Objective: To investigate the efficacy and safety of Xinqin Granules combined with cetirizine hydrochloride and mometasone furoate in treating children with adenoid hypertrophy. Methods: A total of 106 children with adenoid hypertrophy were enrolled as subjects. According to the different treatment medications, they were divided into a combination group (n=50) and a control group (n=56). The control group received cetirizine hydrochloride and mometasone furoate treatment, while the combination group received additional Xinqin Granules based on this regimen. After 3 months of treatment, the Adenoid/Nasopharynx ratio (A/N ratio), TCM syndrome efficacy, main TCM symptom scores, and immune function-related indicators were compared between the two groups, and their safety was assessed. Results: After treatment, the A/N ratio in the combination group was lower than that in the control group (P<0.05). The total effective rate of TCM syndrome efficacy in the combination group was higher than that in the control group (P<0.05). After treatment, the scores for nasal congestion and snoring symptoms in the combination group were lower than those in the control group (P<0.05), while there was no statistically significant difference in the mouth-breathing symptom score between the two groups (P >0.05). After treatment, the percentages of CD4? T cells, the CD4?/CD8? T cell ratio, and the levels of immunoglobulin (Ig)G and IgA in the combination group were higher than those in the control group(P<0.05), while the IgE level was lower than that in the control group(P<0.05). There was no statistically significant difference in the percentage of CD8? T cells between the two groups(P>0.05). No adverse reactions occurred in either group during the treatment period. Conclusion: The combination of Xinqin Granules with cetirizine hydrochloride and mometasone furoate is more conducive to improving clinical symptoms and reducing adenoid volume in children with adenoid hypertrophy, resulting in superior therapeutic effects. Its mechanism may be related to regulating the balance of T lymphocyte subsets, and its clinical application is safe and feasible.