Abstract： Objective： To observe the effect of modified Dahuang Fuzi Decoction on the expression levels of serum microRNA-30a (miR-30a) and microRNA-182 (miR-182) in patients with chronic renal failure (CRF). Methods ： A total of 109 CRF patients were selected and divided into the control group (55 cases) and the observation group (54 cases) according to the random number table method. Two cases were dropped off in the observation group， and eventually 52 cases were included， while three cases were dropped off in the control group， and 52 cases were included. The control group was treated with conventional treatment， and the observation group was additionally treated with modified Dahuang Fuzi Decoction based on the treatment of the control group. Both groups were treated for 12 weeks. The clinical effects and adverse reactions in the two groups were compared，and the changes of renal function indexes [serum creatinine (SCr)， urea nitrogen (BUN)， estimated glomerular filtration rate (eGFR)]， renal fibrosis indexes [typeⅢprocollagen (PC-Ⅲ)，laminin (LN)]，and expression levels of serum miR-30a and miR-182 were compared before and after treatment between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of miR-30a and miR-182 expression levels on the therapeutic effect，and Pearson test was used to analyze the correlation between miR-30a and miR-182 expression levels and eGFR. Results： The total effective rate was 86.54% in the observation group， and 67.31% in the control group， the difference being significant (P＜0.05). After treatment， the levels of serum BUN and SCr in the two groups were decreased when compared with those before treatment (P＜ 0.05)， and the eGFR levels were increased when compared with those before treatment (P＜0.05)； the levels of serum BUN and SCr in the observation group were lower than those in the control group (P＜0.05)， and the eGFR level in the observation group was higher than that in the control group (P＜0.05). After treatment， the levels of serum PC- Ⅲ and LN in the two groups were decreased when compared with those before treatment (P＜0.05)， and the levels of serum PC- Ⅲ and LN in the observation group were lower than those in the control group (P＜0.05). After treatment， the expression levels of miR-30a and miR-182 in the two groups were decreased when compared with those before treatment (P＜0.05)， and the expression levels of miR-30a and miR-182 in the observation group were lower than those in the control group (P＜0.05). In the observation group， 45 cases were total effective and seven cases were ineffective. Compared with those in the effective cases，the expression levels of serum miR-30a and miR- 182 in the ineffective cases were increased on the admission day (P＜0.05). The ROC curve showed that the AUC， sensitivity and specificity of serum miR-30a and miR-182 on the therapeutic effect were 0.808， 85.71% and 75.60%，respectively. Pearson test showed that the expression levels of miR-30a and miR- 182 in the observation group were negatively correlated with eGFR (P＜0.05). During the treatment， no serious adverse reactions were observed in the two groups. Conclusion：Modified Dahuang Fuzi Decoction has a good clinical effect on the treatment of CRF，which can promote the recovery of renal function，delay the progression of renal fibrosis， down-regulate the expression levels of serum miR-30a and miR-182， and the detection of miR-30a and miR-182 has a high predictive value for the therapeutic effect.