Objective. To study the clinical value of Xiaozheng decoction combined with bladder perfusion treating bladder cancer after the operation and its effect on serum miR-143 and miR-92a. Methods. The patients in the control group were treated with gemcitabine bladder instillation, and patients in the study group were treated with the combination of gemcitabine bladder instillation + Xiaozheng decoction. The clinical efficacy, postoperative adverse effects, and recurrence between the two groups were compared. miR-143 and miR-92a levels, immune function levels, and tumor factor levels were compared before and after treatment. The relationship between patient prognosis and miR-143/miR-92a expression was analyzed. Results. The overall effective rate of treatment in the study group (86.67%) was significantly increased, and the occurrence of adverse reactions and recurrence were significantly decreased (
P
<
0.05
). After treatment, serum miR-143 and miR-92a levels, CD4+, CD4+/CD8+, and NK levels increased in both groups (P<0.05). CD8+ levels, BTA, NMP, and UBC levels decreased in both groups (
P
<
0.05
). Analysis of survival results indicated that the two-year survival rates of patients with miR-143 and miR-92a high expressions were significantly higher than patients with low expressions (
P
<
0.05
). Conclusion. The efficacy of Xiaozheng decoction combined with bladder perfusion in treating postoperative patients with bladder cancer was significant, which could reduce the incidence of adverse reactions and postoperative recurrence rate, improve serum tumor marker levels, and enhance patients’ immunity with a good prognosis.