Abstract: Taking Xiaochaihu Decoction as an example, the application differences of classical prescriptions in modern medical context and Chinese medicine practice are compared and analyzed from the aspects of clinical application scope, understanding of prescription connotation, dosage specification, dosage form and decoction method. Strategies to solve the differences in efficacy are proposed: integrating the wisdom of classical prescriptions and reshaping the framework of Chinese medicine diagnosis and treatment; transforming the results of modern pharmacology and exploring the principles of classical prescriptions; controlling drug quality standards and exploring new uses and dosages of classical prescriptions; keeping pace with the times in Chinese medicine decoction and strengthening management and control to ensure efficacy. It is believed that combining the essence of Chinese medicine with modern technology can make the application of classical prescriptions maintain traditional characteristics while meeting modern clinical requirements. This can not only improve the adaptability of classical prescriptions to modern complex diseases, but also provide a reference for the modernization of traditional medicine.