To explore the effects of Guizhi Shaoyao Zhimu Decoction on rheumatoid arthritis and its influence on the expression of PD-L1 protein.Methods：A total of 116 patients with rheumatoid arthritis who were admitted to Xiangyang First People's Hospital Affiliated to Hubei University of Medicine from May 2016 to January 2018 were divided into a control group(58 cases)and an observation group(58 cases)according to the order of treatment.In the control group，leflunomide was given orally at a dose of 50 mg at the beginning and 20 mg at the end of 3 days，prednisone tablets at a dose of 10 mg once a day，and diclofenac sodium sustained-release tablets at a dose of 20 mg once a day.The observation group was given diclofenac sodium sustained-release tablets 20 mg，once a day oral，plus Guizhi Shaoyao Zhimu Decoction modified treatment，continuously treated for 8 weeks.The changes of joint tenderness，joint swelling，morning stiffness，VAS score，ESR，CRP and RF were compared between the 2 groups before and after treatment，and the programmed death receptor(PD-L1)protein was compared before treatment，4 weeks after treatment and 8 weeks after treatment.The levels of adverse reactions were summarized during the treatment period and the curative effect was observed after the treatment.Results：There was no significant difference in the number of tenderness，swelling，morning stiffness，VAS score，ESR，CRP and RF between the 2 groups before treatment(P>0.05).After the treatment，the above indexes of the 2 groups were significantly decreased than those before treatment(P<0.05).At the end of treatment，the above indexes of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in PD-L1 between the 2 groups before treatment(P>0.05).After 4 and 8 weeks of treatment，the level of PD-L1 in the observation group was significantly lower than that in the control group(P<0.05).The incidence of gastrointestinal symptoms，pigmentation，subcutaneous hemorrhage and rash in the observation group was significantly lower than that in the control group(P<0.05).The clinical control rate and total effective rate of the observation group were 43.1% and 87.93%，which were significantly higher than those of the control group(31.03% and 75.86%，P<0.05).Conclusion：Guizhi Shaoyao Zhimu Decoction can improve the efficacy of rheumatoid arthritis and reduce adverse reactions，which may be related to the drug can inhibit inflammation and the expression of PD-L1 protein.