Objective To establish a rat model of perimenopausal dry eye with liver and kidney yin deficiency from the perspective of “measuring evidence by prescription” in Chinese medicine. Methods Thirty SPFgrade female SD rats were divided randomly into sham-operated, model, and Qiju Dihuang soup groups (n=10). Rats in the latter two groups underwent bilateral ovariectomy and were given 0.1% benzalkonium chloride eye drops combined with provocation for 10 weeks to establish a model of perimenopausal dry eye with liver and kidney yin deficiency. After modeling, rats in the Qiju Dihuang soup group were gavaged with Qiju Dihuang soup at a dose of 8.37 g/(kg·d), rats in the sham-operated and model groups were gavaged with saline at a rate of 1 mL/100 (g·d) for 21 d. The general condition, retinal screen test scores, tear secretion, time of tear film rupture, and corneal fluorescein staining were observed and recorded in each group. Serum levels of follicle-stimulating hormone (FSH), estradiol (E₂), and progesterone (PROG) were measured by enzyme-linked immunosorbent assay. Pathological damage to the cornea and lacrimal glands were detected by hematoxylin/eosin staining. Expression levels of the inflammatory factors interleukin (IL)-1β and tumor necrosis factor (TNF)-α in the cornea were detected by immunohistochemistry. Results Compared with the sham-operated group, rats in the model group showed behavioral signs of slow action and reaction, irritability, body mass loss, and increased anal temperature (P<0.05), decreased retinal screen test scores (P<0.05), tear secretion (P<0.05), and time of tear film rupture (P<0.05), and pathological damage to the cornea and lacrimal glands. FSH levels increased and E₂ and PROG levels decreased (P<0.05) and expression levels of IL-1 and TNF-α increased in the model group compared with the sham group. All the above indexes were significantly improved in the Qiju Dihuang soup group compared with the model group. Conclusions From the perspective of “measuring evidence by formula” in Chinese medicine, we successfully established a rat model of perimenopausal dry eye with liver-kidney yin deficiency syndrome, which provides a theoretical and experimental basis for future systematic and in-depth research on the mechanism of perimenopausal dry eye with formula and evidence.