Abstract： Lumbar disc herniation （LDH） is a common clinical degenerative spinal disorder. Based on the academic thought of "internal damage to the spleen and stomach gives rise to numerous diseases， " this article systematically elucidates the pathogenic evolution of LDH： spleen-stomach deficiency， insufficiency of qi and blood source， and failure to nourish the muscles serve as the onset of the disease； disharmony of qi and blood， impaired distribution of body fluids，and imbalance of sinews and bones represent the progression of the disease；accumulation of fluid and phlegm， stasis and collateral obstruction， and injury to bones and sinews constitute the deep-seated pathological state. Accordingly， a treatment strategy of "stage-based therapy with synergistic internal and external methods" is proposed： internally， the regulation of the middle energizer and unblocking of collaterals serve as the guiding principle；for spleen-stomach deficiency with qi and blood depletion，formulas for supplementing the middle energizer and benefiting qi，and nourishing blood and relaxing sinews are applied；for fluid accumulation with phlegm formation and stasis with collateral obstruction，formulas for fortifying the spleen，resolving phlegm，dispelling stasis，and unblocking collaterals are applied. Externally， simultaneous regulation of the abdomen and back is emphasized， using abdominal tuina and acupuncture to "draw yang from yin" and restore sinew-bone balance. Daoyin （ancient deep breathing exercises） and core rehabilitation training are integrated throughout the treatment. The synergy of these three approaches achieves the effect of "nourishing the spleen and stomach internally while harmonizing sinews and bones externally，" providing a theoretical reference for the prevention and treatment of LDH in traditional Chinese medicine clinical practice.