Rheumatoid arthritis (RA) is a systemic autoimmune disease

which is classified as "

bi

syndrome (arthralgia)"

"

lì jié

(multiple arthralgia)" and "

wāng bì

(lame impediment)" in traditional Chinese medicine. Its pathogenesis is mainly wind

cold and dampness arthralgia in the early stage

dampness and heat obstruction or cold and dampness obstruction in the active stage

and binding of phlegm and stasis and deficiency of healthy qi in the remission stage. Prof. Wang Qingguo

following the teaching of Zhang Zhongjing

put forward the academic view of "achieving harmony by unblocking and balancing"

and believed that the disharmony of yin and yang caused by the blocking of evil qi was the common pathogenesis of RA. Given the presence of wind

cold

dampness

heat

phlegm

stasis

and deficiency in all the three stages

the common treatment was established

namely

dispelling wind

dissipating cold

eliminating dampness

clearing heat

removing phlegm

dissolving stasis

and supplementing deficiency. Based on the clinical treatment strategy of dispelling excess evil first and reinforcing healthy qi later

and the relationship between the treatment method

the four-step sequential RA diagnosis and treatment plan of "unblocking

balancing

supplementing

and nourishing" was formulated. Unblocking should be regarded as the basic method and primary treatment principle for RA. In the early stage

the unblocking of wind

cold and dampness is the dominant method

in the middle stage

of dampness

heat

phlegm and stasis

and in the late stage

of phlegm and stasis obstruction. Then

the combination of cold and warm medicinals should be adopted as the main strategy to prevent the recurrence of blocking and obstruction. Since evil qi has been removed

the deficiency is fully revealed

the physician should pay attention to nourishing qi and blood

supplementing the liver and kidney

in order to achieve the purpose of eliminating the disease and consolidate the curative effect. If injuries to the tangible are present

phased conditioning and maintenance are required

in order to return the body to the disease-free balanced state. In this study

the four-step sequential RA diagnosis and treatment plan of "achieving harmony by unblocking and balancing" was explained with clinical records.