Abstract： Objective： To observe the regulatory effect of Qingfei Jianpi Tongfu Decoction on gastrointestinal function and its impact on inflammatory indexes in patients with sepsis with lung-intestine excess-heat syndrome. Methods：A total of 84 patients with sepsis with lung-intestine excess-heat syndrome treated at Wenling Hospital of Traditional Chinese Medicine from January 2021 to June 2024 were selected and divided into an observation group and a control group，with 42 cases in each group，using a random number table method. The control group was treated with comprehensive western medicine therapy，while the observation group was treated with Qingfei Jianpi Tongfu Decoction in addition to the treatment of the control group. Both groups were treated for 14 days. Clinical efficacy，traditional Chinese medicine syndrome scores， Gastrointestinal Failure Index（GIF）， Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ），Sequential Organ Failure Assessment（SOFA）scores，and gastrointestinal function- related indicators [diamine oxidase（DAO），D-lactic acid（D-lac），endotoxin，gastrin（GAS），motilin（MTL）， and vasoactive intestinal peptide （VIP）]， as well as inflammatory indexes [white blood cell count （WBC）， procalcitonin（PCT），C-reactive protein（CRP），interleukin-1β（IL-1β），and interleukin-6（IL-6）] levels were compared between the two groups before and after treatment. Adverse reactions and mortality were also recorded. Results：After treatment，the total effective rate in the observation group was 95.24%（40/42），higher than that in the control group at 76.19%（32/42）（P＜0.05）. The scores for abdominal distension and fullness，abdominal pain，body heat and thirst，foul breath，vomiting，constipation or absence of bowel movements，and abdominal gurgling，as well as the total scores of traditional Chinese medicine syndromes in the two groups，were decreased when compared with those before treatment（P＜0.05）；the scores for the aforementioned seven traditional Chinese medicine syndromes and the total score in the observation group were lower than those in the control group（P＜0.05）. The scores of GIF， APACHE Ⅱ，and SOFA were decreased in both groups compared to before treatment（P＜0.05），with the observation group achieving lower scores than the control group（P＜0.05）. DAO， D-lac， endotoxin， and VIP levels were decreased in both groups compared to before treatment（P＜0.05），with the observation group achieving lower levels than the control group（P＜0.05）. MTL and GAS levels were increased in both groups compared to before treatment（P＜ 0.05），with the observation group achieving higher levels than the control group（P＜0.05）. WBC，PCT，CRP，IL- 1β，and IL-6 levels were decreased in both groups compared to before treatment（P＜0.05），with the observation group achieving lower levels than the control group（P＜0.05）. No significant adverse drug-induced reactions were observed in either group during the treatment period. During the 28-day follow-up，no deaths were recorded in the observation group，while one case of death due to multiple organ dysfunction syndrome（MODS）was recorded in the control group. Conclusion： The addition of Qingfei Jianpi Tongfu Decoction to comprehensive western medicine therapy can improve gastrointestinal function and clinical symptoms in patients with sepsis with lung-intestine excess- heat syndrome. The mechanism of action may be related to the regulation of gastrointestinal function-related indicators and inflammatory indexes，thereby protecting the gastrointestinal mucosal barrier function.