Objective: To evaluate the effect of Yaoning decoction combined with Shexiang Zhitong patch in treating lumbar muscle strain(cold dampness and blood stasis) and discuss the mechanism of action according to hemorheology and inflammatory response. Method: One hundred and eighty patients were randomly divided into control group(90 cases) and observation group(90 cases) by using a stratified-block randomized method. Patients in control group received diclofenac sodium sustained release tablets by oral taking

100 mg/time

1 time/day

and diclofenac diethylamine emulgel for external use. Patients in observation group took Yaoning decoction

1 dose/day

and Shexiang Zhitong patch for external use. The treatment was 2 weeks for both groups

and the follow-up lasted for 4 weeks. On day 0

7

14 and 42

pain scores on visual analogue scale(VAS) were evaluated

and both before and after treatment

scores of Oswestry disability index(ODI) and cold dampness and blood stasis syndrome were graded; levels of tumor necrosis factor-α(TNF-α)

interleukin-6(IL-6)

thromboxane B2(TXB2)

6-Ketoprostaglandin Fla(6-Keto-PGFla) and hemorheological property were detected before and after treatment. Result: Ridit analysis results showed that the comprehensive clinical efficacy in observation group was superior to that in control group(P<0.05). On day 7

14 and 42

VAS scores in observation group were lower than those in control group(P<0.01). Individual scores and total scores of ODI index in observation group were lower than those in control group after treatment(P<0.01). The scores of cold dampness and blood stasis syndrome in observation group were lower than those in control group after treatment(P<0.01). The amelioration of hemorheological properties such as whole blood viscosity(high and low shearing)

plasma viscosity

fibrinogen and platelet aggregation rate were superior to those in control group(P<0.01). Levels of serum TNF-α

IL-6 and TXB2 in observation group were lower than those in control group

while the level of 6-Keto-PGFla was higher than that in control group(P<0.01). Conclusion: Yaoning decoction combined with Shexiang Zhitong patch can relieve pain

ameliorate waist function and microcirculation disturbance

and reduce inflammatory response for chronic lumbar strain

with obvious comprehensive clinical efficacy.