Abstract： Objective： To analyze the medication rules of ancient physicians in treating diabetic kidney disease （DKD） based on data mining， and to validate these rules through real-world studies and network proximity analysis. Methods：The fifth edition of the Zhong Hua Yi Dian （Collection of Traditional Chinese Medical Books） was utilized to retrieve oral traditional Chinese medicine （TCM） prescriptions for DKD. The Traditional Chinese Medicine Inheritance Computing System was employed to statistically analyze the properties， flavors， meridian entries， and usage frequencies of the Chinese medicinal herbs in the prescriptions. This was followed by an analysis of herbal association rules， core herbal combinations， and high-frequency herbal combinations. Real-world data and network proximity analysis were then used to conduct a preliminary comparative validation of the characteristics and usage frequency of Chinese medicinal herbs，and core herbal combinations between ancient and modern practices. Results： A total of 376 prescriptions for DKD from the Zhong Hua Yi Dian were included，involving 310 distinct herbs. Coldnatured herbs were the most frequently used， followed by warm-natured herbs； sweet-flavored herbs were the most common， followed by bitter-flavored herbs. The primary meridian entry was the kidney meridian. The top-five most frequently used single herbs were Ophiopogonis Radix， Ginseng Radix et Rhizoma， Poria， Glycyrrhizae Radix et Rhizoma， and Trichosanthis Fructus. Association rule analysis identified 124 herbal combinations with a support degree ≥ 20 and 15 herbal combinations with a confidence level ≥0.9. The real-world study included 30 972 patient visits for DKD， involving 444 distinct herbs. Cold-natured herbs were the most used， followed by warm-natured herbs；bitter-flavored herbs were the most common，followed by sweet-flavored herbs. The primary meridian entry was the kidney meridian，followed by the liver meridian. The rankings of the top-five herbs recorded in the ancient Chinese medical texts all fell within the top 5% of all herbs used in the real-world study. Cluster analysis identified six core herbal combinations，and the Z-scores calculated for the association between each core combination and DKD were all less than -4. Conclusion： The etiology of DKD is primarily attributed to liver-kidney deficiency， accompanied by dysfunction of the spleen， lung， and heart. In treating DKD， ancient physicians not only focused on tonifying deficiency to strengthen healthy qi but also on clearing heat and purging fire， assisted by promoting diuresis， percolating dampness， and inducing astringency to secure essence. In terms of prescription modification and application，particular importance was placed on the use of Jingui Shenqi Pills or Liuwei Dihuang Pills.