Clinical study on the therapeutic effect of large-area cupping therapy for lumbar disc herniation of cold-damp type (a Traditional Chinese Medicine syndrome)

BACKGROUND: Cupping therapy is a commonly used Traditional Chinese Medicine (TCM) modality for treating lumbar disc herniation (LDH) and has gained increasing attention in recent years. Large‐area cupping therapy is characterized by extensive and deep negative‐pressure stimulation, which may exert analgesic effects by improving local circulation and modulating inflammatory mediators. This study aimed to evaluate the clinical efficacy of large‐area cupping therapy in patients with cold‐damp type LDH and to explore its potential mechanisms of action. METHODS: This prospective, randomized controlled trial enrolled 60 patients diagnosed with LDH of the cold‐dampness type. Participants were randomly assigned (1:1) using a random number table to either the observation group (n = 30) or the control group (n = 30). The observation group received large‐area cupping therapy, while the control group underwent conventional infrared therapy. Both groups were treated once every other day for a total of six sessions. Pain was assessed using the Visual Analog Scale (VAS), and TCM symptom scores were recorded. Serum levels of prostaglandin E2 (PGE2) and β‐endorphin (β‐EP) were measured before treatment, after the first session, and after the final session. RESULTS: There were no significant differences between the two groups at baseline in terms of VAS scores, TCM symptom scores, or serum levels of PGE2 and β‐EP (P > 0.05). After treatment, the observation group showed significantly greater improvements in VAS scores, symptom scores, and biochemical markers compared to the control group (P < 0.05). Specifically, PGE2 levels in the treatment group decreased from 123.45 ± 15.93 pg/mL at baseline to 69.79 ± 16.44 pg/mL after treatment, while β‐EP levels increased from 4.38 ± 1.09 ng/mL to 7.74 ± 1.12 ng/mL. The total effective rate was 93.33% in the observation group and 83.33% in the control group, with a between‐group difference of 10.00%; however, this difference was not statistically significant (P = 0.424). No serious adverse events occurred. CONCLUSION: Large‐area cupping therapy demonstrates promising short‐term clinical efficacy in relieving pain and modulating inflammatory mediators in cold‐damp type LDH. While safe and well‐tolerated, further studies with long‐term follow‐up are required to establish the durability of these effects.