Abstract： Objective： On the basis of Clozapine treatment， to observe the efficacy of Yangxin Decoction combined with acupuncture based on syndrome differentiation in the treatment of schizophrenia with auditory hallucinations and its effects on serum inflammatory factor levels. Methods ： A total of 82 cases of patients with schizophrenia with auditory hallucinations were selected and divided into the control group and the observation group according to the random number table method，with 41 cases in each group. The control group was treated with Clozapine， and the observation group was additionally treated with Yangxin Decoction combined with acupuncture based on syndrome differentiation on top of the control group's treatment. Both groups were treated for 12 weeks. The changes in scores of Positive and Negative Syndrome Scale (PANSS)， Auditory Hallucination Rating Scale (AHRS)， Traditional Chinese Medicine Emotional Questionnaire (TCMEQ)， and Schizophrenia Quality of Life Scale (SQLS)， as well as inflammatory factor levels [tumor necrosis factor-α (TNF-α)，interleukin-1β (IL-1β)，interleukin-2 (IL-2)] were observed in both groups. Results： After treatment， the scores of AHRS and PANSS in the observation group were decreased when compared with those before treatment (P＜0.05)，and the scores in the observation group were lower than those in the control group (P＜0.05). After treatment， the main and secondary symptom scores of the TCMEQ in the observation group were lower than those before treatment and those in the control group (P＜0.05)； there was no significant difference in the main and secondary symptom scores of the TCMEQ in the control group before and after treatment (P＞0.05). After treatment， the symptom and side effects， psychosocial scores， and total scores of the SQLS in both groups were reduced when compared with those before treatment (P＜0.05)，and all the above scores in the observation group were lower than those in the control group (P＜0.05)； there was no significant difference in the motivation and energy scores of the SQLS in both groups before and after treatment (P＞ 0.05). After treatment， the levels of TNF- α and IL-1β in serum in the two groups were declined when compared with those before treatment (P＜0.05)，and the IL-2 levels were elevated when compared with those before treatment (P＜0.05)；the levels of TNF-α and IL-1β in the observation group were lower than those in the control group (P＜0.05)，and the IL-2 level was higher than that in the control group (P＜0.05). The incidence of adverse reactions in the observation group was 4.88%，and that in the control group was 19.51%；the difference between the two groups was significant (P＜0.05). Conclusion：For patients with schizophrenia with auditory hallucination， the additional treatment of Yangxin Decoction and acupuncture based on Clozapine can help improve symptoms，enhance quality of life，and effectively inhibit the body's inflammatory responses，with good treatment safety.