Objective:To evaluate the efficacy of Qingqi Huatan Decoction combined with conventional western medicine therapy in the treatment of severe pneumonia with phlegm-heat obstructing the lung syndrome.Methods:A total of 84 patients with severe pneumonia with phlegm-heat obstructing lung syndrome admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from February 2018 to June 2020 were randomly divided into two groups, 42 in each group. The control group was treated with bronchoalveolar lavage (BAL) on the basis of routine treatment, and the combined group was treated with Qingqi Huatan Decoction on the basis of the control group. Both groups were treated for 7 days. The Clinical Pulmonary Infection Score (CPIS) was used to evaluate the degree of pulmonary infection, and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate the severity of the disease. The Serum CRP and IL-6 levels were detected by ELISA, and procalcitonin (PCT) levels were detected by electrochemiluminescence method to evaluate clinical efficacy.Results:The total effective rate was 88.1% (37/42) in the combined group and 69.0% (29/42) in the control group, with a statistically significant difference between the two groups ( χ2=4.53, P=0.033). After treatment, the CPIS (2.19±0.42 vs. 3.66±0.69, t=11.79) and APACHE Ⅱ (9.84±1.31 vs. 11.25±3.22, t=2.63) in the combination group were significantly lower than those in the control group. The serum CRP, PCT, and IL-6 levels in the combination group were significantly lower than those in the control group ( t=30.32, 8.59, 6.08, all Ps<0.001). During the treatment period, there was no obvious abnormality of liver and kidney function in both groups. Conclusion:Qingqi Huatan Decoction combined with conventional western medicine therapy can reduce the degree of pulmonary infection in patients with severe pneumonia with phlegm-heat obstructing the lung syndrome, reduce the level of inflammatory cytokines, and improve clinical efficacy.