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类风湿关节炎中西医结合诊疗专家共识(2025版)

Expert consensus on the diagnosis and treatment of rheumatoid arthritis with integrated traditional Chinese and Western medicine (2025)

摘要类风湿关节炎(RA)作为一种致残率高的慢性自身免疫病,中医药治疗RA历史悠久且独具优势。我国超80%的RA患者接受过中医药治疗,其与常规西药联合使用在提高临床疗效的同时尚能减少部分不良事件的发生,逐渐形成了中西医特色诊疗体系。尽管目前中西医联合治疗RA较为普遍,但其临床适用指征、中西医药物如何联用等均未得到规范,缺乏指导中西医药物联合治疗RA的临床指南或共识。为提升我国RA中西医结合诊治水平,本共识针对RA诊治中的10个关键临床问题,包括RA中西医诊断标准、治疗目标与原则、疗效评估、中成药选择的原则、初治及持续缓解患者的中西医结合治疗、中医特色治疗、功能康复以及难治性RA的诊断与治疗等,基于最新循证医学证据与专家意见,并结合我国临床实际,制定了RA中西医结合诊疗专家共识。本共识旨在筛选与评价中西医结合治疗RA的研究成果和人用经验,通过严谨的循证医学方法,构建一套临床适用性强的诊疗共识,为临床医生提供诊疗参考,进而推动RA诊疗的进步,为RA中西医结合治疗提供新方案。

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abstractsRheumatoid arthritis (RA), as a chronic autoimmune disease with a high disability rate, has a long history and unique advantages in the treatment of RA with Traditional Chinese Medicine (TCM). More than 80% of RA patients in China have received TCM treatment. When combined with conventional Western medicine, it can not only improve the clinical efficacy but also reduce the occurrence of some adverse events, and gradually form a characteristic diagnosis and treatment system of integrated traditional Chinese and Western medicine. Although the combination of traditional Chinese and Western medicine in the treatment of RA is relatively common at present, the clinical indications and the combination of traditional Chinese and Western medicine have not been standardized, and there is a lack of clinical guidelines or consensus to guide the combination of traditional Chinese and Western medicine in the treatment of RA. In order to improve the diagnosis and treatment level of integrated traditional Chinese and Western medicine for RA in China, aiming at 10 key clinical problems in the diagnosis and treatment of RA, including the diagnosis of RA, the treatment goals and principles, the time of efficacy evaluation, the selection of Chinese patent medicines, the integrated traditional Chinese and Western medicine treatment of newly treated patients and patients with persistent remission, the characteristic treatment traditional medicine, functional rehabilitation and the diagnosis and treatment of refractory RA, etc., based on the latest evidence-based medical evidence and expert opinions, and combined with the clinical practice in China, the expert consensus on the diagnosis and treatment of RA in integrated traditional Chinese and Western medicine was formulated. This consensus aims to screen and evaluate the research results and human experience of the treatment of RA in integrated traditional Chinese and Western medicine, and through rigorous evidence-based medical methods, construct a set of diagnosis and treatment consensus with strong clinical applicability, provide diagnosis and treatment references for clinicians, and then promote the level of RA diagnosis and treatment and provide new schemes for the treatment of RA in integrated traditional Chinese and Western medicine.

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