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Wutou decoction (WTD) is a classic Traditional Chinese Medicine (TCM) herbal formula first recorded by the medical sage Zhang Zhongjing in the *Synopsis of Prescriptions of the Golden Chamber* (Jingui Yaolue). It is composed of five herbal ingredients: Radix Aconiti (Wutou), Herba Ephedrae (Mahuang), Radix Astragali (Huangqi), Radix Paeoniae Alba (Baishao), and Radix Glycyrrhizae (Gancao). Wutou decoction is widely used in China for the treatment of joint and inflammatory disorders, including rheumatoid arthritis, osteoarthritis, and cold-dampness type nodular erythema. It exerts anti-inflammatory, analgesic, and immunomodulatory effects by inhibiting inflammatory cytokines (such as TNF-alpha, IL-1beta, and IL-6), modulating the JAK2/STAT3, NF-kB, and Nrf2 signaling pathways, and regulating Treg/Th17 cell balance.
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