Objective:To investigate the efficacy of pungent-heat-dampness-drying method combined with methotrexate in the treatment of rheumatoid arthritis with cold-dampness blockage syndrome and its effect on knee joint function.Methods:A randomized controlled study was conducted on 120 patients with rheumatoid arthritis exhibiting cold-dampness blockage syndrome, who were admitted to the Quzhou Municipal Hospital of Traditional Chinese Medicine between July 2020 and October 2022. Using the random number table method, these patients were randomly assigned to either the control group ( n = 60) or the observation group ( n = 60). The control group received methotrexate tablets exclusively, while the observation group received a combined therapy of pungent-heat-dampness-drying method along with methotrexate. All patients were treated for 4 weeks. At the end of the treatment period, improvements in clinical indices and knee joint function were compared between the two groups. Results:After 4 weeks of treatment, the activity pain time [(0.95 ± 0.05) hours], rest pain time [(0.62 ± 0.08) hours], morning stiffness duration [(0.65 ± 0.02) hours], and pain paralysis duration [(0.52 ± 0.083) hours] in the observation group were significantly lower than those in the control group [(2.13 ± 0.15) hours, (1.36 ± 0.14) hours, (1.23 ± 0.63) hours and (1.02 ± 0.52) hours, respectively] ( t = 57.81, 35.55, 7.13, 7.44; all P < 0.001). The Knee Society Score in the observation group was (35.42 ± 8.26) points, which was significantly higher than that in the control group [(20.23 ± 5.75) points, t = -11.69, P < 0.001]. Additionally, levels of alanine aminotransferase, aspartate aminotransferase, erythrocyte sedimentation rate, and C-reactive protein were significantly lower in the observation group compared to the control group ( t = 26.96, 57.72, 19.44, 12.61, 17.37; all P < 0.05). The knee joint function score in the observation group was (75.42 ± 5.26) points, which was significantly higher than that in the control group [(62.23 ± 5.65) points, t = -13.24, P < 0.05]. Conclusion:The combination of the pungent-heat-dampness-drying method with methotrexate for the treatment of rheumatoid arthritis with cold-dampness blockage syndrome not only effectively improves clinical indices but also significantly reduces knee joint pain and improves knee joint function.