Abstract：Objective：To observe the clinical effect of Jiedu Qingre Xuanfei Prescription combined with bronchoalveolar lavage with the bronchoscope for acute severe pneumonia and its effect on inflammatory indicators in bronchoalveolar lavage fluid. Methods： A total of 100 cases of patients with acute severe pneumonia were selected and divided into the combination group and the lavage group according to the random number table method， with 50 cases in each group. The lavage group was treated with bronchoalveolar lavage with the bronchoscope， and the combination group was additionally treated with Jiedu Qingre Xuanfei Prescription based on the treatment of the lavage group. Both groups were treated continuously for 2 weeks. Traditional Chinese medicine (TCM) syndrome scores and the levels of inflammatory indicators in bronchoalveolar lavage fluid [nuclear factor (NF- κB)，macrophage inflammatory protein 2 (MIP- 2)，high mobility group protein B1 (HMGB1)] and respiratory mechanics indicators [airway resistance (Raw)，work of breathing (WOB)] before and after treatment，as well as clinical effects，were compared between the two groups. Results：The total effective rate was 94.0% in the combination group and 86.00% in the lavage group，and there was no significant difference being found in the comparison of the two groups (P＞0.05). After treatment， the scores of fever and cough， cough with thick and yellow phlegm，short breath and panting，red tongue and slippery pulse，and other syndromes in the two groups were decreased when compared with those before treatment (P＜0.05)，and each TCM syndrome score in the combination group was significantly lower than that in the lavage group (P＜0.05). After treatment，the levels of NF-κ，MIP-2，and HMGB1 in the two groups were significantly decreased when compared with those before treatment (P＜0.05)， and the above inflammatory indicators in the combination group were significantly lower than those in the lavage group (P＜0.05). After treatment，the levels of Raw and WOB in the two groups were decreased when compared with those before treatment (P＜0.05)，and the two levels in the combination group were lower than those in the lavage group (P＜0.05). Conclusion：Jiedu Qingre Xuanfei Prescription combined with bronchoalveolar lavage with the bronchoscope has a definite curative effect in the treatment of acute severe pneumonia， which can improve TCM syndromes and respiratory function，and effectively inhibit pulmonary inflammatory reactions.