthritis (deficiency of liver and kidney, deficiency of both qi and blood). Treatment should benefit kidney and liver, qi and blood, and dredge channels and collaterals. Prescription: Radix Astragali, Rhizoma Cibotii, Radix Paeoniae Alba, Rhizoma Corydalis, Caulis Sinomenii, Caulis Spatholobi, Coicis Semen, Polyporus and Poria each 30g, Radix Angelicae Sinensis, Fructus Psoraleae, Rhizoma Drynariae, Radix Polygoni Multiflori Preparata, Rhizoma Curcumae, Fructus Chaenomelis and Radix Rehmanniae each 65438 02g, decocted in water, with 65438 0 doses per day. At the same time, the traditional Chinese medicine "Sisheng Decoction" is added and subtracted: Radix Aconiti Kusnezoffii, Radix Aconiti, Rhizoma Pinelliae, Rhizoma Arisaematis, Olibanum, Myrrha, Caulis et Folium Gaultheriae Yunnanensis and Radix Angelicae Dahuricae each 65,438 0.5g, Caulis Lonicerae and Caulis Sinomenii each 30g, Radix Clematidis, Radix Astragali and Radix Paeoniae Alba each 60g, and Borneolum Syntheticum 9g (below) are decocted and smoked. In patients with rheumatoid arthritis, pathogenic blood stasis is blocked in joints, bones and muscles, and goes deep into meridians and epiphysis, which is beyond the treatment of general blood-activating drugs. Therefore, using Rhizoma Sparganii and Rhizoma Curcumae to break blood and remove blood stasis requires a large amount of Rhizoma Curcumae. In order to prevent blood stasis caused by Rhizoma Sparganii and Rhizoma Curcumae, it is used together with Radix Astragali to prevent the disadvantages of blood stasis. In this way, not only the qi and blood are not damaged, but also the blood stasis can be quickly eliminated. There is no case of bleeding after taking zedoary for several months to several years in clinic, and the dosage of zedoary in menstrual period of most female rheumatoid arthritis patients is not reduced, and the effect of promoting blood circulation, removing blood stasis and relieving pain is better than that of ordinary drugs for promoting blood circulation. If the joint pain is obvious, the dosage of Rhizoma Corydalis can be increased to 60g, and sinomenine S0g can be added. If the joint is swollen, chills and pains, and there are cold symptoms, Radix Aconiti Preparata 12g, Radix Aconiti Kusnezoffii Preparata 12g and cornu Cervi Pantotrichum powder 9g can be added. At the same time, take scorpion and scorpion capsule orally or grind scorpion and centipede 0.3g each, twice a day. For external use, dried ginger 15g, cinnamon 9g and raw mustard seed 30g can be added into Sisheng decoction, the basic prescription for fumigation and washing of rheumatoid arthritis. For example, Fu XX, female, 42 years old, married. /kloc-0. First visit on March 9th, 995. The patient's limb joint swelling and pain 10 years, aggravated in recent two years. 10 years ago, there was no obvious inducement, knee pain, no redness and burning sensation, and then it gradually spread to the joints of both ankles, wrists and toes, with local swelling and tingling, local pain and unfavorable movement. Stiff in the morning for about 1.5 hours, the skin color around the joints, especially around the finger joints, is getting darker and darker. Subcutaneous nodules can be touched at the elbow olecranon, and can be worn at the waist. The leather nail is wrong, the mouth and lips are purple and dark, the sleep is acceptable, the stomach and intestines are normal, the stool is dry, and the tongue is purple and dark the next day, with a little ecchymosis on the edge, white and greasy fur and fine and smooth pulse. X-ray photos show that both wrists and ankles have rheumatoid joint-like changes. The erythrocyte sedimentation rate 106 mm/h and rheumatoid factor 1:640 were positive. It was diagnosed as rheumatoid arthritis (phlegm and blood stasis, viscera loss). It is intended to promote blood circulation and remove blood stasis, eliminate phlegm and dredge collaterals, supplemented by nourishing liver and kidney, benefiting qi and strengthening spleen. Prescription: