Frequently recurrent nephrotic syndrome (PNS) refers to those who can be in complete remission after hormone therapy, but relapse twice within six months or more than three times within a year. Recurrent renal syndrome can further aggravate the glomerular pathological damage and change from microscopic lesion type to focal segmental sclerosis type and even glomerulosclerosis, and eventually end-stage renal failure, so early and effective treatment is very important. 1, Chinese and Western medicine on the understanding of PRS recurrent nephrotic syndrome, Chinese and Western medicine from different perspectives have different understanding. From the perspective of modern medicine, low adrenal cortisol level is the main intrinsic factor of recurrent attacks of nephrotic syndrome. Due to the application of high-dose glucocorticoids, which can inhibit the secretion of adrenal cortisol by itself and cause adrenal cortex atrophy in serious cases, patients can have different degrees of low adrenal cortisol level after high-dose hormone therapy. At the same time, due to the use of high-dose hormones and cytotoxic drugs, patients may have low autoimmune function and be prone to various infections, and the various immune reactions induced by infections are the main cause of recurrent attacks of the disease. According to Chinese medicine, the main reason for recurrent attacks of nephrotic syndrome is the deficiency of the root cause and the misalignment of the deficiency and the real. The deficiency is mainly in the lungs, spleen and kidneys; in fact, the three aspects are heat, dampness and blood stasis. If the kidney is deficient in regulating water channels and the spleen is deficient in controlling water, edema can occur. If the spleen qi is sunken, the kidney qi is not solid, and the ascending and sealing is not in order, then the water and grain essence (such as protein), is leaked out with urine. The deficiency of the spleen and kidney organs causes water and dampness to stop internally, resulting in internal dampness and turbidity; dampness and turbidity can turn into heat after a long time, and heat can also come from external sensation; water disease and blood, stasis of blood, can damage the water channels of the three jiao, resulting in internal stagnation of water qi and aggravating edema. Zheng deficiency is the main cause of this disease, which can lead to the internal growth of the evil of dampness, heat and stasis. “The evil can further aggravate the deficiency. After treatment, although the positive qi is gradually restored, it is still weak, and although the evil qi is gradually removed, the remaining evil is not yet exhausted, and the intersection of evil and positive is in a relative confrontation state. The disease is in remission, once there is damage to the positive qi or conditions that encourage the evil qi, such as fatigue, feeling external evil, etc., so that the evil potential to flourish and can make the disease repeated. 2, Chinese medicine treatment focuses on supporting the righteousness and eliminating the evil. The righteousness treatment focuses on strengthening the kidneys and the spleen, and the kidney disease is mostly deficiency evidence. Ming dynasty doctor Zhang Jinyue pointed out: “good tonic yang, must be yin in seeking yang; good tonic yin, must be yang in seeking yin.” Therefore, most of the medicines are used to nourish both yin and yang, such as Cordyceps sinensis, Xian Ling Spleen, Cistanches, Cuscuta, Boneset, Radix et Rhizoma, Huai Shan Yao, Dry Lotus Grass, and Chaste Tree, etc. The focus of the formula is based on the diagnosis and treatment, such as kidney yin deficiency, on the basis of nourishing yin, less supplementation of kidney yang products. Prof. Ye emphasized that the main purpose of tonifying the kidney is to nourish the kidney yin with less nourishing and dull products, such as rehmannia, to prevent dampness and trapping the spleen; warming the kidney yang. The use of excessively pungent and dry products, such as sapodilla, cinnamon, etc., to prevent injury to yin and heat. Strengthening the kidneys and spleen has the ability to mobilize the body’s resistance to disease and repair, so it is the rule of treatment. Dampness is an endogenous evil, so strengthening the spleen and transforming dampness is the main rule of treatment that takes into account both the symptoms and the root cause, and it is mostly used in Coix Seed, Atractylodes, Poria, etc. For severe edema, water-reducing products such as Che Qian Zi, Ze Xie Di, Pig Ling, etc. can be used. Professor Ye believes that: clearing heat and detoxifying its treatment is mainly through the inhibition of excessive immune response, thus improving the inflammatory response and tissue damage, this therapeutic effect is similar to hormones, can be used Yinhua, forsythia, dandelion, June snow, etc.. However, bitter-cold products, taken for a long time, tend to hurt the spleen and stomach, and too much restraint, easy to damage the righteousness, so more than 1 to 2 flavors are used, and the daily dose should not be too large. It is pointed out in the “Treatise on Blood Evidence” that “blood and water are inseparable” and “those who suffer from water do not suffer from blood”, so it can be seen that activating blood circulation and removing blood stasis is also a very important aspect in the treatment of this disease, and most of them are used in the