Objective: To study the effects of astragalus life-saving soup + western medicine on cognitive function and quality of life in patients with Alzheimer"s disease. Methods: From January 1, 2021 to December 31,2023, this study enrolled 70 Alzheimer"s disease patients at our hospital for comparative group analysis. The control group received conventional Western medication (donepezil hydrochloride tablets), while the observation group received a combination of Western medicine and traditional Chinese herbal formula Huangqi Xumian Decoction. The comparison focused on evaluating quality of life and cognitive function metrics between the two groups. Results: Prior to treatment, there was no statistically significant difference in the Alzheimer"s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) scores between the two groups (P>0.05). After treatment, the observation group scored lower than the control group (P<0.05). Both groups showed decreased scores on the Activities of Daily Living Scale (ADL), with the observation group scoring even lower (P<0.05). In terms of psychiatric and behavioral symptoms, the control group exhibited higher behavioral pathological scores on the Behavioral Pathology in Alzheimer"s Disease Rating Scale (BEHAVE-AD) after treatment (P<0.05). The incidence rates of adverse reactions were 20.00% in the observation group and 17.14% in the control group, showing no statistically significant difference (P>0.05). Treatment resulted in lower levels of β-amyloid 1-42 and phosphorylated tau protein at threonine 181 (P-TAU-181) in the observation group compared to the control group (P<0.05). The clinical response rate was also lower in the control group than in the observation group (P<0.05). Conclusion: Under the combined treatment of Chinese and Western medicine, the application of Astragalus Xunming Decoction combined with Donepezil Hydrochloride Tablets in Alzheimer"s disease patients has a positive impact on improving the quality of life, can improve the mental and behavioral symptoms of patients, delay the progression of the disease, improve the clinical treatment effect, and at the same time, it does not increase the adverse drug reactions, and has a safe guarantee.