Abstract： Objective： To observe the clinical effect of Sanzi Yangqin Decoction combined with Salmeterol/ Fluticasone on bronchial asthma （BA） and its effect on small airway function. Methods：A retrospective analysis was conducted on the data of 80 cases of BA patients admitted to Lishui City People's Hospital from January 2021 to January 2024. The patients were divided into the western medicine group and the combination group based on different treatment methods， with 40 cases in each group. Both groups received symptomatic treatment for the underlying disease： the western medicine group was treated with Salmeterol/Fluticasone，and the combination group was treated with Salmeterol/ Fluticasone combined with Sanzi Yangqin Decoction. Both groups were compared in terms of asthma attack frequency [Asthma Control Test （ACT）]， small airway function indicators [mean expiratory flow at 25%， 50%， and 75% of forced vital capacity （MEF25，MEF50，MEF75）]，lung function indicators [peak expiratory flow （PEF），forced expiratory volume in one second （FEV1）， forced vital capacity （FVC）， and FEV1/FVC]， adverse reactions， and clinical efficacy. Results：The total effective rate was 97.50% （39/40） in the combination group and 75.00% （30/40） in the western medicine group，with a significant difference between the two groups （P＜0.05）. After treatment，ACT scores in the two groups were increased when compared with those before treatment （P＜0.05），and the scores in the combination group were higher than those in the western medicine group （P＜0.05）. After treatment， the levels of MEF25，MEF50，and MEF75 in the two groups were increased when compared with those before treatment （P＜0.05）， with the combination group showing higher levels than the western medicine group （P＜0.05）. After treatment， the levels of PEF， FEV1， FVC， and FEV1/FVC in the two groups were increased when compared with those before treatment （P＜0.05），with the combination group showing higher levels than the western medicine group （P＜0.05）. The incidence of adverse reactions was 7.50% （3/40） in the combination group and 15.00% （6/40） in the western medicine group， with no significant difference between the two groups （P＞0.05）. Conclusion： Sanzi Yangqin Decoction combined with Salmeterol/Fluticasone can enhance clinical efficacy， effectively reduce symptom attacks in BA patients，and improve small airway function and lung function.