OBJECTIVE: To probe into the efficacy and safety of five anti-tuberculosis combinations with traditional Chinese medicine on conservative treatment of spinal tuberculosis without kyphosis. METHODS: Totally 86 patients with spinal tuberculosis without kyphosis undergoing conservative treatment in the hospital from Jan. 2018 to Feb. 2020 were extracted to be divided into the five-combination group and the traditional Chinese medicine combined group via the simple randomization method

with 43 cases in each group. The five-combination group was given HRZE quadruple preparation combined with streptomycin in the intensive stage

and HRZE quadruple preparation orally in the consolidation stage. Patients in the traditional Chinese medicine combined group were treated with the same anti-tuberculosis treatment during the intensive and consolidation periods as in the five-combination group

and traditional Chinese medicine therapy was selected according to the duration of the disease and symptoms of the patients

such as Yanghe decoction

Buyang Huanwu decoction or Jiawei Qinggu powder for one dose daily. Visual analog scale（VAS）

erythrocyte sedimentation rate（ESR） and C-reactive protein（CRP） levels were assessed before treatment

at the end of intensive stage and drug withdrawal. Patients’ quality of life was evaluated by SF-36 before treatment and at drug withdrawal

changes of Cobb before and after treatment were compared. The surgery rate

recurrence rate

treatment duration and adverse drug reactions were compared between two groups. RESULTS: At the end of intensive stage and drug withdrawal

the VAS score

ESR and CRP levels in two groups were lower than those before treatment

VAS score and CRP levels at the end of intensive stage in the traditional Chinese medicine combined group were lower than those in the five-combination group

with statistically significant differences（P<0.05）. The treatment duration of traditional Chinese medicine combined group was（10.23±0.74） months

shorter than（11.47±0.62） months of the five-combination group; the surgery rate of patients in the traditional Chinese medicine combined group was 2.33%（1/43）

lower than 13.95%（6/43） in the five-combination group

with statistically significant differences（P<0.05）. The recurrence rates of the five-combination group and the traditional Chinese medicine combined group were respectively 2.33%（1/43） and 4.65%（2/43）

with no statistical significance（P>0.05）. After treatment

the SF-36 score of two groups was higher than that before treatment

yet there was no significant difference between two groups（P>0.05）. There was no statistically significant difference in Cobb between two groups before and after treatment（P>0.05）. The incidences of adverse drug reactions of the five-combination group and the traditional Chinese medicine combined group were respectively 16.28%（7/43） and 13.95%（6/43）

with no statistically significant difference（P>0.05）. CONCLUSIONS: For patients with conservative treatment

the combination of traditional Chinese medicine and five anti-tuberculosis combinations can quickly control the pain symptoms of patients with spinal tuberculosis without kyphosis

reduce the surgery rate and recurrence rate

improve the quality of life

and shorten the treatment duration.