ObjectiveTo explore the efficacy of Gulong capsule combined with methotrexate in rheumatoid arthritis (RA) and its influence on the immune inflammatory response.MethodsA total of 120 RA patients admitted to Linquan county people's hospital from January 2023 to March 2024 were selected and randomly divided into the observation group and the control group, with 60 cases in each group. The control group was treated with ibuprofen combined with methotrexate, while the observation group was treated with Gulong capsules combined with methotrexate. Both groups were treated continuously for 12 weeks. The clinical effective rates, tumor necrosis factor (TNF)-α, interleukin (IL)-6, cluster of differentiation (CD)4⁺/CD8⁺, rheumatoid factor (RF), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score in 28 joints (DAS28), morning stiffness duration, changes in the number of swollen joints, the number of tender joints and adverse reactions of the two groups were compared between the two groups.ResultAfter treatment, the total effective rate of treatment in the observation group was higher than that in the control group (90.00% vs. 75.00%, P<0.05). After treatment, the scores of TNF-α, IL-6, CD4⁺/CD8⁺, RF, CRP, ESR, DAS28, the duration of morning stiffness, the number of joint swellers, and the number of joint tenderness were all lower than those before treatment in both groups, and the reduction degree in the observation group was more significant (P<0.05). There was no significant difference in the occurrence of adverse reactions between the two groups (P>0.05).ConclusionThe combination of Gulong capsule and methotrexate in the treatment of RA has a significant effect. It can improve the immune inflammatory response of patients, promote the recovery of joint function, and does not increase adverse reactions. It has a good clinical application value.