Abstract：The incidence of diabetic kidney disease（ DKD），which is one of the leading causes of end-stage renal disease，is increasing year by year. From the perspective of traditional Chinese medicine （TCM），the pathogenesis of DKD is characterized by root deficiency and branch excess： deficiency of the spleen and kidney constitutes the root cause，while damp-turbidity and blood stasis act as branch manifestations. Centered on tonifying the spleen and kidney， invigorating blood to drain water，and generating fluid to moisten dryness，Gualou Qumai Pills matches the syndrome features of DKD featuring concurrent deficiency，stasis，and turbidity. By systematically sorting out relevant literature and experimental research evidence，this paper summarizes the formula compatibility characteristics，indications，and modern pharmacological basis of this prescription. Existing studies indicate that Gualou Qumai Pills presents certain advantages in reducing urinary protein and improving renal function. Its potential mechanisms involve synergistic regulation of multiple signaling pathways， including modulating glucose and lipid metabolism， inhibiting advanced glycation end products （AGEs）-related pathways， anti-inflammation and anti-oxidative stress， alleviating renal fibrosis，promoting renal tissue repair，and regulating autophagy，reflecting the characteristic of multi-component and multi-target comprehensive intervention of Chinese herbal compound prescriptions. Nevertheless，current research still has limitations： the spectrum of blood-absorbed active components and core targets of the complete formula remains unclear，clinical trial sample size is small，and standardized multi-center randomized controlled trials are lacking. In the future，high-quality clinical studies and real-world evidence evaluations should be carried out alongside clarifying the material basis and action network， so as to further verify its efficacy and safety， and to promote its modern development and clinical application.