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Lingzhi + San-Miao-San is a Traditional Chinese Medicine (TCM) herbal combination therapy investigated for the treatment of active rheumatoid arthritis (RA). The formulation consists of a standard preparation of the medicinal mushroom **Lingzhi** (*Ganoderma lucidum*) and the classical TCM formula **San-Miao-San** (SMS), which contains *Rhizoma atractylodis*, *Cortex phellodendri*, and *Radix achyranthes bidentatae*. In clinical studies, the combination has demonstrated potential immunomodulatory effects, specifically by significantly lowering the percentage change of ex vivo-induced levels of the inflammatory cytokine interleukin-18 (IL-18). While it has shown analgesic benefits and is generally well-tolerated, it has not demonstrated significant anti-inflammatory or antioxidant effects on plasma markers such as IP-10, MCP-1, or IL-8 in Phase I clinical evaluations.
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