Abstract：Objective：To observe the clinical effect of Huotan Kaiqiao Decoction combined with warm needling on vascular dementia (VD) of phlegm turbidity obstructing the orifices type. Methods： A total of 86 cases of VD patients of phlegm turbidity obstructing the orifices type were selected and divided into the control group and the combination group according to different treatment methods，with 43 cases in each group， and 3 cases dropped out in each group. The control group was treated with routine western medicine， and the combination group was additionally treated with Huotan Kaiqiao Decoction combined with warm needling based on the treatment of the control group. Both groups were continuously treated for 3 months. Clinical effects were evaluated in the two groups. Traditional Chinese medicine syndrome scores，the scores of cognitive function and activities of daily living，and serum indicators were compared between the two groups before and after treatment. Results：The total effective rate was 90.00% in the combination group，higher than that of 70.00% in the control group (P＜0.05). After treatment，the scores of main symptoms and secondary symptoms in the two groups were decreased when compared with those before treatment (P＜0.05)， and the scores of main symptoms and secondary symptoms in the combination group were lower than those in the control group (P＜0.05). After treatment， the scores of cognitive function and activities of daily living in the two groups were increased when compared with those before treatment (P＜0.05)，and the above scores in the combination group were higher than those in the control group (P＜0.05). After treatment，the levels of interleukin- 18 (IL- 18)，homocysteine (Hcy)，and vascular endothelial growth factor (VEGF) in serum in the two groups were decreased when compared with those before treatment，and the above three levels in the combination group were lower than those in the control group (P＜0.05). The levels of brain derived neurotrophic factor (BDNF) in serum in the two groups were increased when compared with those before treatment，and the level in the combination group was higher than that in the control group (P＜0.05). Conclusion： For VD of phlegm turbidity obstructing the orifices type， Huotan Kaiqiao Decoction combined with warm needling can improve clinical symptoms， cognitive function，and activities of daily living，reduce inflammatory reactions，and promote the recovery of neurological function.