Abstract：Objective：To observe the clinical effect of enema with Tongfu Xingshen Kaiqiao Prescription combined with western medicine on ischemic stroke， and its effect on vascular endothelial function. Methods：A total of 63 cases with ischemic stroke were selected and randomly divided into the observation group and the control group， with 32 and 31 cases in each group， respectively. The control group was given routine modern medicine， and the observation group was additionally treated with enema with Tongfu Xingshen Kaiqiao Prescription based on the treatment of the control group. The two groups were treated for one week. The clinical effects and the conscious time in both groups were compared. Before and after treatment， the changes of scores of National Institute of Health Stroke Scale (NIHSS)， and Full Outline of Unresponsiveness Scale (FOUR)， as well as the levels of von willebrand factor (vWF)， endothelin- 1 (ET- 1)， nitrogen monoxide (NO)， C- reactive protein (CRP)， superoxide dismutase (SOD) and malondialdehyde (MDA) in both groups were compared. The complications in the two groups were observed. Results：The total clinical effective rate was 96.88% in the observation group，higher than that of 80.65% in the control group， the difference being significant (P＜0.05). The conscious time in the observation group was shorter than that in the control group， the difference being significant (P＜0.05). After treatment， the NIHSS scores in both groups were decreased when compared with those before treatment， and the FOUR scores were increased， differences being significant (P＜0.05)； the NIHSS scores in the observation group were lower than those in the control group， and the FOUR scores were higher than those in the control group，differences being significant (P＜0.05). After treatment，the levels of vWF and ET-1 in both groups were decreased when compared with those before treatment，and the NO levels were increased， differences being significant (P＜0.05)； the levels of vWF and ET- 1 in the observation group were lower than those in the control group，and the NO level was higher than that in the control group，differences being significant (P＜0.05). After treatment，the levels of CRP and MDA in both groups were decreased when compared with those before treatment， and the SOD levels were increased， differences being significant (P＜0.05)； the levels of CRP and MDA in the observation group were lower than those in the control group，and the SOD level was higher than that in the control group， differences being significant (P＜0.05). The incidence of complications was 12.5% in the observation group， lower than that of 35.48% in the control group， the difference being significant (P＜0.05). Conclusion： Enema with Tongfu Xingshen Kaiqiao Prescription combined with western medicine for ischemic stroke can improve the clinical effect， well shorten the conscious time， enhance the vascular endothelial function and decrease the incidence of complications.