Abstract: Objective To explore the effect of cetirizine adjuvant therapy on pulmonary ventilation function and Toll-like receptor(TLR)level in macrophages of peripheral blood in children with acute asthma attack. Methods A total of 120 children with acute asthma attack in Second Affiliated Hospital of Air Force Military Medical University were randomly divided into experimental group(n=60)and control group(n=60). The control group was treated with budesonide aerosol inhalation and the experimental group was treated with cetirizine on the basis of the control group, the treatments of two groups were lasted for 5 days. The therapeutic effects, the disappearance time of clinical symptoms, adverse reactions after 5 days of treatment were observed. Lung ventilation function ［forced expiratory volume In one second(FEV₁), forced vital capacity(FVC), peak expiratory flow rate(PEFR)］ and the levels of TLR1, TLR2 and TLR4 in macrophages of peripheral blood before and after 5 days of treatment were also compared. Results The total effective rate of the experimental group was 91.67%, which was higher than 75.00% of the control group after 5 days of treatment(P< 0.05); the disappearance time of wheezing, coughing and lung wheezing in the experimental group- were shorter than that in the control group(P< 0.05); the levels of FEV₁, FVC and PEFR after 5 days of treatment in the two groups were higher than those before treatment, and the experimental group was higher than those in the control group(P< 0.05); the levels of TLR1 and TLR2 in blood macrophages were higher than those before treatment, and the level of TLR4 in the experimental group was lower than those in the control group, and the experimental group was better than that in the control group(P< 0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05). Conclusion Cetirizine adjuvant therapy can enhance the curative effect, pulmonary ventilation function, improve the level of TLR in macrophages of peripheral blood, and promote the recovery of children with acute asthma attack, and it is safer.