Abstract： Objective： To observe the clinical effect of Qingre Huatan Huoxue Prescription combined with Azithromycin on mycoplasma pneumoniae pneumonia (MPP) in children with the syndrome of phlegmheat obstructing the lung and its effects on inflammatory factors. Methods：A total of 110 cases of MMP children with the syndrome of phlegm-heat obstructing the lung were divided into the control group and the treatment group according to the random number table method，with 55 cases in each group. The control group was treated with Azithromycin，and the treatment group was additionally treated with Qingre Huatan Huoxue Prescription based on the treatment of the control group. Both groups were continuously treated for 16 days. Traditional Chinese medicine (TCM) syndrome scores， blood gas analysis indicators， and the levels of serum inflammatory factors were compared between the two groups before and after treatment. Clinical effects and the incidence of adverse reactions were evaluated in the two groups. Results： After treatment， the total effective rate was 85.45% in the control group， lower than that of 98.18% in the treatment group (P＜0.05). After treatment，TCM syndrome scores (fever，cough，expectoration) and the levels of tumor necrosis factor-α (TNF-α)，interleukin-6 (IL-6)，and C-reactive protein (CRP) in serum in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels of partial pressure of oxygen in blood (PO2)，partial pressure of carbon dioxide (PCO2)，hemoglobin (Hb)，and blood oxygen saturation (SaO2) were increased (P＜0.05)；TCM syndrome scores and the levels of serum inflammatory factors in the treatment group were lower than those in the control group (P＜0.05)， and blood gas analysis indicators in the treatment group were higher than those in the control group (P＜0.05). The incidence of adverse reactions was 3.64% in the treatment group，lower than that of 18.18% in the control group (P＜0.05). Conclusion：Qingre Huatan Huoxue Prescription combined with Azithromycin has a significant curative effect in the treatment of MPP in children with the syndrome of phlegm- heat obstructing the lung and can improve clinical symptoms and blood gas indicators and reduce inflammatory responses of the body，with high safety.