[Warming acupuncture combined with Duhuo Jisheng decoction for lumbar disc herniation of qi stagnation and blood stasis accompanied with liver-kidney deficiency: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic effect between warming acupuncture combined with Duhuo Jisheng decoction and Duhuo Jisheng decoction alone in the treatment of lumbar disc herniation (LDH) of qi stagnation and blood stasis accompanied with liver-kidney deficiency.

METHODS: A total of 104 patients with LDH of qi stagnation and blood stasis accompanied with liver-kidney deficiency were randomly divided into an observation group (52 cases, 2 cases dropped out) and a control group (52 cases, 2 cases dropped out). The control group was treated with modified Duhuo Jisheng decoction. The observation group was treated with warming acupuncture on the basis of the treatment in the control group, bilateral Shenshu (BL23), as well as ashi points and Yanglingquan (GB34), Dachangshu (BL25), Kunlun (BL60) on the affected side were selected, 30 min each time, once a day for 4 weeks. The visual analogue scale (VAS) score, Oswestry disability index (ODI) score, Japanese Orthopaedic Association (JOA) score and lumbar motion before and after treatment in the two groups were observed. The average electromyography (AEMG) during both extension and flexion movements before and after treatment in the two groups was measured, and the flexion-relaxation ratio (FRR) was calculated. The serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) before and after treatment in the two groups were detected. The clinical efficacy was evaluated after treatment in the two groups.

RESULTS: After treatment, the VAS and ODI scores were decreased compared with those before treatment (P<0.05), while the JOA scores were increased (P<0.05) in the two groups; and the VAS and ODI scores in the observation group were lower than those in the control group (P<0.001), while the JOA score was higher (P<0.001). After treatment, the range of motion for forward flexion, backward extension and lateral bending was increased in both groups compared with that before treatment (P<0.05), and the indexes in the observation groups were greater than those in the control group (P<0.001). After treatment, the AEMG during extension was increased compared with that before treatment (P<0.05), while the AEMG during flexion and FRR were decreased (P<0.05) in both groups; and the AEMG during extension in the observation group was higher than that in the control group (P<0.001), and the AEMG during flexion and FRR in the observation group were lower than those in the control group (P<0.001). After treatment, the serum levels of IL-6 and TNF-αin both groups were decreased compared with those before treatment (P<0.05), and the indexes in the observation group were lower than those in the control group (P<0.001). The total effective rate of the observation group was 92.0% (46/50), which was higher than 76.0% (38/50) in the control group (P<0.05).

CONCLUSION: Warming acupuncture combined with Duhuo Jisheng decoction can alleviate pain in patients with LDH of qi stagnation and blood stasis accompanied with liver-kidney deficiency, improve lumbar function and range of motion, enhance lower back muscle strength, and suppress inflammatory response. Its therapeutic effect is superior to that of Duhuo Jisheng decoction alone.