Rheumatoid arthritis (RA) is a common autoimmune disease characterized by synovitis in clinical practice. Inflammatory cytokines and osteoclasts stimulate synovial tissue proliferation, inflammatory reactions, bone destruction, and joint dysfunction, play the key role in the pathogenesis of RA. This article reviews the relevant research on the intervention of RA through the regulation of osteoprotegerin (OPG)/receptor activator of NF-κB (RANK)/receptor activator of NF-κB ligand (RANKL) signaling pathway by traditional Chinese medicine monomers and their extracts, traditional Chinese medicine formulas and preparations,  traditional Chinese medicine compatibility, and traditional Chinese medicine treatment. The results indicate that the effective molecular mechanisms in traditional Chinese medicine are different, but they can play a role in regulating signaling pathways, stimulate osteoblast activity, inhibit inflammatory cytokine secretion, reduce osteoclast differentiation, prevent and treat RA. This provides a theoretical basis for the multi target and multi pathway treatment of RA in traditional Chinese medicine.

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