Objective To observe the clinical efficacy of bone-setting manipulation combined with TCM internal and external treatment for lumbar disc herniation.Methods Totally 240 cases with lumbar disc herniation were selected, and were divided into treatment group and control group according to the random number table method, with 120 cases in each group. Both groups were in bed for rest and did functional exercise. At the same time, modified Mahuang Fuzi XixinDecoction combined withDuhuo JishengDecoction were given, 1 dose per day, three times a day, orally, and were wrapped with a cloth bag dregs, adding 200 mL of vinegar, placed in lumbosacral region afer heating, 2 times a day, external treatment. The treatment group was given bone-setting manipulation combined with TCM internal and external treatment, and the control group was given traction therapy, 1 time for Monday, Wednesday and Friday, 4 weeks as a course of treatment, for continuous 2 courses. The clinical efficacy, visual analogue scale (VAS), Oswestry disability index (ODI), and serum NO content were observed.Results Compared with before the treatment, VAS and ODI score decreased significantly after the first and second courses (P<0.05); The treatment group was significantly lower than the control group at the same time after treatment (P<0.05). The total effective rate was 91.67% (110/120) in treatment group, and 83.33% (100/120) in control group, with statistical significance (Z=-2.103,P=0.036). Compared with before treatment, the NO level of the two groups significantly decreased after treatment, with statistical significance (P<0.05). The NO level in the treatment group was lower than that in the control group after treatment (t=7.843,P=0.041).Conclusion Bone-setting manipulation combined with TCM internal and external treatment have obvious efficacy for lumbar disc herniation, which may be related to down-regulating serum NO level.