Abstract： Objective： To observe the clinical effect of Bushen Jianpi Ditan Zhuyu Decoction combined with western medicine for polycystic ovary syndrome（PCOS） of obesity type. Methods： A total of 84 PCOS patients of obesity type treated at Traditional Chinese Medicine Hospital of Xinyang from October 2022 to October 2023 were selected and divided into the observation group and the control group using a random number table method， with 42 cases in each group. The control group was treated with western medicine （Metformin Hydrochloride Sustained- Release Tablets and Ethinyl-estradiol Cyproterone Acetate Tablets）， while the observation group was treated with Bushen Jianpi Ditan Zhuyu Decoction on the basis of the control group. Both groups were treated for three menstrual cycles. Compared the traditional Chinese medicine （TCM） syndrome scores， lipid metabolism indicators [triglycerides （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） levels]，body mass index （BMI），homeostasis model assessment of insulin resistance index （HOMA-IR） ， sex hormones [testosterone （T） ， follicle stimulating hormone （FSH） ， luteinizing hormone （LH），and LH/FSH ratio]，and polycystic ovary status （follicle number，maximum follicle diameter，and ovarian volume） before and after treatment between the two groups. Patients were followed up for three months after treatment to assess the clinical effects. Results： The TCM syndrome scores in both groups were decreased when compared with those before treatment （P＜0.05），and the TCM syndrome scores in the observation group were lower than those in the control group （P＜0.05）. The levels of TG，TC，LDL-C，HOMA-IR，and BMI in both groups were decreased when compared with those before treatment （P＜0.05），and the levels of TG，TC，LDL-C，HOMA-IR， and BMI in the observation group were lower than those in the control group （P＜0.05）. Both groups showed an increase in HDL-C levels when compared with those before treatment （P＜0.05）， with the observation group having a higher HDL-C level than the control group （P＜0.05）. The levels of serum T， LH， and LH/FSH ratio in both groups were decreased when compared with those before treatment （P＜0.05），and the levels of serum T，LH，and LH/FSH ratio in the observation group were lower than those in the control group （P＜0.05）. The number of follicles in both groups were decreased when compared with those before treatment （P＜0.05），the maximum follicle diameter was increased when compared with that before treatment （P＜0.05），and the ovarian volume was decreased when compared with that before treatment （P＜0.05）； the observation group had fewer follicles than the control group （P＜0.05）， a larger maximum follicle diameter than the control group （P＜0.05），and a smaller ovarian volume than the control group （P＜ 0.05）. Follow up for three months after treatment，the total effective rate was 87.50% （35/40） in the observation group， which was higher than that of 67.50% （27/40） in the control group （P＜0.05）. Conclusion：Compared with the use of western medicine alone，the combination of Bushen Jianpi Ditan Zhuyu Decoction and western medicine can improve the efficacy of treating PCOS of obesity type， effectively alleviate clinical symptoms， reduce body weight， regulate blood lipids and sex hormone levels，and improve polycystic ovary syndrome.