Abstract： Objective： To observe the clinical efficacy of Qizhe Xiaoying Prescription combined with Selenious Yeast in the treatment of Hashimoto's thyroiditis （HT） with benign thyroid nodules of qi deficiency and phlegm coagulation type，and to investigate its effect on inflammatory responses. Methods：A total of 66 patients with HT and benign thyroid nodules of qi deficiency and phlegm coagulation type，treated at Dongguan Traditional Chinese Medicine Hospital from April 2023 to October 2024，were selected．They were randomly divided into the treatment group and the control group using the random number table method， with 33 cases in each group． During the study， 1 case dropped out from the control group and 1 case was excluded from the treatment group， resulting in 32 patients in each group completing the study． The control group was treated with Selenious Yeast Capsules， while the treatment group received Qizhe Xiaoying Prescription combined with Selenious Yeast Capsules． Both groups were treated for 12 weeks． Traditional Chinese medicine syndrome scores， levels of anti-thyroid peroxidase antibody （TPOAb）， anti-thyroglobulin antibody （TgAb） ， thyroid-stimulating hormone （TSH） ， free thyroxine （FT4） ， free triiodothyronine （FT3），interleukin-17 （IL-17），interferon-γ （IFN-γ），and interleukin-10 （IL-10），as well as changes in thyroid isthmus thickness and the maximum diameter of the largest nodule，were observed before and after treatment in both groups． The traditional Chinese medicine syndrome efficacy and the incidence of adverse reactions were compared between the two groups. Results：After 12 weeks of treatment，traditional Chinese medicine syndrome scores and levels of TPOAb， TgAb， IL-17， and IFN- γ in both groups decreased compared with those before treatment（ P＜0.05）．The treatment group showed lower traditional Chinese medicine syndrome scores and lower levels of TPOAb， TgAb， IL-17， and IFN-γ than the control group （P＜0.05）． IL-10 levels in both groups increased compared with those before treatment （P＜0.05）， and the treatment group had higher IL-10 levels than the control group（ P＜0.05）．The thyroid isthmus thickness and the maximum diameter of the largest nodule in the treatment group decreased compared with those before treatment and were smaller than those in the control group （P＜0.05）． In the control group，there were no statistically significant differences in thyroid isthmus thickness and the maximum diameter of the largest nodule compared with those before treatment （P＞0.05）．There were no statistically significant differences in FT3， FT4， and TSH levels within each group before and after treatment，nor between the two groups after 12 weeks （P＞0.05）．The total effective rate for traditional Chinese medicine syndrome efficacy in the treatment group was 90.63% （29/32），higher than that of 65.63% （21/32） in the control group （P＜0.05）．The incidence of adverse reactions was 9.38% （3/32） in the treatment group and 6.25% （2/32） in the control group， with no statistically significant difference between the two groups （P＞0.05）． Conclusion： Qizhe Xiaoying Prescription combined with Selenious Yeast shows significant clinical efficacy in the treatment of HT with benign thyroid nodules of qi deficiency and phlegm coagulation type．Its mechanism may involve alleviating the inflammatory responses.