Abstract： Objective： To observe the clinical efficacy of modified Qingjin Huatan Decoction plus Erchen Decoction combined with conventional therapy in treating acute exacerbation of bronchiectasis with phlegm-heat obstructing the lung syndrome. Methods：A total of 120 patients with acute exacerbation of bronchiectasis with phlegm- heat obstructing the lung syndrome treated in Wuyi Branch of Hangzhou Hospital of Traditional Chinese Medicine from October 2021 to June 2024 were selected and divided into a control group and a combination group （n=60 per group） using a random number table method. The control group received conventional therapy， while the combination group received modified Qingjin Huatan Decoction combined with Erchen Decoction on the basis of the control group′s regimen. Clinical efficacy，symptom and sign relief time，and safety，as well as traditional Chinese medicine syndrome scores， inflammatory factors [procalcitonin（PCT）， high-sensitivity C-reactive protein （hs-CRP）， tumor necrosis factor-α（ TNF-α），and interleukin-17（ IL-17）]，pulmonary function [forced expiratory volume in one second（ FEV1）， forced vital capacity（FVC）， and FEV1/FVC]， oxidative stress indicators [reactive oxygen species （ROS）， malondialdehyde （MDA）， and nitric oxide （NO）]， intercellular adhesion molecule-1 （ICAM-1）， leukotriene B4（ LTB4），and human neutrophil peptides 1-3（ HNP1-3） levels before and after treatment，were compared between the two groups. Results：The total effective rate was 90.00% （54/60） in the combination group，higher than that of 76.67% （46/60） in the control group （P＜0.05）. After treatment， traditional Chinese medicine syndrome scores for cough，expectoration，hemoptysis，chest tightness and dyspnea，fever，and dry mouth，as well as the total score， decreased in both groups compared with those before treatment （P＜0.05），and the combination group had lower scores than the control group （P＜0.05）. The combination group had shorter duration of cough，expectoration，hemoptysis， lung rales， and dyspnea relief than the control group （P＜0.05）. Levels of PCT， IL-17， hs-CRP， and TNF- α decreased in both groups compared with those before treatment （P＜0.05），and the combination group had lower levels than the control group（ P＜0.05）. FEV1 and FVC levels，and FEV1/FVC values increased in both groups compared with those before treatment （P＜0.05），and the combination group had higher levels and values than the control group （P＜ 0.05）. Levels of ROS，MDA，and NO decreased in both groups compared with those before treatment （P＜0.05），and the combination group had lower levels than the control group （P＜0.05）. Levels of ICAM-1， LTB4， and HNP1-3 decreased in both groups compared with those before treatment （P＜0.05），and the combination group had lower levels than the control group （P＜0.05）. Both groups of medications had good safety. Conclusion：Modified Qingjin Huatan Decoction combined with Erchen Decoction and conventional therapy is effective in treating acute exacerbation of bronchiectasis with phlegm-heat obstructing the lung syndrome. It can promote symptom relief， shorten symptom duration，reduce inflammation and oxidative stress responses，and has good safty.