〔Abstract〕 Objective To observe the clinical effect of Jianpi Yishen Recipe in treating primary hypothyroidism of spleen and kidney yang deficiency syndrome. Methods 90 patients with primary hypothyroidism with spleen and kidney yang deficiency syndrome admitted to Yangjiang Hospital of Traditional Chinese Medicine from June 2018 to January 2020 were selected and divided into a control group and an observation group according to different treatment plans, with 45 cases in each group. The patients in the control group were treated with levothyroxine sodium tablets, and the patients in the observation group were treated with levothyroxine sodium tablets combined with jianpi yishen recipe. The changes in traditional Chinese medcial (TCM) syndromes and thyroid function of the two groups before and after treatment were compared, and the therapeutic effects were compared. Results After treatment, the TCM syndrome scores of the two groups of patients decreased to varying degrees, and the scores of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). Before treatment, there was no significant difference in thyroid function between the two groups of patients (P > 0.05); after treatment, the free triiodothyronine (FT3) and free thyroxine (FT4) of the observation group were higher than those of the control group, thyroidstimulating hormone (TSH) was lower than that of the control group, the differences were statistically significant (P < 0.05). The total effective rate of the observation group was 91.11%, which was higher than 73.33% in the control group. The difference was statistically significant (P < 0.05). Conclusion When treating primary hypothyroidism with yang deficiency syndrome of spleen and kidney, taking levothyroxine sodium tablets combined with Jianpi Yishen recipe has a significant effect, which helps to improve the patient's thyroid function and relieve clinical symptoms.