Objective To evaluate the efficacy and safety of Chinese medicine combined with chemotherapy in the initial treatment for secondary pulmonary tuberculosis （TB）. Methods Totally 1 402 cases of secondary pulmonary TB from 13 domestic agencies were randomized into the trial group and control group

with 701 in each. All patients were treated with 2HREZ/4HR chemotherapy program. The trial group was added with Chinese medicine according to the patterns: patients with lung yin deficiency pattern were given Ziyin Runfei Particles （yin-enriching lung-moistening particles）

patients with yin deficiency fire effulgence pattern were given Feitai Capsule and patients with qi-yin deficiency pattern were given Shuangbai Oral Liquid. The sputum smear

blood and liver function were detected monthly. The chest X-ray was reviewed and TCM patterns were scored bimonthly. The treatment course lasted for 6 months. The sputum smear-negative rate

lung shadows absorption

cavity closure

TCM pattern efficacy and side reactions were observed in both groups. Results The sputum smear-negative rate in the trial group was superior to that in the control group after 1-month treatment （P<0.05）. There was no significant difference between groups in the sputum smear-negative rate after 2-month

3-month

4-month

5-month and 6-month treatment （P>0.05）. The obvious absorption and absorption in the trial group was superior to that in the control group （P<0.01）. There was no significant difference between groups in the cavity closure （P>0.05）. The markedly effective rate of patients with three patterns in the treatment group was superior to that in the control group （P<0.01）. There was a significant difference between groups in the total effective rate of patients with yin deficiency fire effulgence pattern （P<0.01）. There was no significant difference between groups in the total effective rate of patients with other two patterns （P>0.05）. There was a significant difference between groups in the abnormal liver function （P<0.05）

leukopenia （P<0.05）

and gastrointestinal adverse reactions （P<0.01） in the trial group and control group respectively

and less side reaction occurred in the trial group. Conclusion Integrative medicine therapy is effective and safe in the initial treatment for secondary pulmonary TB.