Abstract： Objective： To observe the clinical effect of Tiaoqi Huoxue Sanjie Prescription combined with ultrasound-based drug delivery in the treatment of nodular goiter of phlegm accumulation and blood stasis type. Methods： A total of 60 patients with nodular goiter who visited Traditional Chinese Medicine Hospital of Huzhou from January 2022 to January 2023 were selected and randomly divided into control group and observation group according to the random number table method， with 30 cases in each group. Both groups received oral administration of Tiaoqi Huoxue Sanjie Prescription， and the observation group was additionally treated with ultrasound-based drug delivery therapy. Both groups were treated for eight weeks. Clinical effects were evaluated in the two groups. Traditional Chinese medicine syndrome scores， thyroid function-related indicators， and the number and maximum diameter of nodules measured by thyroid ultrasound examination were compared between the two groups before and after treatment. The occurrence of adverse reactions was observed. Results： The total effective rate in the observation group was 53.33% （16/30），which was higher than that of 26.67% （8/30） in the control group （P＜0.05）. After treatment，the traditional Chinese medicine syndrome scores in the observation group were lower than those before treatment and those in the control group （P＜0.05） . After treatment，the maximum diameter of nodules in the two groups were declined significantly compared to those before treatment （P＜0.05），and the maximum diameter of nodules in the observation group was smaller than that in the control group （P＜0.05） . After treatment， there were no significant changes in thyroid function-related indicators in the two groups compared to those before treatment （P＞0.05） . No significant adverse reactions occurred during the treatment period in both groups. Conclusion： The combination of oral administration of Tiaoqi Huoxue Sanjie Prescription and ultrasound-based drug delivery can effectively reduce nodules， alleviate clinical symptoms， and have a definite therapeutic effect. It will not impact on thyroid function， exhibit no significant adverse reactions，and possess excellent safety.