Abstract： Objective： To observe the clinical effect of the therapy of Tianma Gouteng Decoction combined with Ziprasidone on schizophrenia. Methods：A total of 80 patients with first-episode schizophrenia were divided into the control group and the observation group according to the random number table method，with 40 cases in each group. The control group was treated with Ziprasidone，and the observation group was treated with Tianma Gouteng Decoction combined with Ziprasidone. Before and after treatment， the Montreal Cognitive Assessment (MoCA) scores， Positive and Negative Syndrome Scale (PANSS)， Schizophrenia Quality of Life Scale (SQLS) scores，prospective memory test and indexes of inflammatory factors，including tumor necrosis factor-α (TNF-α)，interleukin-6 (IL-6) and interleukin-10 (IL-10)，were compared between the two groups. The clinical effects and incidence of adverse reactions in the two groups were evaluated in the two groups. Results：The total effective rate in the observation group was higher than that in the control group，the difference being significant (P＜0.05). After treatment，the scores of PANSS and SQLS，including aspects of psychosocial，motivation and energy，symptoms，and side effects in the two groups were lower than those before treatment (P＜0.05)， and the scores of MoCA， time- based prospective memory and event- based prospective memory were higher than those before treatment (P＜ 0.05)；the scores of PANSS and SQLS in the observation group were lower than those in the control group， and the scores of MoCA， time- based prospective memory and event- based prospective memory were higher than those in the control group (P＜0.05). After treatment，the levels of TNF-α，IL-6 and IL-10 in the two groups were lower than those before treatment (P＜0.05)，and the above indexes of inflammatory factors were lower than those in the control group (P＜0.05). There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups (P＞0.05). Conclusion：The therapy of Tianma Gouteng Decoction combined with Ziprasidone has a definite curative effect on schizophrenia， which can improve cognitive function and memory function， reduce the inflammatory responses，and enhance the quality of life of patients，with high safety.