〔Abstract〕Objective To explore the clinical efficacy of sufei pinggan yangyin decoction assisted montelukast sodium in the treatment of children with chronic bronchial asthma. Methods A total of 122 children with chronic bronchial asthma treated in Wancheng District Maternal and Child Health Hospital of Nanyang City from January 2019 to March 2020 were selected and divided into combined group and western medicine group according to random number table method, with 61 cases in each group. The western medicine group was treated with montelukast sodium, and the combined group was treated with sunfei pinggan yangyin decoction assisted montelukast sodium. The efficacy, lung function [vital capacity (FVC)], immune function [immunoglobulin A (IgA), IgE, IgM], Toll-like receptor 4 (TLR4) / nuclear transcription factor-κB (NF-κB) signaling pathway expression and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The total effective rate in the combined group was 93.44%, which was higher than 80.33% of the western medicine group, and the difference was statistically significant (P < 0.05). After treatment, FEV1 and FVC in the combined group were higher than those in the western medicine group, with statistical significance (P < 0.05). After treatment, the serum IgA and IgM in the combined group were higher than those in the western medicine group, and IgE was lower than that in the western medicine group, with statistical significance (P < 0.05). After treatment, TLR4 and NF - κB in the combined group were lower than those in the western medicine group, the differences were statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Sunfei pinggan yangyin decoction assisted montelukast sodium has a significant effect on the treatment of children with chronic bronchial asthma, which can improve lung function and immune function by regulating the expression of TLR4 / NF - κB signaling pathway, with high safety