Abstract： Objective： To observe the clinical effects of modified Gualou Qumai Prescription combined with Dienogest Tablets in the treatment of adenomyosis （AM） of phlegm damp stasis type. Methods：A total of 86 cases of patients who had AM of phlegm damp stasis type and received treatment at the Zhengzhou Second People's Hospital from August 2021 to February 2024 were selected and divided into the control group and the study group，using a random number table method，with 43 patients in each group. The control group was treated with Dienogest Tablets，and the study group was treated with modified Gualou Qumai Prescription combined with Dienogest Tablets. Both groups were treated for six menstrual cycles. The clinical effects， Visual Analogue Scale （VAS） scores， Pictorial Blood Loss Assessment Chart （PBAC） scores， uterine volume， endometrial thickness， sex hormones [estradiol（E2）， folliclestimulating hormone （FSH）， and luteinizing hormone （LH）]， angiogenic factors [prostaglandin F2α （PGF2α）， angiopoietin-2 （Ang-2） ， and vascular endothelial growth factor （VEGF）]， oxidative stress indicators [malondialdehyde （MDA）， silencing signal regulatory protein 6 （Sirt6）， and superoxide dismutase （SOD）]， and incidence of adverse reactions were compared between the two groups. Results：After treatment，the total effective rate in the study group was 83.72% （36/43），which was higher than that of 65.12% （28/43） in the control group，with the difference being significant （P＜0.05）. The VAS and PBAC scores in the two groups were decreased，uterine volume decreased，and endometrial thickness were declined when compared with those before treatment，with significance in differences （P＜0.05）；when compared with those in the control group，the VAS and PBAC scores in the observation group were lower，the uterine volume was smaller，and the endometrial thickness was thinner，with differences being significant （P＜0.05）. The levels of LH， FSH， PGF2 α， Ang-2， VEGF， and MDA in the two groups were decreased when compared with those before treatment， while the levels of E2， Sirt6， and SOD were increased when compared with those before treatment，with differences being significant（ P＜0.05）；the levels of LH，FSH，PGF2 α， Ang-2，VEGF，and MDA in the study group were lower than those in the control group，while the levels of E2，Sirt6， and SOD were higher than those in the control group， with differences being significant （P＜0.05）. The incidence of adverse reactions was 4.65% （2/43） in the study group and 9.30% （4/43） in the control group，with no significance in the difference（ P＞0.05）. Conclusion：Compared with the simple treatment with only Dienogest Tablets，the modified Gualou Qumai Prescription combined with Dienogest Tablets in the treatment of AM of phlegm damp stasis type can enhance clinical effects， effectively regulate sex hormone levels， reduce oxidative stress responses in the body and endometrium thickness，inhibit angiogenesis，and improve clinical symptoms such as dysmenorrhea，with high safety.