Abstract：Objective：To observe the curative effect of modified Bawei Jieyu Decoction combined with Escitalopram for mild and moderate depression with liver constraint and spleen deficiency syndrome and its effects on adenosine triphosphate (ATP)， adenosine diphosphate (ADP)， and adenosine monophosphate (AMP). Methods：A total of 104 cases of patients with mild and moderate depression with liver constraint and spleen deficiency syndrome were selected and divided into the observation group and the control group according to the random number table method，with 52 cases in each group. The control group was treated with Escitalopram，and the observation group was treated with modified Bawei Jieyu Decoction combined with Escitalopram. Clinical effects were compared between the two groups. Traditional Chinese medicine (TCM) syndrome scores，scores of 24-item Hamilton Depression Rating Scale (HAMD-24)，and levels of ATP， ADP， and AMP were compared before and after treatment between the two groups. Results：After treatment，the total effective rate was 94.23% in the observation group，higher than that of 80.77% in the control group (P＜0.05). After treatment，the TCM syndrome scores of rib- side distension and pain，depressive emotion，abdominal distension，and loose stool in the two groups were decreased (P＜0.05)，and the scores in the observation group were lower than those in the control group (P＜0.05). After treatment，HAMD-24 scores in the two groups were decreased (P＜0.05)，and HAMD-24 scores in the observation group were lower than those in the control group (P＜0.05). After treatment，AMP level in the control group was increased (P＜0.05)， ATP level in the observation group was increased (P＜0.05)， and the levels of AMP and ADP in the observation group were lower than those in the control group (P＜ 0.05)， and ATP level in the observation group was higher than that in the control group (P＜0.05). Conclusion：Modified Bawei Jieyu Decoction combined with Escitalopram has good curative effects in the treatment of patients with mild and moderate depression with liver constraint and spleen deficiency syndrome and can help improve depression symptoms and effectively increase the level of ATP.