Abstract： Rheumatoid arthritis（RA）is an autoimmune disease with unknown etiology， and its pathological changes often involve multiple systems and organs besides the major joint lesions. Currently， the diagnosis and treatment of this disease primarily focus on local joint lesions， while systemic manifestations， including intestinal symptoms， have not received much attention. The theory of "the earth element （spleen and stomach） as the pivot coordinating the other four zang-organs with the circulation of a single qi" emphasizes the regulatory role of the spleen and stomach in the middle energizer on the other four zang-organs and the body's qi mechanism. The "gut-joint axis"， from the perspective of organ interaction， focuses on the connection between the gut and the joints. There are commonalities between these two theories in understanding the pathogenesis and treatment strategies of RA. This article aims to explore the relationship between these two theories to provide some assistance in the clinical diagnosis and treatment of RA.