By analyzing the connotation of "

kenang

（窠囊）" and its relationship with adenoid hypertrophy （AH） in children， this paper suggests that

kenang

plays a significant role in the development process of pediatric AH， from the initial accumulation of phlegm-dampness in the early stage， to the binding of phlegm and stasis in

the middle stage， and finally the healthy

qi

deficiency with phlegm stagnation in the late stage， and may also serve as a key entry point for the diagnosis and treatment. From the perspective of "

kenang

"， and in combination with the core pathogenesis of pediatric AH characterized by lung heat and phlegm stasis， this paper proposes that the key therapeutic principles include clearing heat to resolve phlegm， activating blood to remove stasis， and reducing swelling to dissipate nodules. A staged treatment strategy based on the self-formulated

Bizhi Formula

（鼻窒方） with modifications is used. In the early stage of the disease， the treatment should be soothing the wind and relieving the exterior， resolving phlegm and dredging the orifices to prevent the initial knot of

kenang

， for which

Bizhi Formula

and

Cangerzi Powder

（苍耳子散） with modifications can be used. In the middle stage， the treatment should be dissolving phlegm and expelling stasis， dispersing knots and unblocking orifices to break down the establishment of

kenang

， and

Bizhi Formula

combined with

Haizao Yuhu Decoction

（海藻玉壶汤） with modifications is suggested. In the late stage， the treatment emphasizes reinforcing healthy

qi

and consolidating the root， resolving phlegm and dredging collaterals in order to prevent recurrence of

kenang

， and the suggested prescription is modified

Bizhi Formula

combined with

Shenling Baizhu Powder

（参苓白术散）.