Abstract：Objective：To observe the clinical efficacy of Qingxin Dingzhi Decoction combined with highfrequency transcranial magnetic stimulation (rTMS) in the treatment of schizophrenia (SP) and its impact on brain neurotrophic factor levels. Method： A total of 106 patients with SP were selected as the study subjects and randomly divided into an trial group and a control group，with 53 cases in each group，using a random number table method. Both groups were given basic treatment， while the control group was treated with high-frequency rTMS. In the trial，Qingxin Dingzhi Decoction was added to the control group for treatment. Both groups were treated for four weeks. Compare the clinical efficacy，traditional Chinese medicine (TCM) syndrome scores， positive and negative symptom scale (PANSS) scores， negative symptom scale (SANS) scores， and levels of brain-derived neurotrophic factor (BDNF) and glial derived neurotrophic factor (GDNF) between the two groups. Results：The total effective rate of the trial group was 94.34%， while that of the control group was 77.36%. The difference between the two groups was statistically significant (P＜0.05). After treatment， the TCM syndrome scores of both groups decreased compared to those before treatment (P＜0.05)，and the TCM syndrome scores of the trial group were lower than those of the control group (P＜0.05). After treatment， the PANSS and SANS scores of both groups decreased compared to before treatment (P＜0.05）， and the PANSS and SANS scores of the trial group were lower than those of the control group (P＜0.05). After treatment，the levels of serum BDNF and GDNF in both groups increased compared to those before treatment (P＜0.05)，and the levels of BDNF and GDNF in the trial group were higher than those in the control group (P＜0.05). Conclusion： The combination of Qingxin Dingzhi Decoction and high-frequency rTMS has a significant therapeutic effect on SP， which is beneficial for reducing TCM syndrome and improving negative symptoms in patients. Its mechanism of action may be related to the upregulation of brain neurotrophic factors.