To explore the efficacy and mechanism of Xiaoer Baotaikang Granules in the treatment of herpangina with wind-heat attacking spleen syndrome in children.Methods:The randomized controlled trial(RCT) was performed.Sixty-four herpangina children with wind-heat attacking spleen syndrome treated in the Pediatrics Department，Wuhan Hospital of Traditional Chinese Medicine from January 2021 to January 2022 were enrolled and randomly divided into a control group(n=32) and an observation group(n=32).All children underwent conventional treatment，while those in the observation group received additional oral Xiaoer Baotaikang Granules.In both groups，treatment lasted five days.The antipyretic time，pharyngeal pain relief time，herpes resolution time，and food intake recovery time of the two groups were recorded and compared.At the same time，the inflammatory factors interleukin-6(IL-6)，serum amyloid A(SAA)，and myocardial damage index creatine kinase-MB(CK-MB) were statistically analyzed.Results:The total effective rate of the observation group was 96.88%，higher than 84.38% of the control group(P<0.01).The antipyretic time，pharyngeal pain relief time，herpes resolution time，and food intake recovery time of the observation group were shorter than those of the control group(P<0.01).After treatment，the levels of IL-6，SAA，and CK-MB in the two groups were lower than those before treatment，and the levels in the observation group were all lower than those of the control group(P<0.05).Conclusion:Xiaoer Baotaikang Granules in the treatment of herpangina children with wind-heat attacking spleen syndrome characterized by fever can significantly shorten the antipyretic time，relieve the symptoms of pain and loss of appetite，promote the healing of herpes，and reduce myocardial damage，with definite clinical efficacy and no obvious adverse reactions.The underlying mechanism may be mainly related to the reduction of inflammatory factors，thereby inhibiting the inflammatory response，and at the same time，preventing myocardial damage.