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Background Symptomatic management is essential in dengue fever, yet effective therapies to alleviate clinical manifestations remain limited. We evaluated Qinge Tuire Jiedu Granules (QGTR), a traditional Chinese medicine formulation, for its efficacy in improving symptomatic outcomes in mild dengue patients.Methods In this double-blind, randomized, placebo-controlled trial, 45 mild dengue patients were randomized 2:1 to receive QGTR (12g, tid, n=31) or a matched placebo (n=14) for 5 days alongside standard care. Symptom scores, viral load, NS1 protein, and IL-6 were assessed at days 0, 2, 4, and 6.Results QGTR significantly alleviated multiple clinical manifestations, with diarrhea scores reduced by day 2 (mean difference: 0.58±0.26, P=0.049), and rash and arthralgia scores improved by days 4 and 6 (all P<0.05). Notably, gastrointestinal symptom relief was rapid in onset, preceding improvements in other manifestations. Concurrently, serum viral titers decreased 33.38% more by day 4 (P=0.046), NS1 protein levels were lower at day 2 (P=0.011), and IL-6 concentrations were significantly suppressed across days 2, 4, and 6 (all P<0.05). The early resolution of diarrheal symptoms coincided with virological and inflammatory improvements, suggesting integrated therapeutic effects. ( IDDF2026-ABS-0315 Figure 1. Symptoms and laboratory test trends of dengue fever patients)Conclusions QGTR effectively relieves gastrointestinal and other symptoms in mild dengue patients, with rapid diarrheal symptom improvement representing a prominent clinical response. These findings support QGTR integration into symptomatic management protocols and highlight gastrointestinal manifestations as responsive therapeutic indicators.Abstract IDDF2026-ABS-0315 Figure 1