Abstract：Objective：To observe the clinical efficacy of Xianjie Powder in treating low-medium risk pulmonary nodules of phlegm stasis and heat junction type. Methods： A total of 144 patients with low-medium risk pulmonary nodules of phlegm stasis and heat junction type who visited the Henan General Hospital and the First Affiliated Hospital of Henan University of Chinese Medicine from November 2023 to November 2024 were selected and divided into an observation group and a control group，with 72 cases in each group，using a random number table method. During the treatment，12 cases in the observation group and 8 cases in the control group were excluded. The observation group took the Chinese medicine Xianjie Powder （Granules） orally， while the control group took a placebo of Xianjie Powder （Granules）. After three months of treatment， a follow-up chest CT was performed； the clinical efficacy and incidence of adverse reactions were compared between the two groups；the grading of pulmonary nodules was assessed； the changes in the maximum diameter of the nodules，the number of nodules，and their density in the chest CT before and after treatment were compared. Results：After three months of treatment，the total effective rate was 55.0% （33/ 60） in the observation group and 12.5% （8/64） in the control group，with a statistically significant difference between the two groups （P＜0.05） . After treatment， the pulmonary nodule area on the maximum diameter section in the observation group was reduced compared with that before treatment （P＜0.05）；with superior reduction compared with the control group， while the difference was not statistically significant （P＞0.05）. After treatment， the number of pulmonary nodules in the observation group significantly decreased compared with that before treatment （P＜0.05）； with greater reduction compared with the control group，while the difference was not statistically significant （P＞0.05）. No statistically significant difference was observed in the pulmonary nodule area on the maximum diameter and pulmonary nodule number in the control group before and after treatment （P＞0.05）. Both groups showed no statistically significant differences in pulmonary nodule density grading before and after treatment （P＞0.05）. No adverse reactions occurred in either group during the treatment period. Conclusion：Xianjie Powder has good clinical efficacy in treating low-medium risk pulmonary nodules of phlegm stasis and heat junction type. It can reduce the nodule area at the maximum diameter section，the number，and has good safety.