Objective To investigate the therapeutic efficacy of Suzi Jiangqi Decoction and Sanzi Yangqin Decoction combined with ambroxol hydrochloride in elderly patients with community-acquired pneumonia (CAP) of phlegm turbidity obstructing lung syndrome. Methods A total of 148 elderly patients with phlegm-turbidity obstructing lung type CAP admitted to our hospital were prospectively selected as the study subjects (selection time: January 2023-November 2025). They were randomly divided into reference group (74 cases, treated with ambroxol hydrochloride) and Chinese medicine group (74 cases, treated with additional Suzi Jiangqi Decoction and Sanzi Yangqin Decoction combined with ambroxol hydrochloride). The incidence of adverse reactions and clinical efficacy were compared between the two groups, as well as the lung function indexes [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC], cellular immune function indexes [CD3+^{, CD4}+^/CD8+^{, CD4}+^{, CD8}+^{], TCM syndrome scores}, inflammatory mediators [amyloid A (SAA), CXC chemokine ligand 10 (CXCL10), interleukin-6 (IL-6), pentraxin 3 (PTX3)] levels before and after treatment. Results Compared with the total effective rate of the reference group (83.78%), the Chinese medicine group (95.95%) was significantly higher (P<0.05); after treatment, the levels of SAA, TCM syndrome scores, CXCL10, CD8⁺, IL-6 and PTX3 in the Chinese medicine group were lower than those in the reference group (P<0.05), and the levels of FVC, CD3+^{, FEV}1, CD4+^/CD8+^{, PEF, CD4}+^{and FEV}1/FVC were higher than those in the reference group (P<0.05). There was no significant difference being found in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Suzi Jiangqi Decoction combined with Sanzi Yangqin Decoction + Ambroxol Hydrochloride is effective in the treatment of CAP in elderly patients with phlegm turbidity obstructing lung syndrome, which can reduce inflammatory reaction and clinical symptoms, and improve lung function and cellular immune function.