Rheumatoid Arthritis (RA) Treatments in Traditional Chinese medicine perspective

Rheumatoid Arthritis
Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than in men and generally occurs after the ages of 40 and diminishes the quality of life of many elders.
Treatments
In traditional Chinese medicine perspective
According to the article of TCM Differentiation & Treatment for Rheumatic Arthritis & Rheumatoid Arthritis by Sam Shien-Chien Liang, C.A. PH.D. In TCM RA is chracterized asa type of “bi” syndrome ( Bi-syndrome is a disease characterized by pain, numbness, and dyskinesia of the muscle and joints of the limbs), wind “bi”, heat “bi”, cold “bi”, damp “bi”.
E.3.1. Heat “Bi”
1. Symptoms include pain, redness, inflammation, and localized heat sensation in the joints, fever, aversion to wind, thirst, and irritability.
2. Treatment: strengthen spleen, drain dampness, clear heat, detoxify, open channels.
3. Formulas:
a. For redness, swelling, and pain, 
fomula includes Cinnamon & Anemarrhena Combination
a.1.(Gui Zhi Shao Yao Zhi Mu Tang) + Stephania & Astragalus Combinationa,2,(Fang Ji Huang Qi Tang) + Cinnamon & Angelica Formula
a.3.(Shang Zhong Xia Tong Yong Tong Feng Tang)
b. For redness, swelling, pain, and dampness
Cinnamon & Anemarrhena Combination (Gui Zhi Shao Yao Zhi Mu Tang) + Ma Huang & Coix
Combination (Ma Xing Yi Gan Tang)
c. For redness ,swelling, pain, aversion to wind, thirst, and irritability
Cinnamon & Anemarrhena Combination (Gui Zhi Shao Yao Zhi Mu Tang) + Ma Huang & Gypsum Combination (Yue Bi Tang) + Stephania & Astragalus Combination
d. For heat, pain, and subdermal red spots
Cinnamon & Anemarrhena Combination (Gui Zhi Shao Yao Zhi Mu Tang) Stephania & Astragalus Combination (Fang Ji Huang Qi Tang) + Tang Kuei & Anemarrhena Combination (Dang Gui Nian Tong Tang)
E.3.2. Wind “Bi”
a. Symptoms include soreness and pain in the joints throughout the body, often bigger joints such as the elbow, knee, and ankle joints, thin white coat, floating rapid or floating slow pulse.
b. Treatment: expel wind, disperse evil, dry dampness, activate blood.
c. Formulas
Cinnamon & Angelica Formula (Shang Zhong Xia Tong Yong Tong Feng Tang) + Stephania & Carthamus Combination (ShuFeng Huo Xue Tang) + Stephania & Astragalus Combination (Fang Ji Huang Qi Tang)
E.3.3. Cold (painful) “Bi”
a. Symptoms include excruciating pain in the joints, immobility, foot swelling, localized pain, no redness and local heat sensation, pain is aggravated by cold and alleviated by warmth, white tongue coat, wiry and tight pulse.
b. Treatment: warm yang, disperse cold, activate blood, dispel wind, dry damp, stop pain, and open channels.
c. Formulas
Wu Tou & Cinnamon Combination (Wu Tou Gui Zhi Tang) + Dang Gui & Astragalus Combination
(Dang Gui Bu Xue Tang) + Clematis & Stephania Combination (Shu Jing Huo Xue Tang)
E.3.4. Damp (stagnant) “Bi”
a. Symptoms include numbness, heavy sensation, and pain in the joints, localized pain and swelling, slow
exacerbation, flabby tongue with teethmarks, white greasy tongue coat, soggy or slow pulse.
b. Treatment: tonify mspleen, dry dampness, warm yang, dispel wind, disperse cold, open channel.
c. Formulas
c.1. Ma Huang & Asarum Combination (Ma Huang Fu Zi Xi Xin Tang) + Cinnamon, Hoelen & Atractylodes Combination (Gui Zhi Jia Ling Fu Zhu Tang)
c.2. Coix Combination (Yi Yi Ren Tang) or Chiang-huo & Tu-huo Combination (Qiang Huo Sheng Shi Tang)
E.3.5. Qi & Blood Stagnation “Bi”
a. Symptoms include swollen, painful joints, dull skin, color, dry lips, chest congestion, palpitation,
dark tongue, and choppy pulse.
b. Treatment: activate blood, relieve stagnation, mstop pain, open channels.
c. Formulas
Clematis & Stephania Combination (Shu Jing Huo Xue Tang) or Drive Out Blood Stasis from a Painful Body Decoction (Sheng Tong Zhu Yu Tang) + Stephania & Astragalus Combination (Fang
Ji Huang Qi Tang) + Dang Gui & Anemarrhena Combination (Dang Gui Nian Tong Tang)
E.3.6. Liver & Kidney Deficiency type Wind Cold Damp “Bi”
a. Symptoms include painful joints in the extremities, coldness and sore pain in the low back, numbness and immobility of the lower extremities, pain is aggravated by rainy weathers, thin white and slightly greasy tongue coat, soggy and slow, or deep and thin pulse.
b. Treatment: tonify and nourish liver and kidneys, benefit the blood and qi, dispel wind, disperse cold, dry dampness.
c. Formulas:
c.1. For lower extremities:
Du-huo & Loranthus Combination (Du Huo Ji Sheng Tang) or Three Painful Obstruction Decoction (San Bi Tang) + Cinnamon & Anemarrhena Combination (Gui Zhi Shao Yao Zhi Mu Tang) + Major Siler Combination (Da Fang Feng Tang)
E.3.7. Qi & Blood Deficiency type Wind Cold Damp “Bi”
a. Symptoms include sore pain in the low back and legs, numbness and trembling of the lower extremities, fatigue, shortness of breath, pale face and lips, dull pain in the joints, pale tongue, thin white tongue coat, deep and weak, or deep and thin pulse.
b. Treatment: benefit qi, nourish blood, warm and open channels.
c. Formulas
Astragalus & Cinnamon Twig Five Substance Decoction (Huang Qi Gui Zhi Wu Wu Tang) or Major Siler Combination (Da Fang Feng Tang) + Dang Gui & Anemarrhena Combination (Dang Gui Nian Tong Tang) + Coix Combination (Yi Yi Ren Tang)
E.3.8. Yin Cold Stagnation “Bi”
a. Symptoms include aversion to cold, swelling and dull pain throughout the body, swelling in the joints, no redness and local heat, numbness, clear and long stream urination, white tongue coat, slow and thin, or deep and thin pulse.
b. Treatment: warm and tonify yang, disperse cold, clear stagnation.
c. Formulas: Ma Huang & Asarum Combination (Ma Huang Fu Zi Xi Xin Tang) + Cinnamon, Hoelen & Atractylodes Combination (Gui Zhi Jia Ling Fu Zhu Tang) + Stephania & Astragalus Combination (Fang
Ji Huang Qi Tang) or Coix Combination (Yi Yi Ren Tang)
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