Objective: To discuss the clinical effect and the action mechanism of Guishao Shangjin decoction by oral administration combined Tongluo Zhitong powder by external application in treating patients with acute lumbar sprain (ALS). Method: Ninety patients were randomly divided into control group (45 cases) and observation group (45cases) by random number table. Patients in control group took oral 0.2 g lbuprofen tablets 3 times daily plus dichofenac diethylammon by external application. Patients in observation group took oral Guishao Shangjin decoction and Tongluo Zhitong powder by external application. Patients in two groups received a 5-day period of treatment. The pain

tenderness

swelling and ecchymosis scores were recorded. The waist movement obstacles and waist dysfunction scores were conducted. The change of blood rheology

β-endorphin (β-EP)

thromboxane B2 (TXB2)

6-Ketone prostaglandin Fla (6-Keto-PGFla) were detected before and after treatment. Result: The clinical curative effect in observation group was superior to that incontrol group through Ridit analysis (P<0.05). Scores of pain

tenderness

swelling and ecchymosis in observation group were lower than those in control group (P<0.01). Scores of waist movement obstacles and waist dysfunction in observation group were lower than those in control group (P<0.01). Improvement of blood rheology indexes including whole blood viscosity (high shear

low shear)

plasma viscosity

fibrinogen and platelet aggregation rate in observation group were superior to those in control group (P<0.01). After treatment

levels of β-EP and 6-Keto-PGFlα of observation group were higher than those in control group (P<0.01)

while the TXB2 level was lower than that in control group (P<0.01). Conclusion: Guishao Shangjin decoction by oral administration combined Tongluo Zhitong powder by external application could promote blood circulation

reduce inflammatory reaction

and improve level of β-EP in patients with ALS. It has a good analgesia and detumescence effect

and coud enhance the recovery of waist activity function.