Abstract：Objective：To observe the clinical efficacy of Yiqi Yangyin Quyu Prescription combined with western medicine in treating patients with diabetic kidney disease （DKD） in stage Ⅲ-Ⅳ with atherosclerosis （AS） of qi-yin deficiency complicated with blood stasis syndrome，and to evaluate its effect on lipid metabolism. Methods：A total of 80 patients with DKD in stage Ⅲ-Ⅳ with AS of qi-yin deficiency complicated with blood stasis syndrome who were admitted to the Department of Nephrology，Pinghu Chinese Medicine Hospital Affiliated to Jiaxing University from April 2023 to March 2024 were selected and divided into the observation group and the control group using the random number table method，with 40 cases in each group. During the study，two cases dropped out and three cases were excluded from the observation group， while one case dropped out and two cases were excluded from the control group. The control group received western medicine treatment，while the observation group received Yiqi Yangyin Quyu Prescription on the basis of the control group's treatment. Both groups were treated for 24 weeks. The traditional Chinese medicine （TCM） syndrome efficacy and safety were evaluated. The following parameters were compared between the two groups： ASrelated indicators [carotid intima-media thickness （IMT）， plaque area]， TCM syndrome scores， lipid indicators [triglycerides （TG），total cholesterol （TC），low-density lipoprotein cholesterol （LDL-C），high-density lipoprotein cholesterol （HDL-C）]， kidney function indicators [serum creatinine （SCr） ， estimated glomerular filtration rate （eGFR）， 24-hour urinary protein quantification （24hUTP）]， and blood glucose indicators [fasting blood glucose （FBG）， 2-hour postprandial blood glucose （P2hBG）， glycated hemoglobin （HbA1c）]. Results： The total effective rate of TCM syndrome efficacy was 94.29% （33/35） in the observation group，which was significantly higher than 29.73%（ 11/37） in the control group（ P＜0.05）. After treatment，IMT was thinner and plaque area was reduced in both groups compared with those before treatment （P＜0.05）；the observation group showed thinner IMT and smaller plaque area than the control group （P＜0.05）. After treatment， TCM syndrome scores decreased in both groups compared with those before treatment （P＜0.05），with lower scores in the observation group than those in the control group （P＜0.05）. After treatment， levels of TG， TC， LDL-C， SCr， 24hUTP， FBG， P2hBG， and HbA1c decreased in both groups compared with those before treatment （P＜0.05），while levels of HDL-C and eGFR increased compared with those before treatment（ P＜0.05）. The observation group demonstrated lower levels of TG，TC，LDL-C， SCr， 24hUTP， FBG， P2hBG， and HbA1c， and higher levels of HDL-C and eGFR compared with those in the control group （P＜0.05）. No significant adverse reactions were observed in either group. Conclusion： Yiqi Yangyin Quyu Prescription combined with western medicine is a safe and effective treatment for patients with DKD in stage Ⅲ-Ⅳ with AS of qi-yin deficiency complicated with blood stasis syndrome. It helps regulate lipid metabolism，reduce plaque area，improve kidney function，and subsequently delay disease progression.