目的：观察补益肝肾方联合针刺对老年退行性腰椎管狭窄患者的临床疗效。方法：选取102例老年退行性腰椎管狭窄患者，采用随机数字表法分为针刺组和补益肝肾方合并组，每组51例(针刺组脱落1例，补益肝肾方合并组脱落1例、剔除1例)。两组均接受基础治疗，针刺组在此基础上进行针刺治疗，补益肝肾方合并组在针刺治疗同时服用补益肝肾方，两组患者均连续治疗1个月。治疗前、后检测患者补体(C)1q/肿瘤坏死因子(TNF)相关蛋白3(CTRP3)、TNF-α、单核细胞趋化蛋白-1(MCP-1)水平；治疗前、后检测患者微循环指标(血细胞比容、血浆黏度、纤维蛋白原水平)，记录患者神经源性跛行距离；治疗前、后通过疼痛视觉模拟评分(VAS)、Roland-Morris功能障碍调查表(RMDQ)、Oswestry功能障碍指数(ODI)评价患者腰部疼痛情况、腰椎功能，比较两组中医证候评分及临床疗效。结果：治疗后，两组患者TNF-α、MCP-1水平较治疗前降低(P<0.05)，且补益肝肾方合并组低于针刺组(P<0.05)；治疗后，两组CTRP3水平较治疗前升高(P<0.05)，补益肝肾方合并组高于针刺组(P<0.05)；治疗后，补益肝肾方合并组患者总有效率为97.96%，针刺组总有效率为84.00%，补益肝肾方合并组患者疗效优于针刺组(P<0.05)。两组血细胞比容、血浆黏度、纤维蛋白原水平较治疗前降低(P<0.05)，且补益肝肾方合并组低于针刺组(P<0.05)；治疗后，两组ODI、RMDQ、VAS评分相较治疗前降低(P<0.05)，且补益肝肾方合并组低于针刺组(P<0.05)；治疗后，两组神经源性跛行距离较治疗前增加(P<0.05)，且补益肝肾方合并组神经源性跛行距离较针刺组长(P<0.05)；治疗后，两组腰腿酸痛、形羸气短、腿膝无力评分及中医证候评分较治疗前降低(P<0.05)，且补益肝肾方合并组低于针刺组(P<0.05)。结论：补益肝肾方联合针刺治疗老年退行性腰椎管狭窄患者，可调节血清炎症介质水平，改善椎管微循环及神经源性跛行，缓解腰部疼痛，提升腰椎功能及临床疗效。

Objective:To observe the clinical efficacy of Buyi Ganshen Formula(补益肝肾方) combined with acupuncture on elderly patients with degenerative lumbar spinal stenosis. Methods:A total of 102 elderly patients with degenerative lumbar spinal stenosis were selected and divided into the acupuncture group and Buyi Ganshen Formula combination group by using random number table method,with 51 cases in each group(1 case dropped out in the acupuncture group,1 case dropped out and 1 case was excluded in the Buyi Ganshen Formula combination group). Both groups were given basic treatment simultaneously. The acupuncture group received acupuncture treatment on this basis,while Buyi Ganshen Formula combination group received administration of Buyi Ganshen Formula on the basis of the treatment of the acupuncture group. Both groups of patients were treated continuously for one month. The levels of C1q/TNF-related protein 3(CTRP3),tumor necrosis factor-α(TNF-α),and monocyte chemoattractant protein 1(MCP-1) in patients before and after treatment were observed. Microcirculation indicators of patients were detected before and after treatment:Hematocrit,plasma viscosity,fibrinogen level,the distance of neurogenic claudication of the patients were recorded. Before and after treatment,the lumbar pain and lumbar function of the patients were evaluated by visual analogue scale(VAS) for pain,roland morris disability questionnaire(RMDQ),and oswestry disability index(ODI). The traditional Chinese medicine syndrome score and the clinical efficacy were compared between the Buyi Ganshen Formula combination group and the acupuncture group. Results:After treatment,the total effective rate of patients in the Buyi Ganshen Formula combination group was 97.96%,and that in the acupuncture group was 84.00%. The efficacy in the Buyi Ganshen Formula combination group was better than that in the acupuncture group(P<0.05). The levels of TNF-α and MCP-1 in both groups were lower than those before treatment(P<0.05),and the levels of TNF-α and MCP-1 in th Buyi Ganshen Formula combination group were lower than those in the acupuncture group(P<0.05). After treatment,the levels of CTRP3 in both groups were higher than those before treatment(P<0.05). The level of CTRP3 in the Buyi Ganshen Formula combination group was higher than that in the acupuncture group(P<0.05). After treatment,the hematocrit,plasma viscosity,and fibrinogen levels in both groups were lower than those before treatment(P<0.05),the hematocrit,plasma viscosity and fibrinogen levels in the Buyi Ganshen Formula combination group were lower than those in the acupuncture group(P<0.05). After treatment,the ODI,RMDQ,and VAS scores of both groups were lower than those before treatment(P<0.05),and the ODI,RMDQ,and VAS scores of the Buyi Ganshen Formula combination group were lower than those of the acupuncture group(P<0.05). After treatment,the distance of neurogenic claudication in both groups increased compared with that before treatment(P<0.05),and the distance of neurogenic claudication in the Buyi Ganshen Formula combination group was longer than that in the acupuncture group(P<0.05). After treatment,the scores of soreness and pain in the waist and legs,emaciation and shortness of breath,weakness in the legs and knees,and total scores in both groups were lower than those before treatment(P<0.05),and those in the Buyi Ganshen Formula combination group were lower than those in the acupuncture group(P<0.05). Conclusions:Buyi Ganshen Formula combined with acupuncture can regulate the levels of serum inflammatory mediators,improve the microcirculation of the spinal canal and neurogenic claudication,relieve lumbar pain,enhance lumbar function and clinical efficacy in the treatment of elderly patients with degenerative lumbar spinal stenosis.