To explore the clinical significance of traditional Chinese medicine (TCM) differential treatment of myelodysplastic syndrome (MDS) in accurate age.Methods:A total of 43 patients with MDS from the outpatient in hematology department of Xiyuan Hospital, China Academy of Chinese Medical Sciences during 2014 to 2016 were selected and differentiated as liver-kidney yin deficiency syndrome and spleen-kidney yang deficiency syndrome.They were treated with Compound Qinghuang Powder (CQHP) for 2 courses, and the objective differences under accurate indicators of patients with two syndromes in chromosomal karyotypes, IPSS risk stratification and gene mutation, as well as the therapeutic response to the treatment with CQHP were analyzed.Results:1）The clinical characteristics of two syndrome types:a.MDS subtype:The number of RAEB patients in spleen-kidney yang deficiency group (5/31) was significantly larger than that in liver-kidney yin deficiency group (0/12)(P<0.05).b.Chromosomalkaryo types:The proportion of patients with sound karyotypes (normal karyotype,+8,-Y) in spleen-kidney yang deficiency group(22/31) was significantly lower than that in liver-kidney yin deficiency group (3/12) (P<0.05).c.IPSS risk stratification:The proportion of low-risk patients in spleen-kidney yang deficiency group (4/31) was significantly lower than that in liver-kidney yin deficiency group (3/12) (P<0.05).d.Gene sequencing:The number of patients with combined mutation in spleen-kidney yang deficiency group (11/14) was larger than that in liver-kidney yin deficiency group (1/4)(P<0.05).2）For the patients' responds to the treatment with CQHP, the overall effective rate was 90.69%.a.Efficient rate of spleen-kidney yang deficiency group (30/31) was significantly higher than that of liver-kidney yin deficiency group (9/12) (P<0.05).b.Peripheral blood count:HB and NEUT in spleen-kidney yang deficiency group were significantly increased (P<0.05).c.Blood transfusion:48% patients did not receive blood transfusion after treatment (12/25).Blood transfusion volume per capital in two groups was significantly decreased (P<0.05).Conclusion:From the perspective of chromosomal karyotypes, IPSS risk stratification and gene sequencing, patients with MDS of spleen-kidney yang deficiency syndrome is more likely to have objective indicators with poor prognosis, but have a better response to treatment of CQHP.TCM differential treatment is conducive to providing accurate treatment.