Radix Astragali, Semen Persicae (mashed), Rhizoma Curcumae, Caulis Spatholobi, Rhizoma Corydalis, Herba Asari, Rhizoma Cibotii, Coicis Semen, Polyporus and Poria each 30g, Squama Manis (parched first) and Radix Rehmanniae each 20g, Rhizoma Arisaematis Preparata and Rhizoma Chuanxiong each15g, and Nidus Vespae 9g, and decocted with water. After taking the medicine for 2 weeks, the joint swelling and pain gradually eased, the activity increased, sometimes the skin was numb, and there were still dizziness and palpitations. The above prescription has achieved initial curative effect, adding Notoginseng Radix 15g and Caulis Piperis 20g, and adding and subtracting according to the syndrome. After taking more than 60 doses, the swelling and pain of limbs and joints basically disappeared, and the grip strength of both hands was enhanced and the spirit was good. Only in the morning, my joints still feel sour, my stomach is satisfied, and my stool is adjusted. The erythrocyte sedimentation rate 1.7mm/h and rheumatoid factor 1: 80 were positive. 3. Yang deficiency of spleen and kidney, stagnation of yin and cold: liver, spleen and kidney of rheumatoid arthritis are damaged, and vital qi is insufficient. Due to the different constitution and pathogenic factors of patients, there may be different manifestations of yin flourishing and yang declining. If the body is yang-deficient, the spleen and kidney are deficient, the cold pathogen is felt, and the yin and cold stagnate, it becomes the syndrome of yang-deficiency and cold excess. Symptomatic joint swelling and cold pain, even if ice is applied, the pain will be relieved when it is cold. Visible joint deformation, curl, pale face, fatigue, eating less cold, weak waist and knees, long urine, pale tongue with white fur and heavy pulse. Syndrome analysis shows that human body is yang-deficient, and exogenous pathogenic factors are excessive cold, internal and external pathogenic factors, meridian obstruction and stagnation of qi and blood. Cold is yin evil, and its sex is stagnant, so the joints are swollen and cold; Heat makes qi and blood smooth, so its pain is relieved; When it is cold, the blood will coagulate and converge, so the pain will increase; Cold phlegm congeals and blood stasis is not good, then the joints are deformed; Kidney yang loses its warmth, so the waist and knees are sore and weak, with cold limbs; Insufficient kidney-yang, insufficient gasification, and water that does not turn into qi will make urine last for a long time; Deficiency of spleen-yang can not transport Shui Gu and enhance physical strength, so people are tired and eat less. Pale tongue, thin coating and heavy pulse are all manifestations of yang deficiency of spleen and kidney and stagnation of yin and cold. Treatment: Warming spleen and kidney, dispelling cold, promoting blood circulation and dredging collaterals. Yanghe decoction is modified. Radix Aconiti Preparata, Cortex Cinnamomi, Radix Rehmanniae Preparata each 65438±02g, Cornu Cervi powder (prepared), Fructus Psoraleae, Rhizoma Drynariae and Semen Sinapis Albae each 65438±05g, Radix Astragali, Radix Astragali Preparata, Rhizoma Cibotii, Rhizoma Corydalis, Semen Coicis preparata and Caulis Spatholobi each 30g, and Herba Ephedrae (below) 9g. In the prescription, Radix Aconiti, Cortex Cinnamomi and Caulis Spatholobi warm yang to dispel cold, promote blood circulation and remove blood stasis; Psoralea corylifolia, Rhizoma Drynariae, cornu Cervi powder, and Rhizoma Cibotii warm and tonify kidney-yang, strengthen tendons and bones; Rehmannia glutinosa nourishes yin and blood, and neutralizes the warmth and dryness of drugs such as Radix Aconiti, Cortex Cinnamomi and Rhizoma Zingiberis Preparata. White mustard seed phlegm except skin membrane; Keywords ephedra ascending yang, developed mechanism, exogenous pathogenic factors; Rhizoma corydalis regulates qi, promotes blood circulation and relieves pain; Astragalus membranaceus, Atractylodes macrocephala and Coix lachryma-jobi