Abstract：Palindromic rheumatism（PR）falls under the category of impediment syndrome in traditional Chinese medicine. Its fundamental pathogenesis involves deficiency of healthy qi and invasion of external pathogens—primarily wind pathogen—coupled with cold，dampness，or heat. These factors obstruct the flow of qi and blood of meridians and collaterals， resulting in pain due to blockage. If pathogens persist， they cause collateral obstruction， qi stagnation， phlegm accumulation，and endogenous blood stasis. The binding of phlegm and stasis further depletes healthy qi. New pathogenic factors then trigger latent pathogens，disrupting the balance between healthy qi and pathogens and leading to recurrent disease episodes. The "accumulation-aggravation" theory emphasizes the interaction between pathogens and healthy qi，highlighting how cumulative pathogenic factors induce disease—paralleling the progression of PR. Guided by this theory，clinical prevention and treatment should focus on eliminating pathogens before they become dominant， and reinforcing healthy qi before its decline. This approach offers novel strategies to prevent PR recurrence and improve clinical management.