Abstract： Objective： To observe the clinical effect of Huazhuo Tongluo Dingxuan Decoction combined with western medicine on vertigo of phlegm and blood stasis obstructing orifices type. Methods： A total of 80 cases of patients with vertigo of phlegm and blood stasis obstructing orifices type，treated in People's Hospital of Wuxing District of Huzhou/Huzhou Maternity & Child Health Care Hospital from June 2020 to June 2023， were selected and divided into the treatment group and the control group according to the random number table method， with 40 cases in each group. The control group was treated with Betahistine and Promethazine Hydrochloride， and the treatment group was additionally treated with Huazhuo Tongluo Dingxuan Decoction based on the treatment of the control group. Both groups were treated for 14 days. The traditional Chinese medicine （TCM） syndrome scores， Dizziness Assessment Rating Scale （DARS） scores， cerebral （basilar， left vertebral， right vertebral） artery blood flow velocity， erythrocyte aggregation index，whole blood high-shear viscosity，plasma viscosity，endothelin-1 （ET-1），and calcitonin gene- related peptide （CGRP） levels in the two groups were compared before and after treatment. Clinical effects and adverse reactions in the two groups were also evaluated. Results：After treatment，the total effective rate was 95.00% （38/40） in the treatment group， higher than that of 77.50% （31/40） in the control group， with a significant difference （P＜ 0.05）. After treatment，both groups showed increased cerebral artery blood flow velocity （basilar，left vertebral，right vertebral） and CGRP levels compared to before treatment （P＜0.05）， and DARS scores， TCM syndrome scores， erythrocyte aggregation indexes， whole blood high-shear viscosity， plasma viscosity， and ET-1 levels were decreased （P＜0.05）. The treatment group had higher cerebral artery blood flow velocity and CGRP level than the control group （P＜0.05），and lower DARS score，TCM syndrome score，erythrocyte aggregation index，whole blood high-shear viscosity， plasma viscosity， and ET-1 level than the control group （P＜0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Huazhuo Tongluo Dingxuan Decoction combined with western medicine for vertigo of phlegm and blood stasis obstructing orifices type can improve cerebral blood flow velocity，alleviate hypercoagulable states，and reduce vertigo symptoms，with significant clinical effects and high safety.