Objective:To explore the therapeutic effect of Taohong Siwu decoction combined with tranexamic acid in the treatment of chloasma, and its influence on the level of sex hormone and oxidative stress parameters.Methods:From January 2017 to December 2019, 96 cases with chloasma in Yiwu Hospital of Traditional Chinese Medicine were selected and divided into observation group (48 cases) and control group (48 cases) according to the random digital table method.The control group was given tranexamic acid.The observation group was given Taohong Siwu decoction on the basis of the control group.The course of treatment in both two groups was 12 weeks.The therapeutic effect, melasma area and severity index (MASI) score, sex hormone and oxidative stress level before and after treatment, and the adverse reactions were compared between the two groups.Results:The total effective rate of the observation group (91.67%) was higher than that of the control group (68.75%) (χ 2=7.940, P<0.05). The MASI score of the observation group[(8.64±1.27)points] was lower than that of the control group[(17.93±2.53)points] ( t=22.736, P<0.05). The serum levels of E 2 [(19.83±4.21)ng/L], LH [(3.79±0.68)mU/L] and FSH [(5.23±1.76)mU/L] in the observation group were lower than those in the control group [(43.79±4.69)ng/L, (5.81±1.07)mU/L and (10.64±2.60)mU/L] ( t=26.339, 11.039, 11.938, all P<0.05). The MDA of the observation group [(3.67±0.40)μmol/L] was lower than that of the control group [(4.52±0.32)μmol/L], while the SOD of the observation group[(78.84±5.67)IU/L] was higher than that of the control group[(60.65±5.29)IU/L], the differences were statistically significant( t=11.496, 16.252, all P<0.05). Conclusion:Taohong Siwu decoction combined with tranexamic acid has good effect on chloasma patients.It can improve the level of sexual hormone and oxidative stress, and has no obvious adverse reactions.