To observe the therapeutic efficacy of the addition and subtraction of Modified Tongdu Huoxue Decoction (通督活血汤加减) and the conservative protocol of electroacupuncture intervertebral foraminal stimulation in the treatment of degenerative lumbar spinal stenosis.

A total of 108 patients with degenerative lumbar spinal stenosis admitted from January 2023 to October 2024 were prospectively selected and randomly divided into two groups using envelope method. Both groups were given celecoxib capsules and conventional Tuina treatment, the electrical stimulation group was combined with electroacupuncture intervertebral foraminal stimulation on its basis, and the comprehensive group was treated with Modified Tongdu Huoxue Decoction with electroacupuncture intervertebral foraminal stimulation on its basis. The TCM symptom scores, the changes of visual analogue scale (VAS) scores and Oswestry disability index (ODI) were assessed in the two groups, and the levels of interleukin-1β (IL-1β), silent information regulator 1 (SIRT1), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), lumbar lordosis, Cobb angle and intervertebral space and blood rheology changes were observed. And painfree walking distance and incidence of adverse reactions were analyzed.

Comparing with those before treatment, there was no difference in TCM symptom scores, VAS scores, ODI scores or pain-free walking distance of the two groups after treatment (P>0.05). TCM symptom scores, VAS scores and ODI scores were lower in both groups, and lower in the comprehensive group after treatment (P<0.05). The pain-free walking distance was elevated in both groups, and higher in the comprehensive group (P<0.05) after treatment. Comparing with those before treatment, there was no difference in SIRT1, IL-1β, TNF-α or MCP-1 of the two groups after treatment (P>0.05). After treatment, SIRT1 was elevated in both groups, and was higher in the comprehensive group (P<0.05). The levels of IL-1β, TNF-α and MCP-1 were lower in both groups, and were lower in the comprehensive group after treatment (P<0.05). Comparing with those before treatment, there was no difference in lumbar lordosis Cobb angle or intervertebral space height of the two groups after treatment (P>0.05). After treatment, the lumbar anterior convex Cobb angle and intervertebral space height of the two groups were elevated, and higher in the comprehensive group (P<0.05). Comparing with those before treatment, there was no difference in blood rheology of the two groups after treatment (P>0.05). Comparing with those before treatment, hematocrit, fibrinogen, plasma viscosity and whole blood high cut viscosity were lower in the two groups, and lower in the comprehensive group (P<0.05). There was no difference in the incidence of total adverse reactions such as gastrointestinal reactions, skin injury, malaise and rash between the two groups (P>0.05).

The treatment of degenerative lumbar spinal stenosis with a conservative regimen of Modified Tongdu Huoxue Decoction and electroacupuncture intervertebral foraminal stimulation reduces pain, improves blood rheology and reduces inflammatory stimuli.