Objective To observe the clinical effect of Sancai combined acupuncture on discogenic sciatica. Methods 162 patients with discogenic sciatica admitted to the Department of Rehabilitation Medicine of our hospital from February 2021 to December 2022 were randomly divided into control group， conventional acupuncture group and Sancai acupuncture group. The control group was treated with non-steroidal anti-inflammatory drugs for oral analgesia，the conventional acupuncture group was treated with conventional acupuncture，and the Sancai acupuncture group was treated with combined acupuncture based on Sancai theory， that is， the traditional scalp acupuncture combined with Shanyuan's new scalp acupuncture was used in the sky， the fire needle was used in the ground to rob the root point，and the human body was treated with the movement acupuncture after the press needle was buried. All three groups were intervened for 4 weeks. The pain visual analogue score （VAS）and Oswestry dysfunction index （ODI） were evaluated before，4 weeks after and 2 and 4 weeks after the intervention in the three groups， and the levels of serum substance P （SP）， chemokine ligand 10（CXCL10）， calcitonin related gene peptide （CGRP） were collected before and after the intervention， and the motor conduction velocity （MCV） and sensory conduction velocity （SCV） of the sural nerve were measured. Results There was an interaction between treatment method and time on VAS and ODI （P < 0.05）， and the main effect of treatment method and time on VAS and ODI was significant （P < 0.05）. The VAS and ODI results of the three groups at 4 weeks，2 weeks and 4 weeks after treatment were better than those before treatment， and the difference was statistically significant （P < 0.05）. The VAS score and ODI score of Sancai acupuncture group at the end of 2 and 4 weeks of treatment were lower than those of the other two groups， with significant difference （P < 0.05）； However， after 4 weeks of treatment， the levels of SP， CXCL10 and CGRP in the three groups were lower than those before treatment， and the levels of MCV and SCV were higher than those before treatment， except for CXCL10， MCV and SCV in the control group （P < 0.05）. In comparison between groups， the levels of CXCL10 and CGRP in Sancai acupuncture group were lower than those in the other two groups （P < 0.05）， lower in SP Sancai acupuncture group than those in the control group （P < 0.05）， and there was no difference between the two groups （P > 0.05）. In MCV and SCV， Sancai acupuncture group was higher than those in the other two groups （P < 0.05）. Conclusion Sancai combined acupuncture can effectively intervene the pain and dysfunction of patients， improve many laboratory indicators， and increase nerve conduction velocity， which is worthy of further study.