1.Therapeutic Effect and Mechanism of Shentong Zhuyutang Combined with Dilongtang in Treatment of Lumbar Disc Herniation with Qi Stagnation and Blood Stasis Syndrome
Huangsheng TAN ; Yinbo WANG ; Yong HUANG ; Juyi LAI ; Hualong FENG ; Zhiming LAN ; Yuanfei FU ; Yong JIANG ; Shenghua HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):47-54
ObjectiveTo observe the clinical efficacy of Shentong Zhuyutang combined with Dilongtang in the treatment of lumbar disc herniation (LDH) with Qi stagnation and blood stasis syndrome, and its effect on nucleus pulposus reabsorption and immune-inflammatory factors, exploring its therapeutic mechanism from the perspective of reabsorption. MethodsA total of 120 patients with LDH from the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, treated between June 2020 and January 2023, were randomly divided into the control group (52 cases, with 8 dropouts) and the observation group (49 cases, with 11 dropouts) according to a random number table. The control group received routine treatment, while the observation group was treated with Shentong Zhuyutang combined with Dilongtang in addition to routine treatment. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, and traditional Chinese medicine (TCM) syndrome score were measured before treatment and after 3 courses of treatment. Venous blood samples were collected for the determination of serological indexes. MR examination was performed during the 6-month follow-up to calculate the absorption rate. ResultsAfter treatment, both groups showed significant reductions in VAS, ODI, TCM syndrome score, serum tumor necrosis factor (TNF)-α, matrix metalloproteinase (MMP)-9, and vascular endothelial growth factor (VEGF) levels, and a significant increase in JOA score compared with pre-treatment values (P<0.05). Compared with the control group, the observation group showed significantly lower VAS, ODI, TCM syndrome score, serum TNF-α, MMP-9, and VEGF levels, and a significantly higher JOA score (P<0.05). The proportion of nucleus pulposus reabsorption in the observation group was 57.14% (28/49), significantly higher than 21.15% (11/52) in the control group (χ2=6.161, P<0.05). ConclusionShentong Zhuyutang combined with Dilongtang can effectively relieve pain, improve lumbar function, and alleviate TCM clinical symptoms in LDH patients with Qi stagnation and blood stasis syndrome. Imaging findings suggest that the treatment promotes the reabsorption of nucleus pulposus protrusion, while laboratory testing shows reduced serum levels of TNF-α, MMP-9, and VEGF, which contribute to the rehabilitation of patients.