Myelodysplastic syndromes are a group of clonal diseases originating from hematopoietic stem cells. They are characterized clinically by chronic progressive hematocrit of unknown origin, increased or normal bone marrow hematopoietic cells, morphologic changes with abnormal development, frequent lethal infections and bleeding during the course of the disease, and a high risk of transformation to acute leukemia. Recent retrospective clinical studies of MDS have shown that the overall leukemic transformation rate of MDS is about 30%, and most patients with MDS die either from leukemia or from infections, bleeding, and transfusion-related diseases due to hematocrit. At present, there is no specific treatment for MDS except for non-clearing allogeneic stem cell transplantation, and it has been a very difficult clinical problem to improve the efficacy, prolong the survival and improve the quality of life of MDS. Chinese medicine and the combination of Chinese and Western medicine have achieved certain efficacy in the treatment of this disease. Myelodysplastic syndrome (MDS) is not recorded in traditional Chinese medical texts, but in the past 10 years, Chinese medicine has studied the etiology and treatment of this disease. In the past decade, Chinese medicine practitioners have been studying the etiology and treatment of MDS, and most of them have classified it as “deficiency labor”, “acute consumption”, “blood evidence”, “internal injury and fever”, “fever in the body” and “fever in the body”. “It is believed that the etiology of the disease is due to the deficiency of congenital endowment, loss of nourishment, emotional and moral disorders, and poor diet, resulting in the deficiency of both spleen and kidney and the depletion of the source of blood production, or the external infection of the six evil spirits, or the injury caused by evil toxins, which turn into heat, burning the blood channels and depleting the fluids, resulting in the deficiency of both qi and yin and the internal obstruction of blood stasis, resulting in a wide range of symptoms. In the course of the disease, Yin and Yang deficiency, Qi failure, Yang deficiency and blood loss, and the death of Yin and Yang are also seen. The lesions are in the kidney and the spleen, and the deficiency is mostly seen in Qi and blood deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency; the actual evidence is mostly seen in heat and toxicity, blood stasis and stagnation. According to the WHO risk classification of MDS, the pathogenesis of MDS is based on the principle of “deficiency of essence, internal accumulation of evil and toxicity, and the axis of positive and negative effects”, combined with its pathogenetic characteristics and clinical typing, MDS is treated by typing and staging, and certain clinical efficacy has been achieved. In clinical treatment, it is found that the low-risk stage of MDS is mostly seen in patients with deficiency of spleen and kidney, resulting in deficiency of yin and loss of yang, and failure to transform essence and blood; the middle-risk stage is mostly seen in patients with deficiency of qi and yin for a long time, resulting in deficiency of liver and kidney, and internal heat and toxicity; the high-risk stage is mostly seen in patients with deficiency of qi and yin for a long time, resulting in internal stasis and toxicity. Low-risk stage: This stage is mostly for low-risk types such as RA, RCMD and RAS, including some patients with intermediate-risk type I MDS. Chromosomal examination is mostly without obvious chromosomal changes or good type chromosomes, with primitive cells <5%. The clinical symptoms are mainly anemia, which may be accompanied by irregular fever, mild bleeding symptoms, chlorosis or grayish dullness, lassitude, palpitation, dizziness, lumbar spine, impotence and weakness of both feet, fever from time to time, or fever in the heart of hands and feet, thin white coating, pale tongue or with teeth marks, and weak pulse. Most of the symptoms are due to deficiency of both spleen and kidney, deficiency of qi and yin, loss of yin and yang, and failure to transform essence and blood. Spleen deficiency is a lack of source of Qi and Blood biochemistry, see the face is atrophied or with gray dull, tiredness and reduction; kidney stores essence, the main bone marrow, essence and blood of the same source, kidney deficiency is the essence of blood can not be turned into blood, to fill the internal organs and veins, see the waist and spine soreness, both feet impotence and weakness; qi deficiency can not be turned into essence, blood deficiency is the heart loss of nourishment, see palpitations and dizziness; yin and blood deficiency, sometimes fever, or heat in the hands and feet. The treatment is to benefit qi and nourish blood, tonify the spleen and kidney, and fill in the marrow. The formula uses raw roasted Astragalus, Radix Codonopsis, Radix Rehmanniae, Radix Angelicae Sinensis, Cornu