Abstract：Objective：To observe the clinical efficacy of Chinese medicine syndrome differentiation and treatment combined with western medicine in treating functional constipation complicated with anxiety. Methods： A total of 120 patients with functional constipation complicated with anxiety admitted to the Department of Coloproctology，The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine，from January 2023 to June 2024 were enrolled. Using a random number table method，patients were equally divided into an observation group and a control group，with 60 patients in each group；no cases were excluded or dropped. The control group received Lactulose plus Escitalopram Oxalate，whereas the observation group received syndrome-differentiated Chinese medicine treatment in addition to the control group. Both groups were treated for five weeks. Clinical efficacy was compared，and changes in Hamilton Anxiety Scale（HAMA）scores，Patient Assessment of Constipation-Quality of Life（PAC-QOL）scores，and main constipation symptom scores were compared before and after treatment. Results： After treatment， the total effective rate in the observation group was 96.7%（58/60），higher than that of 80.0%（48/60）in the control group（P＜ 0.05）. The HAMA and PAC-QOL scores decreased in both groups（P＜0.05），and the decreases were greater in the observation group（P＜0.05）. Scores for defecation difficulty，stool features，defecation duration，defecation frequency， sensation of incomplete evacuation/tenesmus/bloating， and total scores decreased in both groups（P＜0.05）； the abdominal distension score in the control group showed no significant change before and after treatment（P＞0.05）. Compared with the control group， the observation group exhibited lower scores for defecation difficulty， defecation duration， defecation frequency， incomplete evacuation/tenesmus/bloating， abdominal distension， and total scores （P＜0.05），and the difference in stool features score was not statistically significant（P＞0.05）. Conclusion：Syndromedifferentiated Chinese medicine combined with western medicine can further improve clinical efficacy in patients with functional constipation complicated with anxiety，relieve constipation，alleviate anxiety，and enhance quality of life.