Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (36): 9462-9468.doi: 10.12307/2026.901

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Shaoyao Gancao Decoction combined with shock wave therapy for treating gluteus medius syndrome: a randomized controlled trial on structural improvement of the tendon

Shi Tengbo1, 2, Zhang Mengyu3, Wang Xingfei1, 2, Fu Zhuo2, Li Chenyang2, 4, Meng Xiangxi1, 2, Liu Hao1, 2, Guo Chaowei2, He Zike1, 5, #br# Tang Yanfeng2#br#   

  1. 1School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; 2Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China; 3The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China; 4Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China; 5Joint Department, Henan Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • Received:2025-10-15 Revised:2026-03-10 Online:2026-12-28 Published:2026-05-21
  • Contact: Tang Yanfeng, MS, Associate professor, Master’s supervisor, Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China Co-corresponding author: He Zike, MS, Associate professor, Master’s supervisor, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Joint Department, Henan Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • About author:Shi Tengbo, MS candidate, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China Zhang Mengyu, PhD candidate, The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China Shi Tengbo and Zhang Mengyu contributed equally to this work.
  • Supported by:
    Special Project of Traditional Chinese Medicine Research in Henan Province, No. 2025ZY1021 (to TYF); Special Project of Top TCM Talents Training Project of Henan Province, No. 2022ZYBJ22 (to TYF); Special Key Project of TCM Scientific Research of Henan Province, No. 20-21ZY1061 (to TYF)

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Abstract: BACKGROUND: Gluteus medius syndrome is a chronic painful disorder characterized by tendon degeneration, aseptic inflammation, or myofascial injury of the gluteus medius muscle. Current Western treatments primarily include extracorporeal shock wave therapy and nonsteroidal anti-inflammatory drugs, but long-term efficacy remains limited. Shaoyao Gancao Decoction, a classical formula, is known for its blood-activating and pain-relieving effects. However, the clinical efficacy of its combination with extracorporeal shock wave remains unclear.
OBJECTIVE: To evaluate the clinical efficacy of Shaoyao Gancao Decoction combined with extracorporeal shock wave therapy in treating gluteus medius syndrome (qi stagnation and blood stasis syndrome) and assess its synergistic effects on pain relief, functional recovery, and inflammation modulation.
METHODS: A prospective randomized controlled trial was conducted, enrolling 165 patients with gluteus medius syndrome meeting both Western and traditional Chinese medicine diagnostic criteria. Participants were randomly divided into three groups: the extracorporeal shock wave therapy group (extracorporeal shock wave therapy alone, every 3 days for a total of 4 consecutive sessions), the Shaoyao Gancao Decoction group (Shaoyao Gancao Decoction alone, once daily for 15 days), and the combination group (Shaoyao Gancao Decoction + extracorporeal shock wave therapy), with 55 patients in each group. Patients’ visual analog scores, Harris hip scores, and ultrasound echo intensity were compared before and after treatment. Serum levels of inflammatory cytokines (prostaglandin E2, substance P, interleukin-6, tumor necrosis factor-α) were also detected to evaluate the efficacy and adverse reactions of traditional Chinese medicine.
RESULTS AND CONCLUSION: (1) The combination group exhibited significantly lower visual analog scale scores at 3 day, 1 week, and 3 months after treatment compared with monotherapy groups (P < 0.05). At 3 months post-treatment, the Harris Hip Score in the combination group (86.4) surpassed those of the extracorporeal shock wave therapy group (79.6) and the Shaoyao Gancao Decoction group (76.8). (2) The repair of gluteus medius tendon structure in the combination group was more significant, and the echo intensity was 112.6, which was better than that of the extracorporeal shock wave therapy group (138.7) and the Shaoyao Gancao Decoction group (158.4). (3) Inflammatory markers (prostaglandin E2, substance P, interleukin-6, tumor necrosis factor-α) decreased more markedly in the combination group (P < 0.05). (4) The total effective rate was 80% in the combination group, significantly higher than that in the extracorporeal shock wave therapy group (64%) and the Shaoyao Gancao Decoction group (59.2%), with a lower incidence of adverse events. To conclude, the combination of Shaoyao Gancao Decoction and extracorporeal shock wave therapy synergistically alleviates pain, promotes functional recovery, and suppresses inflammatory responses in gluteus medius syndrome, demonstrating superior efficacy to monotherapies with a favorable safety profile.

Key words: Shaoyao Gancao Decoction, extracorporeal shock wave therapy, gluteus medius syndrome, inflammation, qi stagnation and blood stasis syndrome

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