Abstract： Objective： To observe the clinical effect of the combination use of Yiqi Tongqiao Decoction and western medicine on patients with acute cerebral infarction of large-artery atherosclerosis type of qi deficiency and blood stasis type．Methods：A total of 100 patients with acute cerebral infarction of large-artery atherosclerosis type of qi deficiency and blood stasis type who were treated at the outpatient of Anyang Hospital of Chinese Medicine from January 2021 to December 2023 were selected and divided into the western medicine group and the integrated Chinese and western medicine group by the random number table method，with 50 cases in each group．Both groups were treated with basic therapy and Clopidogrel Bisulfate Tablets combined with Argatroban Injection， and the integrated Chinese and western medicine group was additionally treated with Yiqi Tongqiao Decoction． Both groups were treated for 14 days．Before and after treatment，the scores of the China Stroke Scale（CSS），Loewenstein Occupational Therapy Cognitive Assessment（LOTCA）and Functional Comprehensive Assessment Scale（FCA）in the two groups of patients were evaluated，the mean diffusivity（MD）and fractional anisotropy（FA）of frontal white matter，the common carotid artery intima-media thickness， plaque area， specific impedance and average blood flow velocity， and the levels of serum CX3CL1， amyloid β protein 1-42 （Aβ1-42）， neurofilament light chain （NfL） protein， brain-derived neurotrophic factor（BDNF）， Sestrin2（SESN2）， reactive oxygen species（ROS）， and monoamine oxidase（MAO） were detected． After the course of treatment ended， the clinical effects were compared between the two groups． Results：After treatment，the total effective rate in the integrated Chinese and western medicine group was higher than that in the western medicine group（P＜0.05）． The scores of LOTCA and FCA in both groups were elevated when compared with those before treatment，and the CSS scores were reduced when compared with those before treatment， differences being significant（P＜0.05）． The MD of frontal white matter in both groups was down-regulated when compared with that before treatment， and the FA was up-regulated when compared with that before treatment， differences being significant（P＜0.05）．The MD of frontal white matter in the integrated Chinese and western medicine group was lower than that in the western medicine group， and the FA was higher than that in the western medicine group， differences being significant（P＜0.05）． The average blood flow velocity in both groups was increased when compared with that before treatment， the common carotid artery intima-media thickness and the specific impedance were decreased when compared with those before treatment，and the plaque area was reduced when compared with that before treatment，differences being significant（P＜0.05）．The average blood flow velocity in the integrated Chinese and western medicine group was faster than that in the western medicine group，the common carotid artery intima-media thickness and the specific impedance were both lower than those in the western medicine group，and the plaque area was smaller than that in the western medicine group，differences being significant（P＜0.05）．The CX3CL1 levels in both groups were increased when compared with those before treatment， and the levels of SESN2， ROS and MAO dwindled when compared with those before treatment，differences being significant（P＜0.05）．The CX3CL1 level in the integrated Chinese and western medicine group was higher than that in the western medicine group，and the levels of SESN2，ROS and MAO were lower than those in the western medicine group，differences being significant（P＜0.05）． The levels of Aβ1-42 and BDNF in the two groups were increased when compared with those before treatment，and the NfL levels were reduced when compared with those before treatment， differences being significant（P＜0.05）． The levels of Aβ1-42 and BDNF in the integrated Chinese and western medicine group were higher than those in the western medicine intervention group， and the NfL level was lower than that in the western medicine group（P＜0.05）． Conclusion：The combination use of Yiqi Tongqiao Decoction and Clopidogrel and Argatroban can enhance the clinical effect on patients with acute cerebral infarction of large-artery atherosclerosis type of qi deficiency and blood stasis type， which can effectively reduce the oxidative stress， alleviate the damage to inflammatory responses and nerve cell， improve the atherosclerosis and cerebral hemodynamics，repair the microstructure of white matter in the brain，promote the recovery of neurological and cognitive functions，and improve the daily living ability.