Abstract：Objective：To observe the clinical effect of Qingre Xuanbi Decoction combined with Clarithromycin on chronic rhinosinusitis （CRS） with lung meridian wind-heat syndrome. Methods：A total of 100 cases of CRS patients with lung meridian wind-heat syndrome， treated at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2024 to October 2024，were divided into the control group and the observation group according to the random number table method， with 50 cases in each group. The control group was treated with Clarithromycin Dispersible Tablets，and the observation group was treated with Qingre Xuanbi Decoction based on the treatment of the control group. Both groups were treated continuously for 14 days. Clinical effects and safety as well as the disappearance time of symptoms like rhinorrhea， rhinocleisis， fever， and nasal discharge were compared between the two groups； the levels of total immunoglobulin E （TIgE），eosinophil cationic protein （ ECP），interleukin（ IL）-6，IL-8 and tumor necrosis factor- α （TNF- α） in serum， nasal airway resistance （NAR）， nasal cavity volume （NCV）， and nasal minimum cross-sectional area （NMCA） were compared before and after treatment. Results：After treatment，the total effective rate was 94.00% （47/50） in the observation group， higher than 80.00% （40/50） in the control group （P＜ 0.05）. The time to resolution of symptoms such as rhinorrhea，rhinocleisis，fever，and nasal discharge was shorter in the observation group compared to the control group （P＜0.05）. The levels of ECP，TIgE，TNF-α，IL-6，IL-8，and NAR in the two groups were decreased when compared with those before treatment （P＜0.05）， with the observation group showing lower levels than the control group （P＜0.05）. NCV and NMCA in the two groups were increased when compared with those before treatment （P＜0.05），with the observation group showing greater NCV and NMCA than the control group （P＜0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Qingre Xuanbi Decoction combined with Clarithromycin is effective in treating CRS with lung meridian wind-heat syndrome， which can reduce inflammation and allergic reactions， improve nasal ventilation function，and alleviate clinical symptoms.