Abstract： Objective： To observe the clinical effect of Guikun Fengshi mixture combined with methotrexate(MTX) for bone destruction in patients with rheumatoid arthritis(RA) of cold-dampness obstruction type. Methods：A total of 90 cases of PA patients in the department of nephropathy and rheumatism in Zhongshan Hospital of Chinese Medicine were divided into the observation group， the negative control group and the positive control group according to the random number table method，30 cases in each group. The incidence of adverse reactions in the three groups was observed；the improvement of the joint imaging was evaluated by Sharp- van der Heijde score(SHS)； and the levels of β- Crosslaps(β- CTX)， receptor activator of NF- κB Ligand(RANKL)，osteoprotegerin(OPG) and tartrate- resistant acid phosphatase- 5b(TRACP5b) were detected. Results：After 12 weeks of treatment，the total scores of SHS as well as the scores of clearance and erosion in the three groups showed no improvement when compared with those before treatment(P＞0.05)， and the comparison among the three groups showed no significance in the difference(P＞0.05). After 24 weeks of treatment， the score of articular erosion in the observation group was improved when compared with that before treatment(P＜0.05)，and the above score in the observation group was lower than those in the other two groups(P＜0.05). After 12 weeks of treatment， the levels of OPG，RANKL，TRACP5b，and β-CTX in the three groups were improved when compared with those before treatment(P＜0.05)；after 24 weeks of treatment，the above levels in the three groups were improved when compared with those before treatment(P＜0.05)，and the levels of OPG，TRACP5b and β-CTX in the observation group were improved when compared with those in the other two groups，the difference being significant(P＜0.05). During the treatment，the comparison of the incidence of adverse reactions among the three groups showed no significance in the difference(P＞0.05). Conclusion：The therapy of Guikun Fengshi mixture combined with MTX can improve the indexes of bone destruction in RA patients，including OPG，RANKL，TRACP5b and β-CTX，which has more advantages in alleviating the articular erosion and destruction in RA patients.