Usage and Safety of Traditional Chinese Medicine in Clinical Treatment of Lumbar Disc Herniation Complicated with Knee Osteoarthritis

doi:10.19803/j.1672-8629.20250950

Abstract

Abstract: Objective To explore the way traditional Chinese medicine (TCM) is used in the treatment of lumbar disc herniation (LDH) complicated with knee osteoarthritis (KOA). Methods Data on Chinese herbal medicine prescriptions and information about patients diagnosed concurrently with LDH and KOA between November 2023 and November 2025 were collected from the hospital information system database of Wangjing Hospital of China Academy of Chinese Medical Sciences and compiled into a unified Excel file. The safety of medications for these patients was assessed based on their medical records following drug administration and in conjunction with the Pharmacopoeia of the People’s Republic of China, drug package inserts and related literature. Results A total of 239 patients were included, with women ages 40 and older accounting for 68.20% of the cohort. Among the 193 TCM herbs, the most frequently used ones included Poria cocos（Schw.）Wolf (143 instances, 4.70%), and Glycyrrhiza uralensis Fisch. (121 instances, 3.98%). The properties of these herbs were predominantly warm (1 124 instances, 36.97%) and neutral (788 instances, 25.92%). In terms of flavor, sweet (1 638 instances, 53.88%) and bitter (1 260 instances, 41.45%) were dominating. The meridian tropisms involved the liver (1 666 instances, 54.80%) and spleen (1 207 instances, 39.70%). The efficacies included dispelling wind-dampness (296 instances, 9.74%) and tonifying the liver and kidney (275 times, 9.05%). Panax notoginseng（Burk.）F. H. Chen-Ligusticum chuanxiong Hort. (confidence 0.93, support 0.22) and Cornus officinalis Sieb. et Zucc.- Poria cocos（Schw.）Wolf (confidence 0.92, support 0.23) were identified as core drug pairs via association analysis. Cluster analysis revealed a total of five drug combinations. Safety evaluation indicated that the treatment of LDH combined with KOA with traditional Chinese medicine was safe. Conclusion The pathogenesis of patients with LDH combined with KOA is basically characterized by underlying deficiency and superficial excess. Clinical treatment is to focus on addressing the root cause by tonifying qi and nourishing blood to strengthen tendons and bones while treating the superficial manifestations by promoting blood circulation, unblocking meridians to relieve pain, dispelling wind, dispersing cold, and eliminating dampness.

Key words: Lumbar Disc Herniation, Knee Osteoarthritis, Patterns of Medication, Safety, Chinese Herbal Compound, Comorbidity

CLC Number:

R961
R282

GUO Xiaofei, FAN Weiming, KANG Jiaqi, BAI Jianqi, WANG Yiming, GUO Dongqi, ZHANG Ping, WANG Yuan, BAI Xuezhu. Usage and Safety of Traditional Chinese Medicine in Clinical Treatment of Lumbar Disc Herniation Complicated with Knee Osteoarthritis[J]. Chinese Journal of Pharmacovigilance, 2026, 23(2): 167-173.

