Abstract： Objective： To observe the clinical efficacy of buccal acupuncture combined with Chinese medicine and intranasal glucocorticoid in the treatment of pediatric adenoid hypertrophy （AH） of qi deficiency and phlegm coagulation type， and to explore the synergistic therapeutic effect of buccal acupuncture. Methods ： A total of 68 children with AH of qi deficiency and phlegm coagulation type treated at Guangdong Provincial Hospital of Chinese Medicine from October 2024 to December 2025 were enrolled and they were randomly divided into the observation group and the control group using the random number table method，with 34 cases in each group. During treatment，3 cases dropped out from the observation group and 2 cases from the control group. The control group was treated with Liujunzi Decoction combined with Xiaoluo Pills and Mometasone Furoate Nasal Spray， while the observation group received buccal acupuncture in addition to the treatment given to the control group. Both groups were treated for four weeks. The clinical symptom scores， adenoid volume scores， and Obstructive Sleep Apnea-18 （OSA-18） quality of life scores before and after treatment， as well as the total effective rates were compared between the two groups. Results： The total effective rate was 93.55% （29/31） in the observation group and 68.75% （22/32） in the control group， with a statistically significant difference between the two groups （P＜0.05）. After treatment， the individual symptom scores （mouth breathing， nocturnal snoring， nasal congestion， rhinorrhea， cough， throat discomfort， tonsil enlargement） and the total symptom score decreased in both groups compared with those before treatment （P＜0.05）； the observation group had lower scores for mouth breathing， nasal congestion， rhinorrhea， and total symptom score than the control group （P＜0.05）， while no significant differences were found between the two groups in scores for nocturnal snoring，cough，throat discomfort，or tonsil enlargement （P＞0.05）. After treatment，the adenoid volume scores decreased in both groups compared with those before treatment （P＜0.05）， and the observation group had a lower adenoid volume score than the control group （P＜0.05）. After treatment，the OSA-18 scores decreased in both groups compared with those before treatment （P＜0.05），and the observation group had a lower OSA-18 score than the control group （P＜0.05）. No significant adverse reactions occurred in either group during treatment. Conclusion： Buccal acupuncture combined with Chinese medicine and intranasal spray significantly improves clinical efficacy in children with AH of qi deficiency and phlegm coagulation type， with certain effects in reducing adenoid volume and improving quality of life，and shows no significant adverse reactions.