Abstract： Objective： To observe the clinical efficacy of Bushen Huoxue Prescription combined with transcervical resection of adhesion （TCRA） for moderate-to-severe intrauterine adhesions. Methods： A total of 106 intrauterine adhesions patients treated at Kaifeng Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were randomly divided into the combination group and the control group （53 cases each）. Both groups underwent TCRA，with the control group receiving Estradiol Valerate Tablets postoperatively and the combination group receiving additional Bushen Huoxue Prescription for three weeks continuously. Evaluated the clinical efficacy in the two groups， and calculated the postoperative bleeding volume， bleeding duration， menstrual recovery time， and abdominal pain duration. Used B-ultrasound to examine endometrial thickness， uterine cavity volume， uterine artery blood flow resistance index （RI），and pulsatility index （PI）. After treatment，a three-month follow-up was conducted to record the occurrence of recurrent intrauterine adhesions，oligomenorrhea，and amenorrhea in the two groups. Results：The total effective rate was 96.23%（ 51/53） in the combination group，which was higher than that of 83.02%（ 44/53） in the control group （P＜0.05）. The postoperative bleeding volume in the combination group was less than that in the control group （P＜0.05），and the duration of bleeding，abdominal pain，and menstrual recovery time were shorter than those in the control group （P＜0.05）. After treatment， the endometrial thickness and uterine cavity volume in both groups increased compared to before treatment （P＜0.05）， and the endometrial thickness and uterine cavity volume in the combination group were both greater than those in the control group （P＜0.05）. After treatment，the RI and PI of the uterine arteries in both groups decreased compared to before treatment （P＜0.05）， and the RI and PI of the uterine arteries in the combination group were lower than those in the control group （P＜0.05）. The recurrence rate of intrauterine adhesions and the incidence of amenorrhea in the combination group were lower than those in the control group （P＜0.05）， and the pregnancy rate was higher than that in the control group （P＜0.05）. Conclusion： The Bushen Huoxue Prescription combined with TCRA significantly improves intrauterine adhesions treatment effects， which can accelerate postoperative recovery， improve uterine cavity morphology and uterine artery hemodynamics， reduce the risk of recurrence of intrauterine adhesions，and increase pregnancy rates.