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References

[1] GUAN SY, ZHENG JX, ZHANG SX, et al.Global Burden of Musculoskeletal Disorders in Adults Aged 50 and Over, 1990-2021: Risk Factors and Sociodemographic Inequalities[J]. J Cachexia Sarcopenia Muscle, 2025, 16(4): e70008.
[2] LI G, NIU W.Challenges Toward Musculoskeletal Injuries and Diseases. In Nanoengineering in Musculoskeletal Regeneration[M]. Pittsburgh: Academic Press, 2020: 1-41.
[3] AMARASINGHE P, WADUGODAPITIYA S, WEERASEKARA I.Biomechanical and Clinical Relationships between Lower Back Pain and Knee Osteoarthritis: a Systematic Review[J]. Syst Rev, 2023, 12(1): 28.
[4] YüZGüLDü U, AYDILEK A, Y1LD1R1M E, et al. Factors Affecting Functional Status in Individuals with Knee Osteoarthritis and Lumbar Degenerative Disease[J]. The Journal of Turkish Spinal Surgery, 2025, 36(4): 148-153.
[5] GOVIL G, TOMAR L, DHAWAN P.Knee-Spine Syndrome: Management Dilemma When Knee Osteoarthritis Coexists with Spine Degeneration[J]. Cureus, 2022, 14(5): e24939.
[6] LI LH, WEI X, ZHU LG, et al.Strategies for Prevention and Treatment of Spinal Degenerative Diseases from Perspective of Traditional Chinese Medicine for Bone Health[J]. China Journal of Chinese Materia Medica(中国中药杂志), 2024, 49(21): 5681-5685.
[7] WANG WW, LIAO CS, LIU HL, et al.Visualized Bibliometric Analysis of Research Hotspots and Trends in Knee Osteoarthritis[J]. Journal of Changzhi Medical College(长治医学院学报), 2025, 39(3): 249-255.
[8] FINE N, LIVELY S, SÉGUIN CA, et al. Intervertebral Disc Degeneration and Osteoarthritis: a Common Molecular Disease Spectrum[J]. Nat Rev Rheumatol, 2023, 19(3): 136-152.
[9] RUSTENBURG C, EMANUEL KS, PEETERS M, et al.Osteoarthritis and Intervertebral Disc Degeneration: Quite Different, Quite Similar[J]. JOR Spine, 2018, 1(4): e1033.
[10] PENG JQ, LI F, ZHU J.Research Status of the Relationship between Knee Osteoarthritis and Lumbar Disc Degenerative Diseases[J]. China Health Standard Management(中国卫生标准管理), 2022, 13(12): 195-198.
[11] CHEN EF, LI GQ.Effect of Lumbar Spinal Massage on Pain and Knee Joint Function in Patients with Knee Osteoarthritis[J]. Traditional Chinese Medicine Rehabilitation(按摩与康复医学), 2022, 13(13): 18-20.
[12] LI JS, WANG JJ.Traditional Chinese Medicine Clinical Research Strategies for Multimorbidity[J]. Acta Chinese Medicine(中医学报), 2025, 40(12): 2487-2491.
[13] ALHUMAIDI RM, BAMAGOUS GA, ALSANOSI SM, et al.Risk of Polypharmacy and Its Outcome in Terms of Drug Interaction in an Elderly Population: a Retrospective Cross-Sectional Study[J]. J Clin Med, 2023, 12(12): 3960.
[14] KANG JQ, BAI JQ, CAI MY, et al.Clinical Medications and Safety of Traditional Chinese Medicine for Osteoporosis Complicated with Lumbar Disc Herniation[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2025, 22(10): 1120-1126.
[15] ZHOU LJ, WANG XY, WU M.Meta-Analysis on Clinical Efficacy and Safety of Traditional Chinese Medicine Compound Combined with Conventional Western Medicine in the Treatment of Acute Coronary Syndrome Complicated with Arrhythmia[J]. Evaluation and Analysis of Drug-Use in Hospitals of China(中国医院用药评价与分析), 2025, 25(9): 1107-1112.
[16] Basic Research and Transformation Society, Professional Committee of Spine and Spinal Cord, Chinese Association of Rehabilitation Medicine. Guideline for Diagnosis, Treatment and Rehabilitation of Lumbar Disc Herniation[J]. Chinese Journal of Surgery(中华外科杂志), 2022, 60(5): 401-408.
