Objective To explore the effect of Liushen pill combined with doxycycline tablets on symptom improvement in patients with moderate to severe acne of lung-stomach damp-heat syndrome. Methods A total of 100 patients with moderate to severe acne of lung-stomach damp-heat syndrome admitted to Yancheng Maternity and Child Health Care Hospital from February 2022 to January 2025 were selected. According to the random number table method, they were divided into the control group (n=50) and the study group (n=50). The control group was treated with doxycycline tablets alone, and the study group was treated with Liushen pill combined with doxycycline tablets. The clinical efffcacy, symptom improvement, symptom regression time and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group was 98.00%, which was higher than 84.00% in the control group (P<0.05). After treatment, the acne symptom score and the skin lesion number in the study group were lower than those in the control group (P<0.05). The regression time of pustules, papules, nodules and cysts in the study group was shorter than that in the control group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Liushen pill combined with doxycycline tablets in the treatment of moderate to severe acne of lung-stomach damp-heat syndrome can improve clinical efffcacy, alleviate acne symptoms, reduce the number of skin lesions, accelerate symptom regression, and has high safety.