Abstract: Objective This study aimed to investigate the regulatory effects of Yupingfeng powder on helper T cell (Th)1 / Th17 immune imbalance and gut microbiota in patients with allergic rhinitis (AR). Methods A total of 104 AR patients admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine between April 2023 and November 2024 were enrolled. With the random number table method, participants were allocated into a study group and a control group (n= 52 each). The control group received conventional therapy, whereas the study group received Yupingfeng powder in addition to the same conventional regimen, with both groups being treated for 4 weeks. Clinical efficacy, Th1-type cytokines interleukin(IL)-2, interferon-γ, Th17-type cytokines (IL-17A, IL-22), serum immunoglobulin E (IgE), eosinophil counts, intestinal microbiota counts, total nasal symptom score (TNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ) score, and Pittsburgh sleep quality index (PSQI) score were compared between the two groups. Results After 4 weeks, the overall response rate in the study group was significantly higher than that in the control group (P＜0.05). Levels of IL-17A, IL-22, IgE, and eosinophils were lower, while those of IL-2 and interferon-γ were higher in the study group compared with the control group (P＜0.05). The count of Escherichia coli was decreased, whereas the counts of Lactobacillus and Bifidobacterium were increased in the study group (P＜0.05). TNSS, RQLQ, and PSQI scores at both 2 and 4 weeks were significantly lower in the study group than in the control group (P＜0.05). Conclusion Yupingfeng powder markedly improves clinical outcomes in AR by rectifying the Th1/Th17 immune imbalance, modulating gut microbiota, and enhancing the quality of life and sleep.