Abstract：Objective：To observe the clinical effect of Chinese medicine hot compress combined with extracorporeal shock wave on knee osteoarthritis with cold-damp bi obstruction syndrome. Methods： A total of 132 cases of patients with knee osteoarthritis with cold-damp bi obstruction syndrome were selected and divided into the control group and the trial group using a random number table method，with 66 cases in each group. The control group received extracorporeal shock wave therapy，and the trial group received Chinese medicine hot compress combined with extracorporeal shock wave therapy. Both groups were treated for four weeks. Compared the clinical efficacy， Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores，Lysholm Knee Score (LKS)，and levels of bradykinin (BK)，prostaglandin E2 (PGE2) and 5-hydroxytryptamine (5-HT) in serum between the two groups. Results：After treatment， the total effective rate was 92.06% in the trial group，which was higher than that of 77.78% in the control group (P＜0.05). The WOMAC scores in both groups were decreased when compared with those before treatment (P＜0.05)，and the LKS scores were increased when compared with those before treatment (P＜ 0.05)；the WOMAC score in the trial group was lower than that in the control group (P＜0.05)，and the LKS score was higher than that in the control group (P＜0.05). The levels of serum BK，PGE2，and 5-HT in both groups were decreased when compared with those before treatment (P＜0.05)， and the levels of serum BK，PGE2，and 5-HT in the trial group were lower than those in the control group (P＜0.05). Conclusion： The combination of Chinese medicine hot compress and extracorporeal shock wave therapy is more effective in treating knee osteoarthritis with cold-damp bi obstruction syndrome than using extracorporeal shock wave therapy alone，which can improve the condition of disease and further reduce the level of pain mediators.