are beneficial to qi and spleen. If the joint pain is obvious, 60 grams of Rhizoma Corydalis, 30 grams of sinomenine and Zaocys 15 grams can be used; If there is obvious cold pain in upper limb joints, cassia twig12g should be added; If you see blood stasis symptoms such as tingling, limited pain and dark tongue, add 30 grams of Rhizoma Curcumae and pangolin 10 grams; If the joints are stiff, especially in the morning, phlegm-dampness is blocked between the joints and the meridians. Add 30 grams of Polyporus umbellatus and 30 grams of Poria to invigorate the spleen, eliminate phlegm and eliminate dampness. External treatment. -Fumigating and washing the basic prescription "Sisheng Decoction" for the treatment of rheumatoid arthritis, adding 60 grams of raw astragalus decoction and 60 grams of broom root. The medical record is Wang XX, female, 33 years old. The patient's finger and foot joints have been stiff, numb and painful for several years, which has worsened in the last two years. Bilateral phalangeal joint swelling, accompanied by cold pain, aggravated cold pain, relieved hot pain. The morning is stiff for more than 2 hours, and the wind and cold are aggravated on rainy days. The stool is false, the urine is long and dull. Pale complexion, mental fatigue, soreness of waist and knees, pale white and greasy tongue and heavy pulse. X-ray of both hands showed osteoporosis and narrow joint space. Rheumatoid factor 1: 160 was positive. It was diagnosed as rheumatoid arthritis (deficiency of spleen and kidney yang, stagnation of yin and cold). Treatment should be warming kidney and spleen, dispelling cold and removing dampness, promoting blood circulation and dredging collaterals. Prescription: Radix Astragali, Rhizoma Cibotii, Rhizoma Corydalis, Caulis Spatholobi, Coicis Semen, Radix Aconiti Preparata, Radix Aconiti Kusnezoffii Preparata and Radix Rehmanniae Preparata each 65,438 02g, Fructus Psoraleae and Rhizoma Drynariae each 65,438 05g, Herba Ephedrae 9 g (below), 2 centipedes, Squama Manis and Fructus Gleditsiae Abnormalis each 65,438 00g, Fructus Gleditsiae Abnormalis. At the same time, Zhengqingfengtongning injection was used for acupoint injection, with each dose of 100 mg and each dose of 1.0 ml. After 20 days of treatment, the stiffness of hands and feet and cold pain were improved, and the morning stiffness was less than 1.5 hours. After another two months of treatment, the condition improved obviously, and the morning stiffness was less than half an hour, and the pain was obviously relieved. Rheumatoid factor 1: 40 was positive. After taking the above drugs for 5 months, the above drugs are added and subtracted to make pills to consolidate the curative effect. Follow-up 1 year showed no recurrence. 4. yin deficiency and heat stagnation, phlegm and blood stasis: deficiency of liver and kidney, long-term love of evil heat, or the transformation of evil heat into heat can cause yin deficiency and heat stagnation. Heat evil, such as blood along the meridian, interweaves with heat evil, which makes blood viscous, leading to blood stasis, blood stasis staying in joints and meridians, resulting in phlegm and blood stasis. In addition, long-term use of spicy, hot and dry products and hormone therapy can cause the syndrome of yin deficiency and internal heat in the middle stage of rheumatoid arthritis. Symptomatic joint pain is localized, accompanied by swelling, aggravation at night, feeling fever and touching subcutaneous nodules. In severe cases, joint deformity, numbness of limbs sometimes, muscle aches, dry mouth and eyes, redness and swelling of cheekbones, night sweats, backache and tinnitus, red tongue with little body fluid, and rapid pulse may occur. Syndrome analysis shows that the body is yin deficiency, and the heat pathogen can not be cured for a long time, or the pathogen changes from heat, and the excess heat hurts the yin and the yin hurts the blood stagnation, so the joint pain is aggravated at night; Deficiency of