Objective To observe the therapeutic effect of large doses of Quick Rebi Beverage （beverage for heat impediment） on refractory rheumatoid arthritis （RA）. Methods Totally 49 cases of refractory RA were randomized into treatment group of 24 cases and control group of 25 cases. The control group was given 20 mg Methotrexate Tablets once weekly

10 mg Leflunomide Tablets once daily

100 mg Nimesulide Capsules twice daily and 20 ml Quick Rebi Beverage three times daily. The treatment group was given 40 to 60 ml Quick Rebi Beverage three times daily in addition to treatment of the control group. The efficacy of both groups was evaluated after 3 months treatment. The number and indices of swollen joints and tender joints

duration of morning stiffness

score of visual analog scale （VAS） for pain

Health Assessment Questionnaire （HAQ） and DAS 28 score were recorded before and after treatment. The erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） was detected. Results The percentage of American College of Rheumatology 20% improvement （ACR 20） in the treatment group and control group was 70.8% and 36.0% respectively

with a significant difference between groups （P<0.05）. The total TCM efficacy in the treatment group and control group was 87.5% and 52.0% respectively

with a significant difference between groups （P<0.05）. There were significant differences between before and after treatment in the indices except the number of swollen joints in the treatment group （P<0.05 or P<0.01）. There were significant differences between before and after treatment in the tender index

morning stiffness

VAS score and CRP in the control group （P<0.05）. The indices except VAS score in the treatment group were superior to those in the control group after treatment （P<0.05 or P<0.01）. Conclusion The large doses of Quick Rebi Beverage is effective for refractory RA. It can obviously relieve the symptoms

signs and inflammatory markers.