Abstract：Objective：To observe the clinical effect of the therapy of Qingfei Jiedu Decoction combined with western medicine on severe pneumonia complicated with acute respiratory distress syndrome in children. Methods：A total of 62 children with severe pneumonia complicated with acute respiratory distress syndrome were selected and divided into the control group and the observation group according to the principle of random control，with 31 cases in each group. The control group was treated with non-invasive positive pressure ventilation (NIPPV) combined with bronohoalveolar lavage，and the observation group was additionally given Qingfei Jiedu Decoction based on the treatment of the control group. The endotracheal intubation rates，mortality，NIPPV time，IPPV time，total assist ventilation time，total oxygen using time and hospitalization time，and the levels of arterial blood gas analysis indexes，pulmonary infection degree and cell free DNA/neutrophil extracellular traps (cf-DNA/NETs) in peripheral blood were compared before and after treatment between the two groups. Results：The endotracheal intubation rate in the observation group was lower than that in the control group (P＜0.05)， and the NIPPV time， IPPV time， total assist ventilation time， total oxygen using time and hospitalization time were shorter than those in the control group (P＜0.05). There was no significant difference being found in the comparison of mortality between the two groups (P＞0.05). After treatment，the partial pressure of oxygen (PaO2) of artery and the ratio of PaO2 and fraction of inspired oxygen (PaO2/FIO2) in the two groups were increased (P＜0.05)， and the partial pressure of carbon oxygen (PaCO2) of artery was decreased (P＜0.05)； the PaO2 and PaO2/FIO2 in the observation group were higher than those in the control group (P＜0.05)， and the PaCO2 was lower than that in the control group (P＜0.05). After treatment， the Clinial Pulmonary Infection Scores (CPIS) and Murray Lung Injury Scores (MLIS) in the two groups were decreased (P＜0.05)，and the above two scores in the observation group were lower than those in the control group (P＜0.05). After treatment，the cf-DNA/ NETs levels in peripheral blood in the two groups were decreased (P＜0.05)，and the cf-DNA/NETs level in the observation group was lower than that in the control group (P＜0.05). Conclusion： The therapy of Qingfei Jiedu Decoction combined with western medicine has a definite curative effect on severe pneumonia complicated with acute respiratory distress syndrome in children，which can effectively improve the arterial blood gas analysis indexes， promote the recovery of lung function and decrease the cf-DNA/ NETs level in peripheral blood.