liver, spleen and kidney, abnormal fluid transport, and blood-heat boiling body fluid into phlegm, phlegm and blood stasis, so subcutaneous nodules, limited joint pain, and even joint deformity; Yin blood can't nourish the tendons, so the limbs are numb and the muscles are clumsy; Kidney deficiency malnutrition, lack of marrow sea, so backache tinnitus; Deficiency fire leads to dry mouth, hot annoyance and red cheekbones; A lot of heat forces body fluids to flow out, leading to night sweats. Red tongue, less body fluid, heavy and thin pulse, and more strings are manifestations of liver and kidney yin deficiency and hyperactivity of liver fire. The treatment method is nourishing yin and clearing heat, supplemented by promoting blood circulation and resolving phlegm, dredging collaterals and relieving pain. Zuoguiyin is a modified prescription. Radix Rehmanniae, Coicis Semen, Polyporus, Poria, Radix Paeoniae Rubra, Caulis Spatholobi and Rhizoma Corydalis each 30g, Fructus Ligustri Lucidi and Ecliptae each 20g, Squama Manis, Radix Rehmanniae Preparata and Fructus Lycii each/kloc-0.5g, Fructus Corni/kloc-0.2g ... Radix Rehmanniae Preparata, Fructus Corni, Fructus Lycii, Fructus Ligustri Lucidi and Ecliptae each nourish liver and kidney; Spatholobus suberectus, Rhizoma Corydalis and Squama Manis promote blood circulation and resolve phlegm; Coicis Semen, Polyporus, Poria, invigorating spleen, resolving phlegm and eliminating dampness; Radix Rehmanniae and Radix Paeoniae Rubra nourish yin and clear heat, remove blood stasis and relieve pain. The dosage of Radix Rehmanniae in the prescription is large, up to 60 grams. Some patients with rheumatoid arthritis due to yin deficiency and heat stagnation are caused by improper long-term use of hormones. Rehmannia glutinosa can not only nourish yin and clear heat, but also contribute to the gradual withdrawal of hormones. If you have symptoms of qi deficiency such as fatigue, fat tongue and tooth marks, add 30 grams of raw Astragalus; If the joint pain is obvious, 60 grams of Rhizoma Corydalis, 30 grams of sinomenine and Zaocys 15 grams can be used; If the joint stings and there is a fixed place, or the tongue sees ecchymosis, add 30 grams of zedoary. In addition, the basic prescription of rheumatoid arthritis "Sisheng Decoction" can be smoked and washed with Radix Aconiti, 60 grams of Radix Rehmanniae and 30 grams of Radix Polygoni Multiflori. Example of medical record XX, male, 65 years old. First visit on February 26th, 1993. Stiffness and pain in the heel joints of fingers, palms and toes, especially in the early morning, lasts for about 4 ~ 6 hours, accompanied by swelling and deformation for more than 2 years. He was diagnosed with rheumatoid arthritis in another hospital. After taking tripterygium wilfordii/kloc-0 for many years, the drug was stopped due to abnormal liver function. At present, the joints of fingers and toes are painful, accompanied by swelling, aggravated at night, and touching the membrane with fever. Subcutaneous nodules can be touched at the achilles tendon of both feet, and the wrists and ankles are swollen and stiff, which is unfavorable for flexion and extension. Elbow and knee flexion and extension difficulties, low fever fluctuation, especially in the afternoon, backache and tinnitus, poor appetite, loose stool and daily walking. Laboratory examination: ESR 1.20 mm/h, rheumatoid factor 1: 1.60 positive. X-ray film shows that the fingers, toes and calcaneus of both hands are osteoporosis, the wrist joints of both hands are cystic, and the joint gap narrows and disappears. He was diagnosed as rheumatoid arthritis (deficiency of true yin, inflammation due to deficiency of fire, phlegm and blood stasis blocking collaterals). It aims at nourishing yin and clearing heat, promoting blood circulation and removing blood stasis, invigorating spleen and resolving phlegm, dredging collaterals and relieving pain. Prescription: Radix Rehmanniae Preparata, Coicis Semen, Polyporus, Caulis Trachelospermi, Radix