Abstract： Objective： To observe the clinical efficacy of modified Chaishao Liujunzi Decoction combined with western medicine in the treatment of chronic renal failure. Methods：A total of 132 patients with chronic renal failure admitted to Wenzhou Hospital of Traditional Chinese Medicine from March 2022 to January 2024 were randomly divided into the observation group and the western medicine group，with 66 cases in each group，using a random number table method. The western medicine group received symptomatic treatment with western medicine， while the observation group received modified Chaishao Liujunzi Decoction on the basis of the western medicine group. Both groups were treated for three months. Compared the levels of inflammatory factors [interleukin-6 （IL-6），24-hour urinary protein quantification and C-reactive protein （CRP）]，toxin clearance rates [β2-microglobulin，parathyroid hormone （PTH） and serum phosphorus]， renal function [blood urea nitrogen （BUN） and serum creatinine （SCr）]， and traditional Chinese medicine syndrome scores before and after treatment in the two groups，and observed the occurrence of adverse reactions. Results：After treatment，the levels of serum IL-6，24-hour urinary protein quantification，and CRP in both groups were decreased when compared with those before treatment （P＜0.05），and the levels of serum IL-6，24- hour urinary protein quantification， and CRP in the observation group were lower than those in the western medicine group （P＜0.05）. The toxin clearance rates of such as β2-microglobulin， PTH， and serum phosphorus in the observation group were higher than those in the western medicine group （P＜0.05）. After treatment，the levels of BUN and SCr in both groups were decreased when compared with those before treatment （P＜0.05），and the levels of BUN and SCr in the observation group were lower than those in the western medicine group （P＜0.05）. After treatment，the scores of various traditional Chinese medicine syndromes in both groups were decreased when compared with those before treatment （P＜0.05），and the scores of various traditional Chinese medicine syndromes in the observation group were lower than those in the western medicine group （P＜0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： The modified Chaishao Liujunzi Decoction combined with western medicine treatment can effectively reduce the levels of inflammatory and urinary protein in patients with chronic renal failure， improve toxin clearance rates， improve renal function， and has high safety.