Abstract：Objective：To observe the clinical efficacy of Yupingfeng Powder combined with Liujunzi Decoction in the treatment of children with adenoid hypertrophy （AH） complicated by obstructive sleep apnea （OSA）. Methods：A total of 68 children with AH complicated by OSA admitted to the Maternity and Children Care Hospital of Lishui City from April 2024 to December 2025 were enrolled. They were divided into a control group and an observation group using the random number table method，with 34 cases in each group. The control group was treated with conventional western medicine，while the observation group was treated with Yupingfeng Powder combined with Liujunzi Decoction on this basis. Both groups were treated continuously for four weeks. The clinical efficacy， traditional Chinese medicine syndrome scores， sleep monitoring parameters [Oxygen Desaturation Index （ODI） score， Apnea-Hypopnea Index （AHI） score， lowest oxygen saturation （SpO2） level， mean SpO2 level]， Pediatric Obstructive Sleep Apnea- 18 （OSA-18） questionnaire scores， and incidence of adverse reactions were compared between the two groups. Results：After treatment，the total effective rate in the observation group was 94.12% （32/34），higher than that of 76.47% （26/34） in the control group （P＜0.05）. After treatment，the scores of traditional Chinese medicine syndrome including snoring，nasal obstruction，mental fatigue and weakness，mouth breathing，sallow complexion，pharyngeal congestion，and runny nose，as well as the total traditional Chinese medicine syndrome scores in both groups decreased compared with those before treatment （P＜0.05），and all scores in the observation group were lower than those in the control group （P＜0.05）. After treatment， ODI and AHI scores in both groups decreased compared with those before treatment （P＜0.05）， and the ODI and AHI scores in the observation group were lower than those in the control group （P＜0.05）. After treatment，the lowest SpO2 level in the observation group increased compared with that before treatment （P＜0.05），but there was no statistically significant difference compared with the control group （P＞0.05）； the lowest SpO2 level in the control group showed no statistically significant difference before and after treatment （P＞ 0.05）. There was no statistically significant difference in the mean SpO2 levels between the two groups before and after treatment （P＞0.05）. After treatment， OSA-18 scores in both groups decreased compared with those before treatment （P＜0.05）， and the OSA-18 score in the observation group was lower than that in the control group （P＜ 0.05）. During treatment，the incidence of adverse reactions was 5.88% （2/34） in the observation group and 8.82% （3/ 34） in the control group，with no statistically significant difference between the two groups （P＞0.05）. Conclusion： Yupingfeng Powder combined with Liujunzi Decoction demonstrates good efficacy in AH complicated by OSA， which can improve sleep respiration and the manifestations of traditional Chinese medicine syndrome，and enhance the quality of life in children.