Objective To observe the therapeutic effect of Toxin-Resolving Blood-Cooling Formula（TRBCF）combined with western medicine for hepatitis B related acute-on-chronic liver failure（HB-ACLF）with heat-toxin stasis bind pattern and research its effective patient population.Methods Totally 105 HB-ACLF patients with heat-toxin stasis bind pattern were randomized into the integrative medicine group of 64 cases and western medicine group of 41 cases.The western medicine group was given western comprehensive treatment.The integrative medicine group was added with TRBCF.The treatment lasted for 8 weeks and the follow-up lasted for 40 weeks.The clinical efficacy in both groups was compared in the 8th and 48th week.The TCM pattern scores and model for end-stage liver disease（MELD）scores in both groups were observed in the 0

2nd

4th

6th

8th

12th

24th and 48th week.The effective patient population was analyzed according to MELD score.Results After 8-week treatment

the total effective rate of the integrative medicine group and western medicine group was 75.00% and 51.22%respectively and the mortality rate was 15.63% and 34.15%respectively

with a significant difference between groups（P<0.05）.In the 48th week

the total effective rate of the integrative medicine group and western medicine group was70.31% and 51.22% respectively and the mortality rate was 21.88% and 39.02% respectively

with a significant difference between groups（P<0.05）.The TCM pattern score and MELD score at each time point of treatment and follow-up was significantly decreased in the integrative medicine group（P<0.05）.The TCM pattern score was significantly decreased in the8th week and at each time point of follow-up and MELD score was significantly deceased in the 6th and 8th week and at each time point of follow-up in the western medicine group（P<0.05）.Comparing with the western medicine group

the TCM pattern score was significantly decreased from the 2nd to 12th week and MELD score was significantly deceased in the 2nd

4th

6th and 8th week in the integrative medicine group（P<0.05）.The mortality rate of patients whose MELD score ranging from 22.6 to 29.9was 23.81% and 58.82% in the integrative medicine group and western medicine group respectively（P<0.05）.Conclusion The combo therapy of TRBCF and western medicine can increase effective rate and reduce mortality rate of HB-ACLF patients whose MELD score ranging from 22.6 to 29.9.