Objective To investigate the therapeutic effect of acupuncture stimulation combined with administration of“Gushen Zhuyu Tang”(decoction for consolidating kidney to eliminate blood stasis

DCKEBS) in the treatment of lumbar disc herniation(LDH) patients. Methods A total of 147 patients with LDH were randomly divided into DCKEBS

acupuncture and DCKEBS+acupuncture groups(n= 49 cases in each group). The patients of the acupuncture group received a) acupuncture stimulation of Dazhui(GV14)

Ganshu(BL18)

Shenshu(BL23)

Tianshu(ST25)

Yanglingquan(GB34)

etc.

b) fire needle pricking of the topical tendons

cord-like points

tender-points

c) row-needles stimulation of the attachment sites of muscles of the sacroiliac joint or crista iliaca

and d) acupotomy-debonding of the topical high-tension muscles

twice a week for 4 weeks. Those patients of the DCKEBS group were ordered to take DCKEBS [containing fried Yiyiren(Semen Coicis)

Shanzhuyu(Fructus Corni)

fried Baizhu(Rhizoma Astractylodis)

Sangjisheng(Ramulus Loranthi)

Duzhong(Cortex Eucommiae)

Buguzhi(Fructus Psoraieae)

etc.] 150 mL

twice daily

continuously for 4 weeks

and those of the DCKEBS+acupuncture group received the combined treatment mentioned above in the acupuncture and DCKEBS groups. The pain severity was assessed by using visual ana-logue scale(VAS

0—10 points) and the modified Japan Orthopaedic Association questionnaire(M-JOA) score(0—30 points)

separately

and the lumbar range of motion(ROM) and lumbar muscle strength were tested to evaluate the lumbar motor function. The levels of serum tumor necrosis factor α(TNF-α)

matrix metalloproteinase-2(MMP-2)

and apoptosis related factors Caspase-3 and Caspase-9 were assayed using ELISA. The total effective rates of the three groups were compared. Results After the treatment

the VAS and M-JOA scores

contents of serum TNF-α

MMP-2

Caspase-3 and Caspase-9 were significantly decreased(P<0.01)

and the myodynamia of lumbar muscular flexor and extensor was considerably increased(P<0.01) in the three groups

and the ROM angles of lumbar extending and buckling were increased(P<0.01) in the DCKEBS+acupuncture group compared with pretreatment. Comparison among the 3 groups showed that the VAS and M-JOA scores

and serum TNF-α

MMP-2

Caspase-3 and Caspase-9 contents of the DCKEBS+acupuncture group were significantly lower than those of both DCKEBS and acupuncture groups(P<0.01)

while the ROM angles of lumbar extending and buckling

and the myodynamia of lumbar muscular flexor and extensor were obviously higher in the DCKEBS+acupuncture group than those of the DCKEBS and acupuncture groups(P<0.01). The total effective rate was 93.88%(46/49) in the DCKEBS+acupuncture group

higher than 75.51%(37/49) in the DCKEBS group and 71.43%(35/49) in the acupuncture group(P<0.05). Conclusion Acupuncture combined with DCKEBS can relieve pain

improve lumbar muscle strength and lumbar movement function

and reduce serum TNF-α

MMP-2

Caspase-3 and Caspase-9 levels in LDH patients.