[17] China Association of Chinese Medicine. Guidelines for INTEGRATED TCM WM Diagnosis and Treatment of Knee Osteoarthritis(2023 edition)[J]. The Journal of Traditional Chinese Orthopedics and Traumatology(中医正骨), 2023, 35(6): 1-10.
[18] Chinese Pharmacopoeia Commission.Pharmacopoeia of the People's Republic of China,Volume I(中华人民共和国药典一部)[M]. Beijing: China Medical Science Press, 2025.
[19] ZHONG GS, YANG BC. Traditional Chinese Pharmacy(中药学)[M]. Beijing: China Publishing House of Traditional Chinese Medicine, 2021.
[20] CHENG J, WEI JH, LIU RZ, et al.Research Progress on Traditional Chinese Medicine Treatment for Lumbar Disc Herniation[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica(云南中医中药杂志), 2025, 14(5): 2109-2116.
[21] ZHANG J, MENG H, QUAN QY.Application of Traditional Chinese Medicine Nursing Combined with Comprehensive Nursing in Patients with Lumbar Disc Herniation[J]. Journal of Practical Traditional Chinese Internal Medicine(实用中医内科杂志), 2023, 37(2): 89-91.
[22] ZHOU YL, LIU ML, LIU W.Research on Analysis of Traditional Chinese Medicine Symptoms, Syndromes, and Medication Rules in Knee Osteoarthritis and Construction of a Visual Network[J]. New Chinese Medicine(新中医), 2025, 57(22): 20-27.
[23] HOFFELD K, LENZ M, EGENOLF P, et al.Patient-Related Risk Factors and Lifestyle Factors for Lumbar Degenerative Disc Disease: a Systematic Review[J]. Neurochirurgie, 2023, 69(5): 101482.
[24] MA D, LIANG Y, WANG D, et al.Trend of the Incidence of Lumbar Disc Herniation: Decreasing with Aging in the Elderly[J]. Clin Interv Aging, 2013, 8: 1047-1050.
[25] LIAO J, WU QY, WU GH, et al.Analysis of Current Status and Trends of Disease Burden of Knee Osteoarthritis in China, 1990-2023[J]. Chinese Journal of Reparative and Reconstructive Surgery(中国修复重建外科杂志), 2025, 39(11): 1381-1387.
[26] DONG Y, YAN Y, ZHOU J, et al.Evidence on Risk Factors for Knee Osteoarthritis in Middle-Older Aged: a Systematic Review and Meta Analysis[J]. J Orthop Surg Res, 2023, 18(1): 634.
[27] TOSI LL, TEMPLETON K, PENNINGTON AM, et al.Influence of Sex and Gender on Musculoskeletal Conditions and How They Are Reported[J]. J Bone Joint Surg Am, 2024, 106(16): 1512-1519.
[28] HART DA.Sex Differences in Biological Systems and the Conundrum of Menopause: Potential Commonalities in Post-Menopausal Disease Mechanisms[J]. Int J Mol Sci, 2022, 23(8): 4119.
[29] HAN Y, LI CL, LYU Y, et al.Analysis of Disease Composition and Characteristics of Elderly Inpatients from 2019 to 2023[J]. Chinese Journal of Geriatric Care(中国老年保健医学), 2025, 23(2): 77-82.
[30] XU Y, WANG GC, YANG ZY.Investigation of Demographic and Clinical Characteristics of 1032 Inpatients with Lumbar Disc Herniation[J]. Sichuan Medical Journal(四川医学), 2024, 45(10): 1118-1120.
[31] CAO L, CUI LL, SUN Y, et al.Research Progress on Pharmacological Action and Mechanism of Clematidis Radix et Rhizoma[J]. Drug Evaluation Research(药物评价研究), 2022, 45(11): 2364-2370.
[32] HUANG Y, LIN Q, TAN X, et al.Rehmannia Alcohol Extract Inhibits Neuropeptide Secretion and Alleviates Osteoarthritis Pain through Cartilage Protection[J]. Heliyon, 2023, 9(9): e19322.
[33] ZHENG N, ZHANG H, LI BC, et al.Research Progress on Chemical Constituents and Pharmacological Effects of Corydalis Rhizoma[J]. Chinese Traditional Patent Medicine(中成药), 2025, 47(3): 872-883.
[34] LENG JY, MA YN, ZHANG C, et al.Advances in Chemical Consti-tuents, Pharmacological Effects and Clinical Application of Baishao (Paeoniae Radix Alba)[J]. Journal of Liaoning University of Traditional Chinese Medicine(辽宁中医药大学学报), 2025, 27(8): 124-131.
