Objective To observe the effect of Yiqi Qingre decoction and acupuncture treatment on the wind and heat in collaterals type of facial paralysis with ear pain in the acute stage. Methods 90 cases of acute facial paralysis with ear pain were randomly divided into common acupuncture group， acupuncture group of nourishing qi and clearing heat（Qingre Yiqi acupuncture group）， and Qingre Yiqi acupuncture group with medicine， each group of 30 cases. Common acupuncture group was treated with conventional acupuncture treatment， acupuncture selected from the affected side Yangbai， Sun， Sizhukong， Sibai， Quanliao， Warehouses， Buccal car， Pull， Bearing slurry， bilateral Hegu and Fengchi； Qingre Yiqi acupuncture group was treated with bilateral Zusanli， Baihui， Waiguan， Dazhui points on the basis of common acupuncture group；treatment group was treated with Yuping Feng pulvis（Huangqi， Baizhu， Fangfeng， fried Gardenia， Jin yinhua， Jiangcan， Dilong） based on Qingre Yiqi acupuncture group. The three groups were treated with 21d for 1 courses， 1 courses of treatment. Ear pain score， duration of acute pain， Toronto of neurological function score and the total efficacy before and after treatment in three groups were observed. Results There were significant differences on duration of ear pain in three groups after the treatment， and the treatment group was significantly less than those of the other two groups（P<0.01）. There were no significant differences on facial nerve score in three groups before the treatment（P>0.05）； there were significant differences on facial nerve score in three groups after the treatment， and the treatment group was significantly higher than that in the other two groups（P<0.01）. There were significant differences on the total efficacy in three groups after the treatment， and the treatment group was better than that in the other two groups（P<0.01）. Conclusion Yiqi Qingre decoction and acupuncture treatment have obvious effect on improving the wind and heat in collaterals type of facial paralysis with ear pain in the acute stage.