Objective:To explore the efficacy of combined white peony total glycosides with conventional clinical treatment for rheumatoid arthritis(RA)complicated by coronary heart disease,and to analyze the mechanism of action.Methods:60 patients with RA complicated by coronary heart disease were selected and divided into a control group and an experimental group based on different treatment plans,30 cases in each group.The control group received conventional treatment with non-steroidal anti-inflammatory drugs,glucocorticoids,and methotrexate,while the experimental group received white peony total glycosides in addition to the control group treatments.Both groups received continuous treatment for 24 weeks.The serological indicators[erythrocyte sedimentation rate(ESR),complement C3,rheumatoid factor(RF),anti-citrullinated peptide antibody(ACCP)],coagulation function[platelets(PLT),platelet activating factor(PAF)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-1(IL-1),tumor necrosis factor-alpha(TNF-α)],T lymphocyte 17(Th17),the ratio of Th17 to regulatory T cells(Treg),Treg levels,as well as pain[visual analog scale(VAS)score],swelling(joint swelling index score),and incidence of adverse reactions were compared between the two groups.Results:After 4,12,and 24 weeks of treatment,the ESR,complement C3,RF,ACCP,PLT,and PAF levels gradually decteased in both groups(P＜0.05),and the experimental group was lower than the control group(P＜0.05).At 24 weeks post-treatment,both groups showed reductions in CRP,IL-6,IL-1,TNF-α,Th17,Th17/Treg,VAS scores and joint swelling indices compared to pre-treat-ment(P＜0.05),with the experimental group showing lower values than the control group(P＜0.05).Treg levels increased compared to pre-treatment,with the experimental group having higher levels than the control group(P＜0.05).There was no significant differ-ence in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:The combination of white peony total glyco-sides with conventional treatment for RA complicated by coronary heart disease is beneficial in improving clinical symptoms such as pain and swelling.The mechanism may be related to the inhibition of inflammatory factor release,modulation of Th17/Treg balance,re-duction of immune indicators,and improvement of coagulation function.