Abstract： Objective： To observe the curative effect of Juhong Capsules combined with Azithromycin on children with mycoplasma pneumoniae pneumonia (MPP) with syndrome of phlegm-heat blocking the lung and its effect on the levels of serum toll-like receptor 4 (TLR4) ， myeloid differentiation factor 88 (MyD88) and nuclear transcription factor κB (NF- κB). Methods： A total of 82 MPP children were selected and divided into the control group and the observation group by random number table method， with 41 cases in each group. The control group was treated with sequential regimen of Azithromycin，and the observation group was additionally treated with Juhong Capsules based on the treatment of the control group. They were treated for two weeks. The clinical effects，disappearance time of symptoms and signs， scores of syndrome of phlegm-heat blocking the lung，and levels of serum T cell subsets，TLR4，MyD88 and NF- κB were compared between the two groups. Results： After two-week treatment， the total effective rate was 97.56% in the observation group，higher than that of 80.49% in the control group (P＜ 0.05). The disappearance time of fever， lung moist rales and cough in the observation group was shorter than that in the control group (P＜0.05). After treatment，each score of syndrome of phlegm-heat blocking the lung in the two groups was reduced when compared with that before treatment (P＜0.05)， and each syndrome score in the observation group was lower than that in the control group (P＜0.05). After treatment，the levels of CD4+ and CD4+/CD8+ in the two groups were increased when compared with those before treatment， while the levels of CD3+ and CD8+ were lower than those before treatment (P＜0.05)； the levels of CD3+ and CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group， and the levels of CD8+ was lower than those in the control group (P＜0.05). After treatment， the levels of serum TLR4，MyD88 and NF-κB in both groups were reduced when compared with those before treatment (P＜0.05)， and the levels of serum TLR4， MyD88 and NF- κB in the observation group were lower than those in the control group (P＜0.05). Conclusion： The therapy of Juhong Capsules combined with Azithromycin has an obvious curative effect on MPP children with syndrome of phlegm-heat blocking the lung， which can promote the improvement of symptoms， signs and traditional Chinese medicine syndromes， enhance their immune function， and effectively inhibit TLR4/MyD88/NF- κB inflammatory pathway.