[35] FENG XC, ZHANG Q, YAO YY, et al. Chemical Biology Study of Chinese Material Medica Based on Theory of Flavors-Take Bitter-Propertied Chinese Material Medica as Examples[J/OL]. Acta Pharma-ceutica Sinica(药学学报), (2026-01-12)[2026-01-13]. https://doi.org/10.16438/j.0513-4870.2025-0427.
[36] ZHAO X, SHI GS, YANG SW, et al.Traditional Chinese Medicine Diagnosis and Treatment of Neuropathic Pain from Theory of Chronic Pain Entering Collaterals[J]. Chinese Journal of Experimental Traditional Medical Formulae(中国实验方剂学杂志), 2023, 29(13): 197-202.
[37] ZHEN XL, LI FY, JIAO WX, et al.Comment on Prescription of Traditional Chinese Medicine Decoction Pieces[J]. China Modern Medicine(中国当代医药), 2025, 32(23): 106-110.
[38] BAI YT, NAN Y, ZHAO JJ, et al.Analysis of Formulation Rules of Astragali Radix and Poria Herb Pair in Prescriptions Based on Data Mining[J]. Chinese Traditional and Herbal Drugs(中草药), 2025, 56(18): 6683-6695.
[39] SUN WT, LI B, HAN SH, et al.Prof. FANG Ding-ya’s Experience in Treating Ankylosing Spondylitis from Gan[J]. Chinese Journal of Integrated Traditional and Western Medicine(中国中西医结合杂志), 2023, 43(8): 992-995.
[40] YAN CL, LIU YQ, LI SH, et al.Effects of Dunhuang Medical Prescription Dabu Shen Decoction on Bone and Renal Functions in Cadmium-exposed Rats[J]. Journal of Li-shizhen Traditional Chinese Medicine(时珍国医国药), 2017, 28(5): 1077-1078.
[41] HUANG YS, CHI XF, JIANG Y, et al.The Clinical Study of Knee Joint Osteoarthritis Treated by Increased Simiao Decoction[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine(实用中西医结合临床), 2014, 14(4): 11-12.
[42] CHEN HY, YAO H, QU HT, et al.Ultrasound Guided Selective Lumber Nerve Block Combined with Fengshi Qutong Capsule for The Treatment of Lumbar Disc Herniation[J]. Clinical Medication Journal(临床药物治疗杂志), 2024, 22(11): 59-62.
[43] LI L, XU Z, WU CY, et al.Effect of Fengshi Qutong Capsule Combined with Celecoxib Capsule in the Treatment of Ankylosing Spondylitis and Its Influence on Hemorheology and Serum Inflammatory Factors[J]. Progress in Modern Biomedicine(现代生物医学进展), 2023, 23(16): 3093-3096.
[44] TAN LQ, CHEN P, WU CG, et al.Effect of Zhengqing Fengtongning Combined with Celecoxib and Mecobalamin on Pain and Lumbar Function in Patients with Lumbar Intervertebral Disc Herniation[J]. Drug Evaluation(药品评价), 2021,18(9): 558-560.
[45] WANG XL, LUO GQ, ZHANG HP, et al.Effect of Gulong Capsules Combined with Glucosamine Hydrochloride Capsules in the Treatment of Knee Osteoarthritis and the Impact on Lequesne Index[J]. Journal of China Prescription Drug(中国处方药), 2024, 22(10): 112-115.
[46] LIANG CH, GUO Y, LU Y.Clinical Study on Danlu Tongdu Tablets Combined With Mecobalamin in Treatment of Lumbar Disc Herniation[J]. Drugs & Clinic(现代药物与临床), 2023, 38(9): 2218-2222.
[47] ZHANG L, ZHANG HM, CAI QJ, et al.Study on the Medication Law of TCM in the Treatment of Knee Osteoarthritis Based on Ancient TCM Books[J]. Chinese Journal of Library and Information Science for Traditional Chinese Medicine(中国中医药图书情报杂志), 2025, 49(4): 63-68.
[48] CHEN S, WU HX, WANG N, et al.Research on the Medication Rules of Traditional Chinese Medicine Compound for the Treatment of Lumbar Intervertebral Disc Herniation Based on National Patents[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine(现代中西医结合杂志), 2022, 31(23): 3295-3301.