Objective To investigate the efficacy of Xuanbi Decoction as an adjuvant therapy for rheumatoid arthritis (RA) with dampness-heat obstruction syndrome, and its impacts on the interleukin-23 (IL-23)/helper T cell 17 (Th17) inflammatory axis, as well as the levels of matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinase-1 (TIMP-1).

Methods A total of 95 RA patients with dampness-heat obstruction syndrome were selected as the study subjects, and randomly divided into control group (48 cases) and observation group (47 cases). The control group received western medicine treatment, while the observation group received Xuanbi Decoction treatment based on the control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, imaging assessment results, disease activity, indicators of the IL-23/Th17 inflammatory axis, MMP-3, TIMP-1 and adverse reactions were compared between the two groups.

Results The total effective rate in the observation group was 95.74%, which was significantly higher than 81.25% in the control group (P < 0.05). After treatment, the TCM syndrome scores (joint pain, joint swelling, yellow and greasy tongue coating as well as slippery and rapid pulse) in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the DAS28 and Sharp scores in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-23, Th17, IL-17 and MMP-3 in the observation group were significantly lower than those in the control group, while the TIMP-1 level was significantly higher (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion Xuanbi Decoction as an adjuvant therapy for RA patients with dampness-heat obstruction syndrome demonstrates significant efficacy and high safety.