Abstract： Objective： To observe the clinical efficacy of oral administration of Qingre Lishi Prescription combined with external application of Ruyi Jinhuang Powder in the treatment of acute gouty arthritis （AGA） of dampheat accumulation type. Methods： A total of 102 AGA patients admitted to Quzhou Hospital of Traditional Chinese Medicine from May 2022 to September 2023 were selected and divided into the combination group and the control group using the random number table method，with 51 cases in each group. Two cases were excluded from each group during treatment， resulting in 49 cases being ultimately included in each group. The control group received Febuxostat treatment，while the combination group received oral administration of Qingre Lishi Prescription combined with external application of Ruyi Jinhuang Powder in addition to the control group′s treatment. The clinical efficacy and incidence of adverse reactions were compared between the two groups. Changes in traditional Chinese medicine syndrome scores，the Short-Form McGill Pain Questionnaire （SF-MPQ） score， and serum levels of C-reactive protein （CRP）， uric acid （UA）， erythrocyte sedimentation rate （ESR）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） before and after treatment were compared between the two groups. Results： The total clinical effective rate was 93.88% （46/49） in the combination group and 79.59% （39/49） in the control group （P＜ 0.05）. After treatment，traditional Chinese medicine syndrome scores for joint pain，joint swelling，limited mobility， fever and thirst，and dark yellow urine decreased in both groups compared with those before treatment （P＜0.05），and the scores of the five traditional Chinese medicine syndrome items in the combination group were lower than those in the control group （P＜0.05）. After treatment， SF-MPQ scores decreased in both groups compared with those before treatment （P＜0.05），and the SF-MPQ score in the combination group was lower than that in the control group （P＜ 0.05）. After treatment， levels of ESR， UA， and CRP decreased in both groups compared with those before treatment （P＜0.05）， and the levels of ESR， UA， and CRP in the combination group were lower than those in the control group（ P＜0.05）. After treatment，levels of IL-6，TNF-α，and IL-1β decreased in both groups compared with those before treatment （P＜0.05），and the levels of IL-6，TNF-α，and IL-1β in the combination group were lower than those in the control group （P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion：Oral administration of Qingre Lishi Prescription combined with external application of Ruyi Jinhuang Powder can alleviate symptoms of AGA，regulate UA and ESR，mitigate the inflammatory responses，and demonstrates high safety.