Abstract：Objective：To observe the effects of modified Banxia Baizhu Tianma Decoction combined with Xifeng Tongnao Capsules on peripheral blood nuclear factor-κB（NF-κB）p50/p65 protein and serum matrix metalloproteinase- 9（MMP-9）levels in patients undergoing mechanical thrombectomy for acute anterior circulation large vessel occlusion． Methods： A total of 88 patients who underwent mechanical thrombectomy for acute anterior circulation large vessel occlusion at Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January 2024 to January 2025 were selected and divided into a Chinese medicine group and a combined treatment group， with 44 cases in each group， using a random number table method． Both groups received conventional western medicine symptomatic treatment． The Chinese medicine group was treated with Xifeng Tongnao Capsules after surgery， while the combined treatment group was additionally treated with modified Banxia Baizhu Tianma Decoction on the basis of the Chinese medicine group．Both groups were treated continuously for 14 days．The efficacy of traditional Chinese medicine syndromes was assessed，and changes in traditional Chinese medicine syndrome scores， neurological deficits [National Institutes of Health Stroke Scale（NIHSS）]， prognosis [modified Rankin Scale （mRS）]，and peripheral blood NF-κB p50/p65 protein expression and serum MMP-9 levels were observed before and after treatment in both groups． Results： After 14 days of treatment， the total effective rate of traditional Chinese medicine syndromes in the combined treatment group was 93.18%（41/44），higher than that in the Chinese medicine group at 77.27%（34/44）（P＜0.05）．The scores for hemiplegia，aphasia，and facial deviation decreased in both groups compared to before treatment（P＜0.05）， with the combined treatment group achieving lower scores than the Chinese medicine group（P＜0.05）．The NIHSS and mRS scores decreased in both groups compared to before treatment（P＜ 0.05）， with the combined treatment group achieving lower scores than the Chinese medicine group（P＜0.05）．The expression of peripheral blood NF-κB p50/p65 protein and serum MMP-9 levels decreased in both groups compared to before treatment（P＜0.05），with the combined treatment group achieving lower levels than the Chinese medicine group （P＜0.05）．Conclusion：Modified Banxia Baizhu Tianma Decoction combined with Xifeng Tongnao Capsules showed good therapeutic effects in patients undergoing mechanical thrombectomy for acute anterior circulation large vessel occlusion． It can reduce traditional Chinese medicine syndrome scores， repair neurological deficits， and improve prognosis． It may also improve systemic inflammatory responses and the degree of brain damage by inhibiting the expression of peripheral blood NF-κB p50/p65 protein and downregulating serum MMP-9 levels.