Abstract：Objective：To observe the clinical efficacy of Jiangzhi Huazhuo Decoction in treating meibomian gland dysfunction （MGD）-related dry eye disease of damp-heat in spleen and stomach type. Methods ： A total of 150 patients with MGD-related dry eye disease of damp-heat in spleen and stomach type treated at Jinhua Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from May 2022 to October 2024 were enrolled and randomly divided into the treatment group and the control group by the random number table method， with 75 patients in each group. The control group received Pranoprofen Eye Drops combined with meibomian gland massage， while the treatment group additionally received oral administration of Jiangzhi Huazhuo Decoction. Both groups were treated for one month. The changes in traditional Chinese medicine （TCM） syndrome scores，ocular surface disease index （OSDI） scores， meibomian gland function， and tear-related indicators [tear break-up time （BUT）， Schirmer´s test（ SIt），and fluorescein sodium staining of cornea and conjunctiva（ FLS）] before and after treatment were observed， and the clinical effects in the two groups were compared. Results： After treatment， the TCM syndrome scores and OSDI scores were decreased in both groups when compared with those before treatment （P＜0.05），and the above scores were lower in the treatment group than in the control group （P＜0.05）. Meibomian gland function was respectively improved in both groups when compared with that before treatment （P＜0.05），and the improvement was better in the treatment group than in the control group （P＜0.05）. BUT were increased （P＜0.05）， SIt values were rose（ P＜0.05），and FLS scores were decreased in both groups when compared with those before treatment（ P＜0.05）； the treatment group had a longer BUT，higher SIt values，and lower FLS scores than the control group （P＜0.05）. The overall effective rate was 92.86% （65/70） in the treatment group， higher than that of 77.94% （53/68） in the control group （P＜0.05）. Conclusion： Jiangzhi Huazhuo Decoction can effectively treat MGD-related dry eye disease of damp-heat in spleen and stomach type，alleviate symptoms，and improve meibomian gland function and tear-related indicators.