Abstract：Objective：To observe the therapeutic effect of Total Glycosides of White Paeony Capsules combined with western medicine on active rheumatoid arthritis and its impact on serum inflammatory factors and myocardial enzyme spectrum. Methods： A total of 92 patients with active rheumatoid arthritis admitted to Chun'an First People's Hospital from January 2022 to June 2023 were selected as research subjects and divided into the study group and the control group，each with 46 cases，using the random odd-even number method. The control group was treated with Methotrexate Tablets， Leflunomide Tablets， and Hydroxychloroquine Sulfate Tablets， and the study group was additionally treated with Total Glycosides of White Paeony Capsules based on the control group. Both groups were treated for six months. The joint pain indexes，joint tenderness indexes，joint swelling indexes，duration of morning stiffness， rheumatoid factor （RF），erythrocyte sedimentation rate （ESR），serum inflammatory factors [interleukin-1 （IL-1）， interleukin-6 （IL-6）， tumor necrosis factor- α （TNF- α）， and C-reactive protein （CRP）]， myocardial enzyme spectrum indicators [aspartate aminotransferase （AST）， lactate dehydrogenase （LHD）， creatine kinase （CK）， and creatine kinase isoenzyme （CK-MB）]， and the scores of Quality of Life scale （QOL） and Activities of Daily Living scale（ ADL） were compared before and after treatment between the two groups. The clinical effects and adverse reactions were also compared between the two groups. Results：The total effective rate in the study group was 97.83% （45/46）， which was higher than that of 82.61% （38/46） in the control group （P＜0.05）. After treatment， the joint pain indexes， joint tenderness indexes， joint swelling indexes， RF， and ESR in both groups were declined （P＜0.05）， with the study group showing lower levels than the control group （P＜0.05）. The duration of morning stiffness was shortened in both groups （P＜0.05），with the study group having a shorter duration than the control group （P＜0.05）. After treatment， the levels of IL-1， IL-6， TNF-α， CRP， AST， LHD， CK， and CK-MB in both groups were decreased （P＜0.05），with the study group showing lower levels than the control group （P＜0.05）. The QOL and ADL scores in the two groups were increased （P＜0.05）， with the study group having higher scores than the control group （P＜0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞ 0.05）. Conclusion： The combination of Total Glycosides of White Paeony Capsules with Methotrexate Tablets and Leflunomide Tablets shows significant therapeutic effects on active rheumatoid arthritis. Without increasing adverse reactions，it can significantly improve serum inflammatory factors and myocardial enzyme spectrum levels.