Research Progress of Rheumatoid Arthritis Treatment with Huangqi Guizhi Wuwutang / 中国实验方剂学杂志

ABSTRACT

Rheumatoid arthritis （RA） is a common immune-mediated inflammatory autoimmunity disease. Due to its clinical characteristics， RA is classified into the category of "Bi syndrome" in traditional Chinese medicine. Huangqi Guizhi Wuwutang （HGW）， originated from Synopsis of Golden Chamber Jinkui Yaolue， is composed of Astragali Radix， Cinnamomi Ramulus， Paeonial actiflora， Zingiberis Rhizoma Recens， and Jujubae Fructus. It has been used for treatment of blood "Bi syndrome" in clinical practice， and nowadays， it is also widely used for treatment of RA or RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome. In 2018， HGW was collected in the Catalogue of Ancient Classical Prescriptions （the First Batch）. In order to provide insight for standardized clinical medication and lay a solid foundation for its further development， we herein reviewed literatures of clinical and animal studies on HGW treatment in RA. According to the basic pathogenesis of RA， HGW can be used for treatment of general RA， RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome alone or in combination with other drugs. The mechanisms of HGW were related to inhibition of inflammatory cytokines expression， inhibition of lipid peroxidation of synovium， and promotion of apoptosis. However， many issues in the current research still needed to be addressed， such as lack of standardization of drug compatibility and dosage， lack of standardization of clinical trial scheme，undefined drug interaction and unclear safety on the combination of Chinese medicine with chemistry drugs， lack of proper syndrome animal model， and limited study about molecular mechanisms. We propose that future research should focus on the standardization of the clinical trial scheme and RA syndrome of HGW， clarify the principle of drug compatibility and dosage， drug interaction and safety. In terms of mechanistic study， the research should focus on animal models of RA syndrome using multiple dimensions such as genetics， transcription， and metabolism.