Abstract: Based on the theory of "the spleen and stomach as the pivot", Professor Xiong Lei's clinical thinking of "moving the pivot and removing stale qi" to treat depression in children and adolescents is summarized. It is believed that the key mechanism of depression in children and adolescents is the unfavorable pivot of the spleen and stomach, and the disharmony between qi and blood of the five organs, which leads to the growth of stale qi, the clouding of the clear orifices by turbid evils, and the malfunction of the spirit. If the pivot is unfavorable, move it, and if the stale qi is endogenous, remove it. Professor Xiong, based on the concept of "treating with orchids and removing stale qi" from The Yellow Emperor's Inner Classic, utilizes aromatherapy in Chinese medicine, taking "moving the pivot and removing stale qi" as the basic treatment, and proposes Xiangzhi Shuxin Formula as the basic formula, which applies five methods of removing dampness, resolving phlegm, eliminating accumulation, removing stasis, and dispersing fire and relieving depression. An experimental case is attached to explain his clinical thinking.