Abstract：Objective：To observe the curative effect of Qingjin Huatan Decoction combined with Meropenem on severe pneumonia（SP）in senile patients. Methods：A total of 120 senile SP patients treated at the People's Hospital of Hebi from April 2023 to February 2024 were selected and divided into the western medicine group and the Chinese medicine group according to the random number table method，with 60 cases in each group. The western medicine group was treated with Meropenem， and the Chinese medicine group was treated with Qingjin Huatan Decoction combined with Meropenem. Clinical effects and the incidence of adverse reactions were compared between the two groups. The changes in lung function indexes [forced expiratory volume in the first second（FEV1）， peak expiratory flow（PEF）， forced vital capacity（FVC），mean maximal expiratory flow（MMEF）]，immune function（CD4+，CD8+，CD4+/CD8+）， blood gas indicators [arterial oxygen partial pressure（PaO2）， carbon dioxide partial pressure（PaCO2）， oxygen saturation（SpO2）]， and levels of interleukin-8（IL-8）， interleukin-10（IL-10）， and neutrophil elastase（NE） before and after treatment were compared between the two groups. Results：The total effective rate of clinical effect was 83.33%（50/60）in the western medicine group and 96.67%（58/60）in the Chinese medicine group，with significant difference between the two groups（P＜0.05）. After treatment，the values of FEV1，PEF，FVC and MMEF in the two groups were increased when compared with those before treatment（P＜0.05）， with higher values in the Chinese medicine group than in the western medicine group（P＜0.05）. After treatment，the levels of CD4+ and CD4+/CD8+ in the two groups were increased when compared with those before treatment（P＜0.05）and CD8+ levels were decreased when compared with those before treatment（P＜0.05）； the levels of CD4+ and CD4+/CD8+ in the Chinese medicine group were higher than those in the western medicine group（P＜0.05），and CD8+ level in the Chinese medicine group was lower than that in the western medicine group（P＜0.05）. After treatment，the values of PaO2 and SpO2 in the two groups were increased when compared with those before treatment and PaCO2 values in the two groups were decreased when compared with those before treatment（P＜0.05）； the values of PaO2 and SpO2 in the Chinese medicine group were higher than in those in the western medicine group and PaCO2 value was lower than that in the western medicine group（P＜0.05）. After treatment， the levels of IL-8， IL-10， and NE in the two groups were decreased when compared with those before treatment（P＜0.05）；the levels of IL-8，IL-10，and NE in the Chinese medicine group were lower than those the western medicine group（P＜0.05）. The incidence of adverse reactions was 8.62%（5/58）in the Chinese medicine group and 14.00%（7/50）in the western medicine group，with no significant difference between the two groups（P＞0.05）. Conclusion： Qingjin Huatan Decoction combined with Meropenem has a good curative effect in treating senile SP patients， which can improve lung function， enhance immune function， and inhibit inflammatory responses with high safety.