Sequelae of pelvic inflammatory disease (SPID) is a common gynecological disease, which is often accompanied by pathological changes and inflammation, and may even lead to infertility. The Yi-Qi-Qing-Shi-Hua-Yu method (YQQSHY), as a traditional Chinese medicine treatment method, is considered to have potential therapeutic effects on SPID. This study will explore the efficacy and potential mechanism of YQQSHY on SPID. This study established a SPID rat model by mixed bacteria and evaluated the regulatory effect of YQQSHY on uterine tissue pathology, immune status, and intestinal flora in SPID rats through histopathology, molecular experiments, immunology, and intestinal flora sequencing analysis. H&E staining showed that YQQSHY significantly reduced the pathological changes and fibrosis in the uterine tissue of SPID rats. ELISA results showed that YQQSHY could significantly reduce the levels of pro-inflammatory cytokines in the serum and vaginal secretions of SPID rats and increase the expression of anti-inflammatory factors. Flow cytometry analysis showed that the YQQSHY treatment group significantly adjusted the proportion of T cells in the peripheral blood of SPID rats. Western blot showed that YQQSHY can regulate TLR4, MyD88, p-NF-KB p65, and induce the transcription of p65 into the nucleus. Immunofluorescence examination of T cell subsets in uterine tissue. In addition, intestinal flora sequencing results showed that YQQSHY significantly modulated the composition and diversity of the intestinal flora of SPID rats. In conclusion, YQQSHY inhibits inflammatory response, regulates T cell ratio, and improves intestinal flora structure through the TLR4/NF-κB signaling pathway, which is the main mechanism for improving uterine inflammation and fibrosis in SPID rats. These findings provide experimental basis and theoretical support for further exploring the application of YQQSHY in clinical treatment.