To investigate the effect and the underlying mechanism of Zilongjin Tablets combined with Anlotinib on angiogenesis and cell growth in lung cancer cells.Methods:A549 cells were divided into control group,Zilongjin Tablets group,Anlotinib group,and Combined group.Cell survival rate,proliferation,apoptosis,angiogenesis ability,and related protein expression were detected using MTT assay,5-ethynyl-2'-deoxyuridine(EdU) assay,colony formation assay,flow cytometry,tube formation assay,and Western blot.Results:Compared with the control group,the Zilongjin Tablets group,Anlotinib group,and combined group showed significantly lower cell survival rate,EdU-positive cell rate,colony formation rate,tube formation number,and levels of phosphorylated vascular endothelial growth factor receptor 2(p-VEGFR2),phosphorylated extracellular signal-regulated kinase(p-Erk),phosphorylated protein kinase B(p-AKT),and B-cell lymphoma-2(Bcl-2)(P<0.05).At the same time,the apoptosis rate and levels of cleaved caspase-3(Cl-caspase-3) and Bcl-2-associated X protein(Bax) were significantly higher(P<0.05).Compared with the Zilongjin Tablets group and Anlotinib group,the combined group showed significantly higher cell survival rate,EdU-positive cell rate,colony formation rate,tube formation number,and levels of p-VEGFR2,p-Erk,p-AKT,and Bcl-2 protein(P<0.05),while the apoptosis rate and Cl-caspase-3 and Bax protein levels were significantly lower(P<0.05).Conclusion:Zilongjin Tablets enhance the inhibitory effect of Anlotinib on angiogenesis and cell proliferation,and induce cancer cell apoptosis.This may be related to the inhibition of VEGFR-2 phosphorylation levels and its downstream signaling pathways.