Objective:To observe the clinical efficacy of Xuefusheng Extract combined with associated prescriptions of syndrome differentiation in the treatment of chronic aplastic anemia and the influence on microRNA,lymphocyte subsets and cytokines in peripheral blood. Methods60 patients with chronic aplastic anemia were randomly divided into the treatment group and control group,30 cases in each group. Another 20 cases were included as the normal control group. The control group was treatedwith the routine basic treatment,and the treatment group was treated with Xuefusheng Extract combined with associated prescriptions of syndrome differentiation based on the treatment for the control group. The treatment course in both groups was 6 months with follow-up for 6 months. The clinical efficacy was observed,and the levels of hematological parameters in peripheral blood(including hemoglobin ,white blood count ,platelet count ,percentage of neutral granulocyte,percentage of lymphocytes and absolute count of reticulocyte ),the microRNA expressions(including miRNA-155-5p and miRNA-1260b) in peripheral blood mononuclear cells,the levels of lymphocyte subsets in peripheral blood(including the proportion of total T cells,B cells,NK cells,Th cells and Tc cells and the ratio of Th/Tc)and the levels of related cytokines in plasma(including interferon-γ,interleukin-12p70,tumor necrosis factor-α and transforming growth factor-β1)were detected and compared.  Results:①The clinical total effective rates were 83.33% in the treatment group and 53.33% in the control group. The clinical efficacy of the treatment group was significantly better than that of the control group(P<0.05). ②After treatment,there were statistically significant differences on the levels of Hb,WBC and Ret between the two groups,and the levels of the treatment group were obviously higher than those of the control group(P<0.05). ③After treatment,there were statistically significant differences on the expression levels of miRNA-155-5p and miRNA-1260b between the treatment group and control group,and expression levels of the treatment group were obviously lower than those of the control group(P<0.05). Compared with the normal group before the treatment,the expression levels of miRNA-155-5p and miRNA-1260b were obviously up-regulated in both treatment and control group(P<0.05). Compared with the normal group after the treatment,the expression levels of miRNA-155-5p and miRNA-1260b were decreased in both treatment and control group,but not reach the normal level(P<0.05). ④After treatment,there were statistically significant differences on the proportion of NK cells,Th cells and Tc cells and the level of Th/Tc between the treatment group and control group(P<0.05). Compared with the normal group before the treatment,the proportion of NK cells and Th cells and the level of Th/Tc in both treatment and control group were obviously lower than those in the normal group(P<0.05),and the proportion of Tc cells in both treatment and control group was obviously higher than that in the normal group(P<0.05). After treatment,there was statistically significant difference on the level of Th/Tc between the treatment group and normal group,and the level of Th/Tc in the treatment group was lower than that in the normal group(P<0.05),while there were no statistically significant differences on the proportion of NK cells,Th cells and Tc cells between the treatment group and normal group(P>0.05). After treatment,there were statistically significant differences on the proportion of NK cells,Th cells and Tc cells and the level of Th/Tc between the control group and normal group,and all the proportion and level in the control group were not to the normal levels(P<0.05). ⑤After treatment,there were statistically significant differences on the levels of IFN-γ,IL-12p70,TNF-α and TGF-β1 between the treatment group and control group(P<0.05). Before treatment,there were statistically significant differences on the levels of IFN-γ,IL-12p70,TNF-α and TGF-β1 between the normal group and treatment or control group,and the levels of IFN-γ,IL-12p70 and TNF-α in the treatment and control group were obviously higher than those in the normal group(P<0.05),and the level of TGF-β1 in the treatment and control group was obviously lower than that in the normal group(P<0.05). After treatment,there were statistically significant differences on the levels of IFN-γ,TNF-α and TGF-β1 between the normal group and treatment or control group,and the levels of IFN-γ,TNF-α and TGF-β1 in the treatment and control group were not to the normal levels(P<0.05),while there was no statistically significant difference on the level of IL-12p70 between the normal group and treatment group,and the level of IL-12p70 in the treatment group recovered to the normal level(P>0.05).  Conclusion:Based on the routine therapy of western medicine,Xuefusheng Extract combined with associated prescriptions of syndrome differentiation shows better efficacy in the treatment of chronic aplastic anemia. Its regulation mechanisms on abnormal immune in aplastic anemia may be associated with the improvement on imbalance of lymphocyte subsets,inhibition on hematopoietic negative regulators and down-regulation of miRNA-155-5p and miRNA-1260b expressions.