Abstract： Objective： To observe the clinical efficacy of Tongfu Zhuyu Prescription combined with western medicine in the treatment of sepsis-induced acute gastrointestinal injury （AGI） with fu-organ excess and blood stasis syndrome. Methods：A total of 126 patients with sepsis-induced AGI with fu-organ excess and blood stasis syndrome admitted to Quzhou Hospital of Traditional Chinese Medicine from January to October 2024 were divided into the trial group and the control group according to the random number table method， with 63 cases in each group. The control group was treated with western medicine，while the trial group was treated with Tongfu Zhuyu Prescription on the basis of the control group. The clinical effect was evaluated after seven days of treatment. The changes in intra-abdominal pressure， bowel sounds per minute， AGI grading， traditional Chinese medicine syndrome scores， and intestinal mucosal barrier function markers [D-lactate and diamine oxidase（ DAO）] levels before and after treatment in the two groups were compared. Prognostic outcomes were observed. Results：After treatment，the total clinical effective rate in the trial group was 83.87% （52/62），significantly higher than that of 67.21% （41/61） in the control group （P＜0.05）. The intra-abdominal pressure in the two groups were decreased when compared with those before treatment （P＜0.05）， and the intra-abdominal pressure in the trial group was lower than that in the control group （P＜0.05）. The bowel sounds per minute in the two groups were increased when compared with those before treatment （P＜0.05），with higher counts of the bowel sounds per minute in the trial group than the control group （P＜0.05）. The AGI grades in the two groups were improved when compared with those before treatment （P＜0.05）， with greater improvement in the trial group than the control group （P＜0.05）. The sub-item scores of traditional Chinese medicine syndromes， such as abdominal pain，abdominal rigidity with tenderness，constipation，vexation and restlessness，and gloomy complexion， in the two groups were decreased when compared with those before treatment （P＜0.05），and the five aforementioned sub-item scores of traditional Chinese medicine syndromes in the trial group were lower than those of the control group （P＜0.05）. The levels of D-lactate and DAO in the two groups were decreased when compared with those before treatment （P＜0.05），and the levels of D-lactate and DAO were lower in the trial group than in the control group （P＜ 0.05）. The trial group had shorter ICU stays than the control group （P＜0.05）. No significant difference in 28-day mortality was noticed between the two groups （P＞0.05）. Conclusion： Tongfu Zhuyu Prescription combined with western medicine in the treatment of AGI with fu-organ excess and blood stasis syndrome exerts certain effect， effectively alleviating gastrointestinal dysfunction， improving intestinal mucosal barrier function， and shortening ICU hospitalization.