Abstract： Objective： To observe the clinical efficacy of modified Sini Powder combined with tuina in treating mesenteric lymphadenitis with liver-spleen stagnation syndrome in children. Methods： A total of 80 children with mesenteric lymphadenitis of liver-spleen stagnation syndrome treated at the outpatient department of pediatrics， Hangzhou Linping Hospital of Integrated Traditional Chinese and Western Medicine from April 2023 to March 2024 were included and divided into the tuina group and the combination group using the random number table method， with 40 cases in each group. The tuina group received tuina therapy， while the combination group received modified Sini Powder orally combined with tuina. Both groups were treated continuously for two weeks. Before and after treatment， abdominal pain scores and traditional Chinese medicine syndrome scores were assessed， the time to relief and disappearance of abdominal pain were recorded， and the longitudinal diameter， transverse diameter of the largest mesenteric lymph node were measured. The clinical efficacy and recurrence rates within one month of follow-up were compared between the two groups. Results： After treatment， the total effective rate in the combination group was higher than that in the tuina group （P＜0.05）. After seven days of treatment，abdominal pain scores were decreased in both groups when compared with those before treatment （P＜0.05）；after 14 days of treatment，abdominal pain scores were further decreased in both groups when compared with those after seven days of treatment （P＜0.05）. The abdominal pain scores in the combination group were lower than those in the tuina group at both seven and 14 days of treatment （P＜0.05）. The time to relief and disappearance of abdominal pain in the combination group was shorter than that in the tuina group（ P＜0.05）. The longitudinal diameter，transverse diameter，and ratio of longitudinal diameter to transverse diameter of the largest mesenteric lymph node were decreased in both groups when compared with those before treatment （P＜0.05）， with the combination group showing lower values than the tuina group （P＜0.05）. Traditional Chinese medicine syndrome scores were decreased in both groups when compared with those before treatment （P＜ 0.05）， with the combination group showing lower scores than the tuina group （P＜0.05）. The recurrence rate in the combination group was lower than that in the tuina group （P＜0.05）. Conclusion：Modified Sini Powder combined with tuina can accelerate the relief of abdominal pain in children with mesenteric lymphadenitis of liver-spleen stagnation syndrome，shorten the disease course，reduce the size of swollen lymph nodes，and reduce recurrence.