Abstract：Objective：To observe the clinical effect of the combination use of Zhuangshen Gujing Prescription and conventional western medicine on IgA nephropathy. Methods：A total of 72 IgA nephropathy patients who were treated in Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine，and Zhuhai People's Hospital from January 2023 to December 2023 were included. They were divided into the control group and the treatment group according to different treatment methods，with 36 cases in each group. The control group was given conventional western medicine for treatment，and the treatment group was additionally treated with modified Zhuangshen Gujing Prescription based on the treatment in the control group. The course of treatment was 24 weeks. The changes in 24-hour urine total protein（24 h-UTP），urinary albumin-to-creatinine ratio（UACR），serum creatinine（SCr），blood urea nitrogen （BUN）and estimated glomerular filtration rate （eGFR）were compared between the two groups before and after treatment，and the clinical effects and safety of medication were evaluated. Results：The total effective rate was 88.89 （32/36）in the treatment group and 77.78（28/36）in the control group；there were no significant differences between the two groups（P＞0.05）.Before treatment，there was no significant difference being found in the comparisons of the levels of kidney function indicators of BUN，SCr，eGFR，24 h-UTP and UACR between the two groups（P＞0.05）. After treatment，the SCr level in the treatment group was lower than that in the control group，and the eGFR level was higher than that in the control group，differences being significant（P＜0.05）；there was no significant difference being found in the comparisons of the levels of BUN，24 h-UTP and UACR between the two groups（P＞0.05）. Before and after treatment，there were no significant differences being found in the levels of safety indicators of K + ，Alb，ALT and AST between the two groups（P＞0.05）. The incidence of adverse reactions was 11.11%（4/36）in the treatment group and 19.44%（7 / 36）in the control group， there being no significant difference between the two groups （P＞0.05）. Conclusion： The therapy of Zhuangshen Gujing Prescription combined with conventional western medicine can improve the clinical effect on IgA，delay the decline of eGFR while reducing proteinuria，and effectively protect the kidney function with good safety.