Abstract: Based on the theory of "thriving spleen in four seasons, preventing pathogenic invasion", Professor Zhao Xia proposes that the core pathogenesis of pediatric recurrent respiratory tract infections (RRTIs) in the intermission stage lies in spleen dysfunction in transportation, unconsolidated lung defense. Specifically, this manifests as spleen deficiency and impaired transportation, leading to stagnation of qi; disharmony of nutritive and defensive qi, resulting in weakened external defense; spleen deficiency generating phlegm, and accumulation of heat and stasis; and dysfunction of zang-fu organs, leading to other complications. The key points of prevention and treatment are promoting spleen transportation to prevent infection and tonifying the lungs to consolidate defensive qi. Specific treatment methods include promoting spleen transportation for infection prevention and consolidating exterior to arrest sweating; treating lung and spleen simultaneously to harmonize nutrient qi and defensive qi; clearing heat and transporting spleen to resolve accumulation and dispel phlegm; regulating the zang-fu organs and performing syndrome-based modification of prescriptions. This theory provides important theoretical basis and clinical guidance for the prevention and treatment of RRTIs.