Objective To explore the characteristics of disease activity in rheumatoid arthritis（RA） patients with different traditional Chinese medicine（TCM） syndromes. Methods A cross-sectional study assessing 1388 RA patients from 18 centers was performed

through a predesigned TCM syndrome questionnaire for RA. TCM syndromes for RA included wind-damp obstruction

cold-damp obstruction

damp-heat obstruction

phlegm and blood stasis obstruction

qi-blood deficiency

and liver-kidney insufficiency. The number of swollen joints

the number of tender joints

erythrocyte sedimentation rate（ESR）

C-reactive protein（CRP）

and disease activity score 28（DAS28） were analyzed. Results There were 135 RA patients with wind-damp obstruction syndrome

272 with cold-damp obstruction syndrome

613 with damp-heat obstruction

142 with phlegm and blood stasis obstruction

47 with qi-blood deficiency

and 179 with liver-kidney insufficiency. Patients with damp-heat obstruction syndrome had a higher number of tender joints and a higher score of DAS28-ESR（4） than patients with other syndromes except for liver-kidney insufficiency（P<0.05）. There were significant differences in the numbers of swollen joints between patients with damp-heat obstruction syndrome

and wind-damp obstruction syndrome

and qi-blood deficiency syndrome（P<0.05）. Patients with damp-heat obstruction syndrome had the highest ESR（P<0.05）. There was no significant difference in CRP between different syndromes（P>0.05）. According to DAS28-ESR scores

patients with wind-damp obstruction syndrome and qi-blood deficiency syndrome were mainly at moderate activity

while the other syndromes were mainly at high activity（P<0.05）. Conclusion The disease activity of RA patients varies with different TCM syndromes

and patients with damp-heat obstruction syndrome has the highest disease activity.