Cervi Pantotrichum, Fried Eucommia, Rhizoma Atractylodes Macrocephalae, Radix Paeoniae Alba, Semen Cuscutae, Rhizoma Polygonatum, Radix Scutellariae Sinensis. Some patients may have symptoms of spleen and kidney yang deficiency, such as fatigue, laziness, white face, cold feet, poor appetite and loose stools, soreness and weakness of the waist and knees, or swelling of the face and feet, pale tongue with white coating and sunken pulse. Clinical discretion can be used Xian Ling Spleen, bone flesh, Shu Shu Pian block, deer horn tablets and other warming medicines for kidney yang. Low-risk treatment is hoped to improve the quality of life by stimulating normal residual hematopoietic stem/progenitor cells, thus increasing the number of blood cells and getting rid of blood transfusion as soon as possible. A large amount of clinical pharmacology has confirmed that Chinese herbal medicines for strengthening the spleen and tonifying the kidney have the effect of promoting the proliferation and differentiation of bone marrow stem cells and early cells and self-replication, while Chinese herbal medicines can improve the imbalance of hematopoietic stimulating factors and hematopoietic inhibiting factors, reduce the apoptosis of hematopoietic progenitor cells, and promote the proliferation and differentiation of early hematopoietic cells through holistic diagnosis and treatment. Intermediate-risk stage: Most of the patients in this stage are RAEB, intermediate-risk-II patients. In addition to anemia, fever, fluctuating fever pattern or even high fever, with skin and mucous membrane bleeding, primitive cells >5%, or even peripheral blood with various types of infantile cells are seen. In addition to the symptoms of Qi-Yin deficiency, epistaxis and bleeding when brushing teeth are also seen, with a light red tongue, thin and greasy coating and a stringent pulse. The clinical evidence is due to deficiency of Qi and Yin, and internal heat and toxicity triggering liver fire. In Chinese medicine, the pathogenesis is mostly based on poison and stasis, with weakness of positive qi, deficiency of qi and yin, and internal heat invading the bone marrow, which consumes the body’s essence and blood for a long time, resulting in a deficiency of essence and blood and deficiency of internal organs; the evil of heat and toxicity evaporates from the bone marrow to the outside, soaking the organs, often triggering the fire in the liver, internally offending the blood, and damaging the ligaments and veins to see bleeding. Water hyacinth, dry lotus herb, celandine herb, lotus root charcoal, etc. Patients in the middle-risk stage often develop faster and later, although the deficiency evidence is heavy, the efficacy of using Yi Qi and nourishing Yin alone is often poor, so we should not omit the anti-cancer drugs for clearing heat and detoxification, and we should use Qing Dai, Flea Hu, White Flowered Snake Tongue Herb, Tiger Balm, etc., or add Liu Shen Wan and Niu Huang Detoxification Tablets, etc. If the bleeding is not obvious, we can add some drugs to activate blood circulation and remove blood stasis, such as Danshen, Safflower, Trigonella, Curcuma, etc. The clinical use of small doses does not aggravate the bleeding. For this stage of the patient’s condition, heavy drugs are used to detoxify and restore the marrow, while drugs that benefit Qi and nourish Yin can improve the body’s own immune function, and drugs that activate blood circulation and remove blood stasis have the effect of regulating immune function, improving the state of immune dysfunction, increasing the sensitivity of red lineage progenitor cells to erythropoietin, causing red blood cells to proliferate and differentiate, and treating the disease with evidence to support the root, enhance the body’s own anti-tumor activity, kill tumor cells, and improve The treatment is aimed at strengthening the body’s own anti-tumor activity, killing tumor cells and improving anemia, so that the disease can be relieved and transferred to low-risk stage. High-risk stage: Patients in this stage are mostly seen with relapsed and refractory MDS, and most of the patients in the high-risk stage have clear basic signs of leukemia. Since it is difficult to remove the evil toxin and relieve the disease in a short period of time with Chinese medicine alone, the combination of Chinese and Western medicine is the main treatment to prolong the patient’s survival. Patients with Qi-Yin deficiency for a long time resulting in internal stagnation of toxins are often seen, and after chemotherapy, symptoms of Qi-Yin deficiency are aggravated, mostly combined with liver fire, so clinical treatment is to benefit Qi and nourish Yin, to support the righteousness and eliminate evil, and also to clear the fire of liver wood, using Prince’s ginseng, Fu Ling, Atractylodes macrocephala, Bai Shao, Tian Dong, Sheng Di, Huang Bai, Bei Sha Shen, Mai Dong, Angelica sinensis, Fructus