Abstract： Objective To explore the therapeutic effect of Pinggan Dingxuan Mixture(平肝定眩合剂)combined with acu-puncture on patients with hyperactive liver-Yang posterior circulatory ischemia(PCI).Methods Between June 2020 and June 2022,90 patients with hyperactive liver-Yang PCI were randomly selected in the hospital and divided into observation group(45 cases)and control group(45 cases)by random number table method.The control group was treated with acupuncture,and the observation group was treated with Pinggan Dingxuan Mixture on the basis of acupuncture.The therapeutic efficacy,adverse reac-tions and the changes of serum fibrinogen(FIB),creatinine(Cr)and alanine aminotransferase(ALT)of the two groups were com-pared.At the same time,the patients were examined by transcranial Doppler ultrasound(TCD).Results There was no difference in the total effective rate and incidence of adverse reactions between two groups(P＞0.05).After treatment,the serum FIB con-centration in the observation group was lower than that in the control group(P＜0.05),and the average blood flow velocity(Vm)in left、right vertebral arteries and basilar artery was higher than that in control group(P＜0.05).After treatment,there were no significant changes in serum Cr and ALT between the two groups(P＞0.05),and there was no statistical significance between the two groups(P＞0.05).Conclusion Pinggan Dingxuan Mixture combined acupuncture and single acupuncture treatment have cer-tain therapeutic effects on hyperactive liver-Yang type PCI,but the combined therapy has more significant positive effects on cer-ebral blood supply and brain cells of patients,and has certain safety,worthy of clinical attention.