Abstract：Objective：To observe the curative effect of the combination use of Tongfu Tongluo Kaiqiao Decoction and western medicine on acute ischemic stroke （AIS） of wind-phlegm-blood stasis obstruction type. Methods：A total of 101 AIS patients admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from May 2022 to May 2024 were selected and divided into the observation group （51 cases） and the control group （50 cases） according to the random number table method. The control group was treated with western medicine，and the observation group was additionally treated with Tongfu Tongluo Kaiqiao Decoction based on the treatment of the control group. Both groups were treated for four weeks. The clinical effects，and the changes in the scores of National Institutes of Health Stroke Scale （NIHSS）， and the levels of nerve factors [brain-derived neurotrophic factor （BDNF）， myelin basic protein （MBP），soluble intercellular adhesion molecule-1 （sICAM-1） and neuron-specific enolase （NSE）]，cerebral hemodynamics [pulsatility index （PI） of artery， mean blood flow velocity （Vm） and resistance index （RI）] and hemorheological indexes before and after treatment were compared between the two groups. Results：The total effective rate was 86.27% （44/51） in the observation group and 70.00%（35/50） in the control group， the difference being significant （P＜0.05）. After treatment， the NIHSS scores in the two groups were reduced when compared with those before treatment（ P＜0.05），and the NIHSS score in the observation group was lower than that in the control group（ P＜ 0.05）. After treatment， the levels of serum NSE， MBP and sICAM-1 in the two groups were down-regulated when compared with those before treatment （P＜0.05），and the BDNF levels were elevated when compared with those before treatment （P＜0.05）；the levels of serum NSE，MBP and sICAM-1 in the observation group were lower than those in the control group（ P＜0.05），and the BDNF level was higher than that in the control group（ P＜0.05）. After treatment， the RI and PI in the two groups were decreased when compared with those before treatment （P＜0.05），and the Vm was increased when compared with that before treatment （P＜0.05）；the RI and PI in the observation group were lower than those in the control group（ P＜0.05），and the Vm was higher than that in the control group（ P＜0.05）. After treatment， the plasma viscosity， and low-shear， medium-shear and high-shear whole blood viscosity in the two groups were decreased when compared with those before treatment （P＜0.05），but there was no significant difference between the two groups （P＞0.05）. Conclusion：The combination use of Tongfu Tongluo Kaiqiao Decoction and western medicine can effectively alleviate the clinical symptoms of AIS patients of wind-phlegm-blood stasis obstruction type， improve the cerebral hemodynamics and nerve factors and restore the nerve function.