Abstract： Objective： To observe the clinical effect of Jiehe Pills combined with routine western medicine on drug-resistant tuberculosis of yin deficiency resulting in vigorous fire and its effect on the expressions of micro ribonucleic acid-30a-5p (miR-30a-5p) and micro ribonucleic acid-431 (miR-431). Methods： A total of 98 cases of patients with drug-resistant tuberculosis of yin deficiency resulting in vigorous fire were divided into the treatment group and the control group according to the random number table method，with 49 cases in each group. The control group was treated with routine western medicine， and the treatment group was treated with Jiehe Pills combined with routine western medicine. Both groups were treated for 6 months. Traditional Chinese medicine (TCM) syndrome scores and the levels of T cell subsets， inflammatory factors [interleukin-4 (IL-4)， C-reactive protein (CRP)， interferon- γ (INF- γ)]， miR-30a-5p， and miR-431 were compared before and after treatment between the two groups； the clinical effects and the incidence of adverse reactions in the two groups were evaluated. Results： After treatment， the total effective rate was 97.96% in the treatment group and 85.71% in the control group， the difference being significant (P＜0.05). After treatment，the levels of miR-30a-5p，CD3+，CD4+，INF-γ and CD4+/CD8+ in the two groups were increased when compared with those before treatment， and the TCM syndrome scores and the levels of CD8+，miR-431，IL-4 and CRP were decreased (P＜0.05). After treatment，the levels of miR-30a-5p，CD3+，CD4+ and INF- γ in serum and CD4+/CD8+ in the treatment group were higher than those in the control group (P＜0.05)，and the TCM syndrome scores and the levels of CD8+，miR-431，IL-4 and CRP in the treatment group 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： Jiehe Pills combined with routine western medicine has a significant curative effect in the treatment of drug-resistant tuberculosis of yin deficiency resulting in vigorous fire type， which can regulate the levels of miR-30a-5p and miR-431， improve immune function and reduce inflammatory responses，with high safety.