Objective: To systematically evaluate the clinical efficacy of topical preparations of Mongolian medicine Manggari hot compress therapy (hereafter referred to as Manggari hot compress therapy) in treating cervical spondylotic radiculopathy (CSR) and explore the possible pharmacological material basis in the formula, providing evidence for the clinical application of Mongolian medicine in the treatment of CSR. Methods: The clinical trial employed a randomized, controlled, open-label, and outcome-assessor-blinded design. The CSR patients who were treated at the Department of Traditional Therapeutics Outpatient Clinic, Xilinguole Meng Mongolian General Hospital between July 1, 2024 and August 31, 2025, were enrolled. They were randomly assigned to three groups: an oral control group (administration of oral administration of mecobalamin tablets combined with cervical electric traction), an experimental group (Manggari external hot compress), and a patch control group (flurbiprofen gel plaster). The intervention lasted two weeks. Before and after treatment, the following subjective indicators were recorded: Mongolian Medicine Syndrome (MMS) score, Visual Analog Scale (VAS) score, Northwick Park Neck Pain Questionnaire (NPQ) score, and tongue morphology. Serum levels of inflammatory markers [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β)] and oxidative stress markers [malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, and glutathione peroxidase (GSH-Px) activity] were measured using enzyme-linked immunosorbent assay (ELISA). Overall therapeutic efficacy was evaluated. One month after treatment completion, a follow-up assessment was conducted, and the MMS, VAS, and NPQ scores were recorded again for all patients. For the pharmacological substance exploration, ultra-high-performance liquid chromatography-Q-exactive orbitrap-mass (UHPLC-QE-MS) was employed to analyze blood-absorbed prototype components of Manggari, under both positive and negative ion modes. The targeting relationship between the core active compounds and the target protein was validated using molecular docking. Results: This study ultimately included 90 patients with CSR for analysis. Baseline characteristics showed no statistically significant differences among the three groups (P > 0.05). (i) Symptom scores. After treatment, the MMS, VAS, and NPQ scores decreased significantly from baseline in all three groups (P < 0.001). At follow-up, there was no significant difference in MMS, VAS, and NPQ scores of the experimental group compared with those at the end of the treatment (P > 0.05). After treatment, the experimental group showed significantly greater reductions in MMS, VAS, and NPQ scores than oral control and patch control groups (P < 0.001). At follow-up, these differences remained significant (P < 0.001). (ii) Inflammatory and oxidative stress markers. After treatment, serum levels of TNF-α, IL-6, and IL-1β, and MDA activity decreased significantly from baseline in all three groups (P < 0.001), and SOD content and GSH-Px activity increased significantly from baseline (P < 0.05). After treatment, the experimental group had significantly lower serum levels of TNF-α, IL-6, and IL-1β than oral and patch control groups. Additionally, it exhibited lower MDA activity and higher SOD content and GSH-Px activity compared with the two control groups. (P < 0.05). (iii) Overall efficacy. The total effective rate was 93.33% in the experimental group, 86.66% in the oral control group, and 83.33% in the patch control group. (iv) Pharmacological substance analysis. A total of 152 compounds were identified in the blood-absorbed components of Manggari. Among them, the core compounds—4-hydroxycoumarin, N-methylanthranilic acid, genistein, and ginsenoside-Rk1—showed binding energies to the key target proteins TNF-α and IL-1β range from − 4.7 to − 7.1 kcal/mol, with the majority of the binding energies being below − 5.0 kcal/mol, suggesting that it generally has a good binding affinity. Conclusion Mongolian medicine hot compress therapy effectively modulates inflammatory and oxidative stress responses through the combined action of its thermal effects and active pharmaceutical ingredients Manggari. It inhibits cervical nerve root inflammation and alleviates radicular pain, improving clinical symptoms, reducing pain severity, and alleviating neck functional disability.

OBJECTIVE：To establish a method for the content determination of apigenin and piperine in the water extract as well as eucalyptol and cumin aldehyde in the volatile oil of Mongolian medicine Sugmel- 3 decoction. METHODS ：HPLC method was adopted for the content determination of apigenin and piperine. GC method was used for the content determination of eucalyptol and cumin aldehyde. The determination of HPLC method was performed on Agilent Eclipse XDB-C 18 column with mobile phase consisted of methanol- 0.1％ phosphoric acid aqueous solution at flow rate of 1.0 mL/min；the detection wavelength was set at 225 nm（apigenin）and 342 nm（piperine）；the column temperature was set at 30 ℃ with sample size of 10 μL. The determination of GC method was performed on Dimensions SH-Rtx- 1 capillary column with high-purity hydrogen as carrier gas ； the injector temperature was set at 270 ℃，with flow rate of carrier gas 1 mL/min by temperature programmed ；the sample size was 1 μL，and split ratio was 1 ∶ 10. RESULTS：The linear ranges of apigenin ，piperine，eucalyptol and cumin aldehyde were 12.5-200 μg/g/mL（r＝0.999 6），87.3-139.7 μg/mL（r＝0.999 9），136-2 187 μg/mL（r＝0.999 9），39-635 μg/mL（r＝0.999 9）， respectively. The quantitation limits were 0.02，0.06，0.06，0.12 μg/mL，respectively. The detection limits were 0.01，0.02，0.03， 0.04 μg/mL. RSDs of precision，stability and reproducibility tests were all less than 4％. The recovery rates of the samples were 89.26％ -97.26％（RSD＝2.69％ ，n＝6），94.20％ -104.01％（RSD＝3.64％ ，n＝6），98.51％ -110.11％（RSD＝3.87％ ，n＝6）， 95.76％-107.82％（RSD＝4.12％，n＝6），respectively. The contents of above components were 0.769-0.828，7.741-7.981，5.284 7- 5.846 6，1.038 6-1.101 2 mg/g（n＝3）. CONCLUSIONS：The established method is simple and feasible ，and can be used for quality control of different parts of Mongolian medicine Sugmel- 3 decoction.