Abstract： Objective： To observe the clinical efficacy of Sanjie Ruanjian Decoction in the treatment of thyroid nodules （TN） complicated with euthyroidism with phlegm blended with blood stasis syndrome. Methods： A total of 66 cases of patients with TN complicated with euthyroidism with phlegm blended with blood stasis syndrome admitted to the Department of Endocrinology of Kaifeng Hospital of Traditional Chinese Medicine from March 2023 to March 2024 were included in the study，and they were divided into the control group and the treatment group by the random number table method，with 33 cases in each group. Two cases were excluded from the control group and 31 cases were finally included； one case was excluded from the treatment group and 32 cases were finally included. In the control group，only reasonable diet，exercise，psychological counseling，and other routine interventions were given，and no medication was given. The treatment group was treated with Sanjie Ruanjian Decoction on the basis of the control group. Both groups were treated for three courses，then the clinical efficacy of the two groups was evaluated，the changes in traditional Chinese medicine （TCM） syndrome scores， ultrasonography of TN， levels of thyroid function indicators [thyroid stimulating hormone （TSH），free thyroxine （FT4），free triiodothyronine （FT3），total triiodothyronine （T3）， and total thyroxine （T4）]， and thyroid antibody indicators [thyroid peroxidase antibody （TPOAb） and thyroglobulin antibody （TgAb）]， as well as liver and kidney function indicators [alanine transaminase （AST）， alanine transaminase （ALT）， serum creatinine （SCr）， and blood urea nitrogen （BUN）] before and after treatment were compared between the two groups. Results： The total effective rate was 75.00% （24/32） in the treatment group and 9.68% （3/31） in the control group， the difference between the two groups being statistically significant （P＜0.05）. After treatment，the TCM scores of the treatment group were decreased compared with those before treatment and were lower than those of the control group，the difference being statistically significant （P＜0.05）；while the comparison of the TCM syndrome scores before and after treatment in the control group showed no statistically significant difference （P＞0.05）. After treatment， the number of nodules and the longest diameter of nodules in the treatment group were reduced compared with those before treatment， and both were less than those in the control group， the differences being statistically significant （P＜0.05）； while the comparison of the number of nodules and the longest diameter of nodules before and after treatment in the control group showed no statistically significant difference （P＞ 0.05）. The comparison of levels of serum TSH，FT3，FT4，T3，and T4 before and after treatment in the two groups showed no statistically significant difference （P＞0.05）. The comparison of levels of serum TPOAb and TgAb in the two groups showed no statistically significant difference （P＞0.05）. The comparison of levels of serum ALT，AST，BUN， and SCr before and after treatment in the two groups showed no statistically significant difference （P＞0.05）. Conclusion： Sanjie Ruanjian Decoction exerts good efficacy in the treatment of patients with TN complicated with euthyroidism with phlegm blended with blood stasis syndrome，which can help to alleviate the clinical symptoms of the patients and have a positive effect on reducing the number of thyroid nodules and shrinking the nodules，moreover，it did not affect thyroid function，liver function，or thyroid antibodies，with higher safety.