Lycii, Chen Pi, Pu Gong Ying, Bai Hua Serpent’s tongue grass, Tiger Balm, raw malt, etc. plus and minus. After the disease stabilizes, it can be strengthened to strengthen the spleen and nourish the kidneys, as well as to clear the liver and drain heat, and the medicine can be changed to raw astragalus, princely ginseng, fried atractylodes, made of semen, angelica, fried eucommia, white cow’s knee, wolfberry, white flower and snake tongue herb, Chen Pi, raw roasted licorice, tiger scepter, cyperus root, chicken blood vine, codonopsis, raw white peony, bone marrow, dandelion, fried cyperus, etc. plus and minus. The prognosis is poor. Combination of traditional Chinese and Western medicine is used to restore the normal hematopoietic function by killing the malignant clone, while not forgetting to regulate the internal organs, support the qi and blood, and remove the remaining evil, in order to consolidate the effect and obtain long-term remission. In Chinese medicine, there is no specific discussion on MDS, but most of them believe that it belongs to the category of “deficiency labor” and “blood deficiency”. Zhang’s Medical General says that “the deficiency of man is either qi or blood, and none of the five viscera and six internal organs can be outside, while the source of blood is the kidney and the source of qi is the spleen”, so the disease is mostly due to deficiency of the spleen and kidney, and various manifestations arise on the basis of deficiency of the spleen and kidney, and deficiency of the kidney leads to deficiency of essence, deficiency of the spleen leads to deficiency of qi, and lack of source of biochemistry of qi and blood leads to deficiency of blood. In the course of the disease, there is often an attack of evil toxins, which can burn the body’s fluids and blood channels, causing blood stasis in the internal organs and meridians, resulting in stagnation of the medulla oblongata, and no new blood to be produced. New blood cannot be produced, which can aggravate blood deficiency. Therefore, the pathology of MDS is not only a deficiency of spleen and kidney, but also a pathology of mixed deficiency and reality. In this treatment, if the deficiency is treated by tonifying the deficiency, the evil toxin will not go away and the new blood will not be produced; if the blood is used to detoxify the toxin, the positive energy will be easily injured. In our clinical practice, according to the risk classification of MDS, the characteristics of miscellaneous pathological changes in each stage of the disease, and the trend of positive and negative, we combine the diagnosis and diagnosis of the disease, and adopt the treatment method of benefitting Qi, nourishing Yin, and supporting the positive, and the treatment method of clearing heat and removing toxins, activating blood circulation and removing blood stasis is carried out in different degrees throughout the diagnosis and treatment. In the treatment of low-risk patients, the use of blood and flesh products that warm the kidney and fill the marrow is often bold; while in the diagnosis and treatment of medium-risk patients, detoxification and restoration of marrow should be the top priority, while taking into account the support of the righteousness, strengthening the spleen, benefiting the kidney, invigorating the blood and eliminating blood stasis, and the treatment of evidence-based; for high-risk patients, the use of traditional Chinese medicine to support the righteousness and anti-cancer, enhance immunity, and suppress tumors with chemotherapy induction, etc., can help patients improve symptoms, overcome bone marrow suppression, and reduce the impact of chemotherapy drugs on the gastrointestinal tract and the blood circulation. It is helpful for patients to improve symptoms, overcome bone marrow suppression and reduce the effects of chemotherapy drugs on gastrointestinal tract and liver and kidney functions. The results of clinical data show that the application of Chinese herbal medicine in the treatment of MDS can regulate the immune function of the patient’s body, promote the apoptosis and differentiation of bone marrow pathological hematopoietic cells, interfere with bone marrow pathological hematopoiesis, stimulate the growth of bone marrow hematopoietic cells, and induce their differentiation and maturation in order to restore the normal hematopoietic function of bone marrow. In the current situation where the diagnosis and treatment of the disease are not perfect, Chinese medicine treatment and the combination of Chinese and Western medicine treatment have their irreplaceable status. A large number of clinical data show that the application of Chinese medicine in the treatment of MDS can significantly improve the clinical symptoms and peripheral blood picture of patients, with more accurate clinical efficacy and lower adverse effects, but its specific mechanism of action still needs to be further explored and studied.