Abstract： Objective： To observe the clinical effect of Qingre Sanjie pills combined with western medicine for acute severe pneumonia. Methods：A total of 74 cases of patients with acute severe pneumonia of phlegm-heat obstructing the lung type were randomly divided into the control group and the observation group，37 cases in each group. Both groups were treated with routine western medicine， and the observation group was additionally treated with Qingre Sanjie pills. Both groups were continuously treated for 12 days. Before treatment and after 12-day treatment，in the two groups，syndrome and sign scores were evaluated. Before treatment and after 12- day treatment，the levels of T lymphocyte subsets，and inflammatory factors in serum including interleukin-4(IL-4)，interleukin-8(IL-8)，and tumor necrosis factor-α(TNF-α) in the two groups were evaluated. The curative effect and the incidence of adverse reactions were compared between the two groups. Results：After treatment，the total effective rate was 94.59% in the observation group，and 78.38% in the control group，the difference being significant(P＜0.05). The syndrome and sign scores of cough，expectoration，fever，asthma， and lung rales in the two groups were decreased when compared with those before treatment(P＜0.05)，and the five scores in the observation group were lower than those in the control group(P＜0.05). The levels of IL-4，IL-8 and TNF-α in the two groups were decreased when compared with those before treatment，and the three indexes above in the observation group were lower than those in the control group，differences being significant(P＜0.05). The levels of CD3 +，CD4 +，and CD4 +/ CD8+ ratio in the two groups were increased when compared with those before treatment，and the three indexes above in the observation group were higher than those in the control group，differences being significant(P＜0.05). Conclusion：In the treatment of patients with acute severe pneumonia of phlegm- heat obstructing the lung type， the application of Qingre Sanjie pills combined with western medicine can effectively improve clinical symptoms，enhance curative effect and body immune function，relieve inflammatory response，and with higher safety.