Objective To observe the clinical efficacy ofZhibai Dihuang Decoction combined with endocrine therapy for kidney-yin deficiency type of advanced prostate cancer and its influence on patient symptoms of hot flashes.Methods Totally 72 cases of advanced prostate cancer patients were randomly divided into the combined group (36 cases) and the control group (36 cases). Patients in the control group were treated with endocrine therapy, while patients in the combined group were additionally treated byZhibai Dihuang Decoction. After 12 weeks of treatment, serum prostate specific antigen (PSA), the international prostate symptom score (I-PSS), the clinical symptoms score, the number of cases of hot flashes and safety index before and after treatment were observed. Results In the course of treatment, the control group and the combined group each had 1 case lost to follow up. PSA and I-PSS in the two groups significantly decreased after treatment (P<0.01). The total efficiency rate of TCM syndrome was 94.3% (33/35) in the combined group, while it was 57.1% (20/35) in the control group, with significant difference (P<0.01). After treatment, the incidence of hot flushes was reduced after treatment in the combined group, but the control group increased, with significant difference (P<0.01). No adverse reaction was found in the two groups.ConclusionZhibai Dihuang Decoction combined with endocrine therapy is more effective than endocrine therapy alone, which can reduce the symptoms of hot flashes.