Abstract: This article summarizes Professor Huang Guicheng's clinical experience in the syndrome differentiation and treatment of lumbar spinal stenosis using the theory of "diseases of tendons, bones and collaterals". It is believed that lumbar spinal stenosis belongs to the syndrome of deficiency in the root and excess in the superficiality, and is closely related to the three zang organs of the liver, spleen and kidney. Deficiency of the liver and kidney leading to a lack of the source of qi and blood, insufficiency of the spleen and stomach giving rise to phlegm and blood stasis, and the invasion of wind, cold and dampness pathogens cause the disease. The key to the pathogenesis lies in the obstruction of the collaterals. Taking the principles of "nourishing the collaterals and strengthening the healthy qi, dredging the collaterals and expelling the pathogens" as the therapeutic principles, Professor Huang is proficient in using insect drugs. The medicinal power can directly reach the collaterals, so that the collaterals can be unobstructed and the qi and blood can flow smoothly, achieving the therapeutic effect of expelling the pathogens, unblocking the collaterals and restoring the healthy qi.