Seventy patients with knee osteoarthritis were randomized to receive Tui-na manipulation plus oral Du-Huo-Ji-Sheng Decoction (n=35) or Tui-na alone (n=35). The primary outcome was change in WOMAC score at 4 weeks. Secondary outcomes included WOMAC subscales (pain, stiffness, physical function) and EQ-5D-5L quality-of-life scores at 2, 4, and 8 weeks. Follow-up lasted 8 weeks. Overall, both groups improved significantly over time, but the add-on herbal therapy produced greater improvements in WOMAC pain at week 8 (p=0.048), stiffness at weeks 2 and 8 (p=0.035 and p=0.008), and EQ-5D index at week 2 (p=0.022). The treatment was safe and well tolerated. These findings suggest that combining Tui-na with Du-Huo-Ji-Sheng Decoction may offer additional long-term benefits for pain and stiffness beyond Tui-na alone.