Abstract： Objective： To observe the clinical effect of the combination use of Wenshen Jianpi Tongyang Prescription and western medicine on steroid-resistant refractory nephrotic syndrome （SRNS） with spleen-kidney yang deficiency syndrome. Methods： A total of 96 patients with SRNS with spleen-kidney yang deficiency syndrome who were treated in Chinese Medicine Hospital of Puyang from March 2022 to January 2024 were selected and divided into the control group and the treatment group according to the random number table method，with 48 cases in each group. The control group was treated with conventional western medicine，and the treatment group was additionally treated with Wenshen Jianpi Tongyang Prescription based on the treatment in the control group. Both groups were treated for 12 weeks. The clinical effects，and the traditional Chinese medicine syndrome scores，renal interlobar artery hemodynamic index， levels of serum ficolin-3 （FCN3）， nuclear factor kappa-B （NF- κB）， procollagen Ⅲ（PC Ⅲ）， monocyte chemoattractant protein-1 （MCP-1）， cystatin C， high-sensitivity C-reactive protein （hs-CRP）， serum creatinine and 24-hour urinary protein quantity before and after treatment were compared between the two groups. Results：After treatment，the total effective rate was 97.83% （45/46） in the treatment group，higher than that of 82.61% （38/46） in the control group （P＜0.05）. The peak systolic velocity （PSV） of interlobar arteries of kidney in the two groups was increased when compared with that before treatment （P＜0.05）， and the PSV of interlobar arteries of kidney in the treatment group was faster than that in the control group （P＜0.05）. The traditional Chinese medicine syndrome scores， resistance index of interlobar arteries of kidney（RI） and pulsatility index（ PI），and the levels of serum FCN3，NF-κB， MCP-1， hs-CRP， PC Ⅲ ， cystatin C， serum creatinine and 24-hour urinary protein quantity in the two groups dwindled when compared with those before treatment （P＜0.05）， and the above indexes in the treatment group were lower than those in the control group （P＜0.05）. Conclusion：The therapy of Wenshen Jianpi Tongyang Prescription combined with western medicine has a good curative effect on SRNS with spleen-kidney yang deficiency syndrome， which can improve the micro-inflammatory state of the body， kidney function and renal hemodynamics， reduce the renal fibrosis，relieve the disease condition and enhance the clinical effect.