Pharmacological Exploration of Traditional Chinese Medicine and Tujia Ethnomedicine in Rheumatoid Arthritis Therapy: From Historical Clinical Wisdom to Contemporary Scientific Inquiry

Rheumatoid arthritis (RA) remains a recalcitrant clinical challenge, as modern therapies are often hampered by adverse effects, suboptimal responses, and failure to achieve radical cure. Traditional Chinese Medicine (TCM) and Tujia ethnomedicine, with centuries of accumulated experience in managing RA (classified as “Bi Syndrome” in TCM), offer distinct theoretical frameworks and abundant therapeutic resources. TCM emphasizes syndrome differentiation-based holistic regulation, while Tujia ethnomedicine relies on indigenous medicinal plants and empirically derived therapies shaped by its unique geographical context. This review aims to accelerate the integration of traditional wisdom with contemporary pharmacology for the development of novel RA therapies. A comprehensive literature search was performed across PubMed, Web of Science, CNKI, and ethnomedical monographs to synthesize data on their theoretical underpinnings, therapeutic strategies, mechanisms of action, and clinical efficacy. TCM and Tujia ethnomedicine possess significant anti-RA effects, characterized by multi-component, multi-target synergistic mechanisms that complement modern medicine. However, they face common challenges including unclear material bases of active components, insufficient standardized clinical evidence, and inadequate quality control protocols. This review provides a critical foundation for integrating TCM/Tujia ethnomedicine with modern pharmacology, highlighting the urgent need for further research to clarify active constituents, establish standardized protocols, and validate clinical efficacy—ultimately facilitating the development of safer, more effective RA therapies.