enomyosis(AM) and its effect on the menstrual amount， the degree of dysmenorrhea， endometrial receptivity and the expression of programmed death ligand- 1(PD- L1). Methods：A total of 104 cases of patients with AM were selected and divided into the abdominal acupuncture group and the acupuncture and medication group according to the random number table method，52 cases in each group. The acupuncture and medication group was given Xiaoyi prescription combined with abdominal acupuncture，and the abdominal acupuncture group was given simple abdominal acupuncture. Both groups were continuously treated for three menstrual cycles. The menstrual amount，the scores of dysmenorrhea，endometrial receptivity and the expression of PD- L1 before and after treatment in the two groups were compared， and the curative effect was evaluated. The incidence of adverse reactions was observed. Results： After treatment， compared with those before treatment， the scores of Pictorial Blood loss Assessment Chart(PBAC) and dysmenorrhea in the two groups were decreased (P＜0.05)，and the uterine volumes were shrunk(P＜0.05)；in the acupuncture and medication group，the decrease of the scores of PABC and dysmenorrhea and the shrinkage of the uterine volume were larger than those in the control group(P＜0.05). After treatment， the richness and the maturation rate of endometrial pinopodes in the two groups were increased when compared with those before treatment(P＜0.05)，and the above two indexes in the acupuncture and medication group were higher than those in the abdominal acupuncture group(P＜0.05). After treatment， the scores of the expression of PDL1 in the two groups were decreased when compared with those before treatment(P＜0.05)， and the above score in the abdominal acupuncture group was lower than that in the control group(P＜0.05). The total effective rate was 94.23% in the acupuncture and medication group， higher than that of 76.92% in the abdominal acupuncture group(P＜0.05). During treatment， no significant adverse reactions occurred in the two groups. Conclusion： The therapy of Xiaoyi prescription combined with abdominal acupuncture has significant curative effect in treating AM， which can effectively alleviate the symptoms of dysmenorrhea，reduce the menstrual amount， shrink the uterine volume，as well as decrease the expression of PD-L1 in ectopic focus and improve endometrial receptivity.