Abstract：Objective：To observe the curative effect of the method of cultivating the vital essence and unblocking the bowels combined with western medicine on ischemic stroke and its effects on atherosclerosis. Methods：A total of 98 cases of patients with ischemic stroke of phlegm-heat and bowel excess type were selected and divided into the combination group and the control group according to the random number table method， with 49 cases in each group. The control group was treated with Atorvastatin Calcium Tablets and Aspirin Enteric- Coated Tablets， the combination group was additionally treated with the method of cultivating the vital essence and unblocking the bowels (Huatan Tongfu Decoction combined with acupuncture with the method of cultivating the vital essence and unblocking the bowels) based on the treatment of the control group. Both groups were continuously treated for 4 weeks. Clinical effects and the incidence of adverse reactions were observed in the two groups. Changes in traditional Chinese medicine (TCM) syndrome scores， neurological function [National Institutes of Health Stroke Scale (NIHSS)]， activity of daily living (Barthel Index)， and plaque parameters [plaque area， total plaque score，and carotid intima- media thickness (IMT)] were compared between the two groups before and after treatment. Results： The total clinical effective rate was 91.84% in the combination group and 75.51% in the control group，the difference being significant (P＜0.05). After treatment，TCM syndrome scores including sluggish speech，facial palsy，half-body numbness，hemiplegia，and profuse and sticky sputum in the two groups were decreased when compared with those before treatment (P＜0.05)，and the above five scores in the combination group were lower than those in the control group (P＜0.05). After treatment，NIHSS scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and Barthel Indexes were increased when compared with those before treatment (P＜0.05)； NIHSS score in the combination group was lower than that in the control group (P＜0.05)，and Barthel Index in the combination group was higher than that in the control group (P＜0.05). After treatment，plaque area， total plaque scores， and IMT in the two groups were decreased when compared with those before treatment (P＜0.05)，and the above three indexes in the combination group were lower than those in the control group (P＜0.05). The incidence of adverse reactions was 8.16% in the control group and 10.20% in the combination group，no significant difference being found in the comparison (P＞0.05). Conclusion：The method of cultivating the vital essence and unblocking the bowels combined with western medicine has good effects and safety in the treatment of ischemic stroke of phlegm-heat and bowel excess type，which can further improve neural function and activities of daily living and reduce carotid plaque.