Abstract： Objective： To observe the clinical effect of modified Wenxin Tongmai Prescription combined with western medicine in treating unstable angina pectoris with the heart-kidney yin deficiency syndrome. Methods：A total of 86 patients with unstable angina pectoris with heart-kidney yin deficiency syndrome treated at the Luoyang Branch of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine/Luoyang Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were selected and divided into the western medicine group and the study group according to the random number table method， with 43 patients in each group. The western medicine group received western medicine treatment，while the study group was treated with the modified Wenxin Tongmai Prescription combined with western medicine. Both groups received continuous treatment for four weeks. Clinical effects，traditional Chinese medicine （TCM） syndrome scores，Seattle Angina Questionnaire （SAQ） scores，duration of angina，number of angina attacks，cardiac output，left ventricular ejection fraction，cardiac indexes，as well as the levels of Notch1， Rho kinase 1 （ROCK1）， endothelial cell-specific molecule-1 （ESM-1）， endothelial microparticles， monocyte chemoattractant protein-1 （MCP-1）， high-sensitivity C-reactive protein （hs-CRP）， and lipoprotein-associated phospholipase A2 （Lp-PLA2） were compared between the two groups. Results： After four weeks of treatment， the total effective rate in the study group was 97.67%（ 42/43），which was higher than that in the western medicine group at 81.40% （35/43） （P＜0.05）. The scores for chest pain， chest tightness， palpitations， soreness and weakness of the waist and knees，and insomnia in the two groups were declined when compared with those before treatment （P＜0.05）； the above five TCM syndrome scores in the study group were lower than those in the western medicine group （P＜0.05）. Both groups showed an increase in SAQ scores when compared with those before treatment （P＜0.05），with the study group having a higher SAQ score than the western medicine group （P＜0.05）. The number of angina attacks in the two groups were decreased when compared with those before treatment （P＜0.05），and the number of angina attacks in the study group was less than that in the western medicine group （P＜0.05）. The duration of angina pectoris in the two groups was shortened when compared with those before treatment （P＜0.05），and the duration of angina pectoris in the study group was shorter than that in the western medicine group （P＜0.05）. Both groups showed an increase in cardiac output，left ventricular ejection fraction，and cardiac indexes when compared with those before treatment （P＜0.05）； the cardiac output，left ventricular ejection fraction，and cardiac index in the study group were higher than those in the western medicine group （P＜0.05）. The levels of Notch1， ROCK1， ESM-1， endothelial microparticles， MCP-1， hs-CRP，and Lp-PLA2 in the two groups were decreased when compared with those before treatment （P＜0.05）；the levels of Notch1， ROCK1， ESM-1， endothelial microparticles， MCP-1， hs-CRP， and Lp-PLA2 in the study group were lower than those in the western medicine group （P＜0.05）. Conclusion： The combination of modified Wenxin Tongmai Prescription and western medicine can improve heart function and vascular endothelial function， inhibit inflammatory reactions，alleviate the disease condition，and enhance quality of life in the treatment of unstable angina pectoris with heart-kidney yin deficiency syndrome.