A randomized controlled trial and promotion study of Tibetan medicine specialty therapy for the treatment of rheumatoid arthritis based on Zelen's design

INTERVENTION: Western medicine routine group:A: Methotrexate 10‐15mg qw PO B: Leflunomide 10‐20 mg qd po C: Tripterygium wilfordii polyglycoside tablets 10‐20 mg tid po New patients: choose one of the A, B, and C options 1 immunosuppressant was maintained before enrollment, and A+B, A+C, or B+C regimens could be selected after enrollment Two immunosuppressants were maintained before enrollment, and A+B+C regimens were selected after enrollment. Remarks: Non‐menopausal women are not treated.;Tibetan Medicine Characteristic Therapy Group:In addition to the conventional group of Western medicine, the following drugs are added: 1.Hour medication (1) Morning: Sezhu Tangnai Powders 2g qd po×12w;(2) Noon: Puga Kua Pills 2g qd po×12w;(3) Evening: Zhencai Nia Pills 2g qd po×12w;(4) Interval: Liechi Atang Powders 5g qd po×5d. 2. Women with postmenopausal syndrome, Weise Nia pills 2g qd po,up to 5 days. 3. Qingpeng ointment is applied externally, bid×3 weeks.; CONDITION: Rheumatoid arthritis PRIMARY OUTCOME: ACR20; SECONDARY OUTCOME: VAS score of patient for overall condition;Tibetan Medicine Symptom Grading Scale Scores;Tender joint count (TJC);Swollen joint count (SJC);C‐reactive protein(CRP);Erythrocyte sedimentation rate(ESR);DAS28‐CRP score;Disability Inde Xof the Health Assessment Questionnaire(HAQ‐DI);Doctor's VAS score for overall condition;Rheumatoid factors(RF);Patient pain VAS score; INCLUSION CRITERIA: 1. Age between 18 and 75 years old (inclusive), male or female; 2. Those who meet the diagnostic criteria of rheumatoid arthritis of Western medicine at the time of screening; 3. Meet the Tibetan medicine "Changzhong" cold syndrome differentiation standards during screening; 4. Consistent with the diagnosis of rheumatoid arthritis (2.6= baseline DAS28 score =5.1) in the active stage of moderate and low disease at screening; 5. Voluntarily sign the informed consent form; 6. Use of traditional disease‐modifying antirheumatic drugs (DMARDs) and tripterygium wilfordii preparations before enrollment, and the types are limited to 2 types; 7. Have not received DMARDs treatment other than leflunomide, methotrexate, tripterygium, etc. within 1 month before enrollment; 8. The use of non‐steroidal anti‐inflammatory drugs or other analgesics for the treatment of RA before enrollment must have been on a stable dose for at least 1 week before enrollmen