Abstract：Objective：To investigate the clinical efficacy of Jianpi Yishen Decoction combined with Candesartan Cilexetil in the treatment of early diabetic kidney disease （DKD）. Methods： A total of 101 patients with early DKD diagnosed and treated at Henan Provincial Chest Hospital and the First Affiliated Hospital of Henan University of Chinese Medicine from December 2021 to December 2024 were selected and divided into the control group of 50 cases and the observation group of 51 cases using the random number table method. Both groups received basic treatment. The control group was treated with Candesartan Cilexetil，while the observation group received Jianpi Yishen Decoction in addition to the control group's treatment. Changes in traditional Chinese medicine syndrome scores， levels of renal function indicators， urinary protein excretion rate， renal hemodynamic parameters [pulsatility index （PI） and resistance index （RI） of the renal main artery]， and serum inflammatory factors [monocyte chemoattractant protein- 1 （MCP-1），transforming growth factor-β1（ TGF-β1），interleukin-1β （IL-1β）] were compared between the two groups before and after treatment. The incidence of adverse reactions during treatment was also statistically analyzed. Results： After 12 weeks of treatment， traditional Chinese medicine syndrome scores decreased in both groups compared with those before treatment， with the observation group showing lower scores than the control group （P＜ 0.05）. After 12 weeks of treatment， levels of serum creatinine and blood urea nitrogen decreased， and glomerular filtration rate increased compared with those before treatment in both groups （P＜0.05）；furthermore，the observation group had lower levels of serum creatinine and blood urea nitrogen and a higher glomerular filtration rate than the control group （P＜0.05）. After 12 weeks of treatment， the urinary protein excretion rate decreased in both groups compared with that before treatment （P＜0.05）， and the observation group had a lower rate than the control group （P＜0.05）. After 12 weeks of treatment，PI and RI of the renal main artery decreased in both groups compared with those before treatment （P＜0.05），and the observation group had lower levels of these two renal hemodynamic parameters than the control group （P＜0.05）. After 12 weeks of treatment，the levels of MCP-1，TGF-β1，and IL-1β decreased in both groups compared with those before treatment， and the observation group had lower levels of these three inflammatory factors than the control group （P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment （P＞0.05）. Conclusion： The combination of Jianpi Yishen Decoction and Candesartan Cilexetil can alleviate clinical symptoms，improve renal function and renal hemodynamics， reduce renal injury and inflammatory response in patients with early DKD，with good safety.