Astragali, Caulis Spatholobi and Rhizoma Corydalis each 30g, Rhizoma Polygonati, Rhizoma Curcumae, and Squama Manis preparata each 65438 05g, Fructus Ligustri Lucidi and Ecliptae each 20g, fried atractylodes 65438 02g, Nidus Vespae and Glycyrrhrizae Radix each 9g, and decocted with water. External use of rheumatoid arthritis fumigation and washing basic prescription "Sisheng Decoction" to remove raw Radix Aconiti, add 30g of spina Gleditsiae and 60g of raw Radix Polygoni Multiflori, and decoct in water to fumigate and wash fingers, toes and calcaneus of both hands. After half a year of treatment with the above methods, the pain of fingers, toes, palms, wrists and ankles of patients was basically eliminated, and the swelling was obviously reduced. Elbow, knee, shoulder and hip joint can stretch freely, and joint stiffness is obviously improved in the morning. The erythrocyte sedimentation rate was 26 mm/h, and rheumatoid factor 1: 40 was positive. The condition is obviously relieved. 5. Cold and heat mixed knot, phlegm and blood stasis blocking collaterals: Yin and Yang deficiency, or recurrent rheumatoid arthritis, wind pathogen, cold and dampness stagnation for a long time, plus the dispute between positive and negative pathogens in the middle stage of rheumatoid arthritis, the love between positive and negative pathogens, the mixture of excess and deficiency, blood stasis and phlegm blocking joints and meridians, forming a syndrome of phlegm and blood stasis blocking collaterals, cold and heat mixed. Symptomatic joint pain and swelling, local contact with fever, but consciously afraid of cold, or contact with heat but consciously fever, low fever or heat image is not obvious, or cold and heat exchange, subcutaneous nodules, severe joint deformity, rigidity, not suitable for flexion and extension, pale or red tongue, yellow or white fur, slow pulse. Syndrome analysis, cold and heat coexist, with symptoms of yin, cold and heat depression. Cold and heat symptoms are often divided into local joints and the whole body, so joint pain, local joint fever, but consciously afraid of cold or not fever, but consciously fever; Phlegm and blood stasis are intertwined in joints, so subcutaneous nodules, unsmooth pulse and joint pain are seen; Evil spirits exist for a long time, and when they penetrate into the epiphysis, the joints will be deformed and stiff. Light or red tongue, yellow or white fur and slow pulse are all signs of cold and heat. The treatment method is mainly to clear heat and dispel cold, supplemented by removing blood stasis, resolving phlegm and dredging collaterals. Prescription Guizhi Shaoyao Mu Zhi Decoction. Ramulus Cinnamomi and Rhizoma Anemarrhenae are 65,438 02g each, Radix Paeoniae Alba, Caulis Lonicerae, Polyporus, Poria, Coicis Semen, Rhizoma Corydalis, Caulis Spatholobi, Rhizoma Cibotii and Plantagenet are 30g each, and Squama Manis, Fructus Psoraleae, Rhizoma Drynariae and Semen Sinapis Albae are each 15g. The evil of honeysuckle. And Anemarrhena asphodeloides. Guizhi, Psoralea corylifolia and Rhizoma Drynariae tonify the evil of warming kidney and dispelling yin and cold; Spatholobus Spatholobus, Rhizoma Corydalis, Squama Manis, Semen Sinapis Albae, and Caragana; Coicis Semen, Polyporus, Poria, invigorating spleen, resolving phlegm and promoting diuresis; Radix Paeoniae Alba and Rhizoma Cibotii tonify kidney and strengthen tendons. Adding Radix Aconiti Preparata and cornu Cervi powder with cold weight; If you have symptoms of qi deficiency such as fatigue, fat tongue and tooth marks, add 30 grams of raw Astragalus; If the joint pain is obvious, 60 grams of Rhizoma Corydalis, 30 grams of sinomenine and Zaocys 15 grams can be used. In addition, 30g of honeysuckle and 30g of Rhizoma Smilacis Glabrae can be added into Sisheng Decoction, the basic prescription for fumigation and washing of rheumatoid arthritis, and decocted in water for fumigation and washing, so as to enhance the power of clearing heat and relieving pain.