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Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with rheumatoid arthritis(RA)and to explore their correlation with serum homocysteine(Hcy)and C-reactive protein(CRP)levels.Methods From December 2021 to December 2023,a total of 186 RA patients admitted to Dezhou Hospital of Qilu Hospital of Shandong University were selected as the study group,and the patients were classified into four TCM syndrome types according to the criteria of TCM syndrome differentiation,namely cold-damp blockage syndrome,qi and blood deficiency syndrome,phlegm-stasis blockage syndrome,deficiency of liver and kidney syndrome.Moreover,100 healthy volunteers who had physical examination at the same hospital during the same period were included as the healthy control group.The distribution of TCM syndrome types in RA patients was investigated,the serum Hcy and CRP levels in the two groups and in RA patients with various TCM syndrome types were observed,and then Pearson's correlation was used for explorating the correlation of serum Hcy and CRP levels with severity of illness of RA patients with different TCM syndrome types.Results(1)Among the 186 RA patients in the study group,there were 41 cases(22.04％)of cold-damp blockage syndrome,40 cases(21.51％)of phlegm-stasis blockage syndrome,50 cases(26.88％)of qi and blood deficiency syndrome,and 55 cases(29.57％)of deficiency of liver and kidney syndrome.(2)The serum Hcy and CRP levels in the study group were(7.61±2.07)μmol/L and(27.93±5.92)mg/L,respectively,which were higher than those of the healthy control group[(5.33±0.91)μmol/L and(1.85±0.67)mg/L,respectively],and the differences were statistically significant(P<0.01).Statistically significant differences of serum Hcy and CRP levels were shown among the patients with various TCM syndrome types(F=7.637,P<0.01;F=5.639,P<0.01).The serum levels of Hcy and CRP in patients with cold-damp blockage syndrome were the highest,and the levels in patients with phlegm-stasis blockage syndrome,qi and blood deficiency syndrome,and deficiency of liver and kidney syndrome were in decreasing sequence.The pairwise comparison between groups showed that the differences were statistically significant(P<0.05).(3)Pearson's correlation analysis showed that Disease Activity Score in 28 joints(DAS28)scores were positively correlated with serum Hcy and CRP levels(r=0.396,P<0.01;r=0.407,P<0.01),and the serum Hcy and CRP levels were positively correlated with the severity of illness in RA patients with different TCM syndrome types(P<0.05 or P<0.01).Conclusion The expression of serum Hcy and CRP in patients with RA is abnormally increased,and the expression levels of serum Hcy and CRP are correlated with TCM syndrome types.RA patients with cold-damp blockage syndrome have the highest expression levels of serum Hcy and CRP.