Abstract：Objective：To observe the clinical effect of Yangxue Qingnao Pills combined with Gabapentin for migraine and its effect on 5- hydroxytryptamine(5- HT) in serum. Methods： A total of 124 cases with migraine were divided into two groups according to the random number table，with 62 cases in each group. The control group was treated with Gabapentin， and the treatment group was treated with Yangxue Qingnao Pills combined with Gabapentin. Before and after treatment，the duration and onset frequency of headache，the scores of Visual Analogue Scale(VAS)，Migraine Specific Quality of Life Questionnaire(MSQ) and traditional Chinese medicine(TCM) syndromes， and the levels of 5- HT， endothelin- 1(ET- 1) and calcitonin gene-related peptide(CGRP) in serum were compared among two groups. The clinical effects and safety in two groups were evaluated. Results：The effective rate was 96.77% in treatment group，higher than that of 82.26% in control group(P＜0.05). After treatment， the duration and onset frequency of headache， VAS scores， TCM syndrome scores， levels of 5- HT， ET- 1 and CGRP in serum in the two groups were decreased(P＜0.05) when compared with those before treatment，and the MSQ scores were increased(P＜0.05)； the improvement of the above indexes in treatment group was better than that in control group(P＜0.05). The comparison of side reactions between the two groups was no significant difference(P＞0.05). Conclusion： Yangxue Qingnao Pills combined with Gabapentin has a definite clinical effect in treating migraine， and can effectively relieve the symptom of migraine， reduce inflammatory responses，and improve quality of life with higher safety.