treatment of motherwort, leech, salvia, whole scorpion and safflower. Professor Ye pointed out that the treatment of activating blood circulation and removing blood stasis can not only improve the hypercoagulability of nephrotic syndrome, but also reduce the kidney pathological damage caused by stagnation in the glomerulus and promote the recovery of kidney function. Prof. Ye emphasized that it is the key of TCM treatment to pay attention to the symptoms and priorities, and to correctly deal with the relationship between supporting the righteous and eliminating the evil. In the remission period, the deficiency of the righteousness and the evil ambush, the treatment should be to support the righteousness as the main focus, and the elimination of evil as a supplement, only emphasize on strengthening the kidneys and spleen, but ignore the remaining evil is not exhausted, it will close the door to stay in the invasion, and the evil will revive and make the disease repeated. Only when the relationship between the two is properly handled can the ideal treatment effect be achieved. The use of glucocorticosteroids and cytotoxic drugs is the main means of treatment for this disease, which has the advantages of fast and accurate efficacy, but also has the disadvantages of large side effects and recurrence after discontinuation of drugs. (1) Glucocorticoids and Chinese medicine treatment Glucocorticoids are the first choice of modern medicine for the treatment of this disease, and the standard hormone therapy of prednisone is often chosen to follow the principle of “the initial amount is sufficient, the reduction should be slow and the course of treatment should be long”. In the initial treatment phase, the dosage of prednisone is 1mg/kg?d, taken in the morning, and then gradually reduced by 5mg every 2 weeks, when reduced to 0.5mg/kg?d, changed to 1mg/kg?d every other day, continuous treatment for 3-6 months, and then gradually reduced to 0.4mg/kg every other day, maintenance treatment for 12-18 months. According to Prof. Ye, under normal circumstances, the concentration of hormones in human blood is highest in the early morning, and the inhibitory effect of prednisone on the hypothalamic-pituitary-adrenal system is 24h, so the early morning dose is exactly close to the peak of corticosteroid secretion, which is the least sensitive to the negative feedback of exogenous hormones and thus has the least inhibition on the adrenal cortex. The standard hormone regimen is conducive to controlling the disease as soon as possible and consolidating the treatment effect. According to Prof. Ye, hormones are masculine products and their side effects are related to their masculine nature. Using the method of nourishing Yin and clearing heat can suppress the masculine nature of hormones and reduce various side effects of hormones. Professor Ye emphasized that the treatment of nourishing Yin and clearing heat should be predictable, as hormones dry heat and hurt Yin. With the reduction of hormones, the gradual addition of warming and kidney products is the main means to consolidate the therapeutic effect and reduce the recurrence of renal syndrome. With the reduction of hormone dosage, patients have different degrees of hormone withdrawal syndrome, manifesting as tiredness and weakness, coldness in the limbs, soreness and weakness in the waist and knees, which are quite consistent with the evidence of “kidney yang deficiency”. It can promote the secretion of adrenal cortex and protect the adrenal cortex from the inhibition of exogenous adrenocorticotropic hormone, so it can help the withdrawal of hormone, reduce the recurrence of the disease during the withdrawal of hormone, and consolidate the treatment effect. (2) Cytotoxic drugs and Chinese medicine are also the main drugs used in the treatment of this disease in modern medicine, and can be used in combination with hormones to complement and synergize each other, thus achieving the purpose of consolidating the treatment effect and reducing the recurrence of the disease. Cyclophosphamide (CTX) is generally used. The specific usage is: when prednisone is reduced to the small dose stage, immediate 1mg?kg-1?d-1 every other day, with saline 20ml plus CTXX0 2g, static push, once every other day, or 8-12mg /kg/d-1, intravenous drip, for 2 days, repeated semi-monthly, the cumulative dose of 150mg /kg. in the hormone small dose maintenance treatment stage, the patient has different degrees of In the low-dose maintenance phase of hormone therapy, patients have varying degrees of kidney yang deficiency, and CTX is an immunosuppressant, which tends to damage kidney yang, so it is advisable to use warm yang products. Leukopenia due to bone marrow suppression is a major recent complication of CTX and a major factor affecting the clinical use of CTX. Professor Ye follows the theory of “the kidney is the main bone and marrow producer” and “the same source of qi and blood” in ancestral medicine, and the clinical use of astragalus, angelica and he shou wu to benefit qi and generate blood on the basis of warming the kidney yang has a good preventive and therapeutic effect on leukopenia. PNS is a common and difficult disease to treat clinically, western medicine treatment is fast and effective, but easy to recur, many patients in the process of hormone withdrawal and reduction of the disease repeated, simple Chinese medicine treatment, the effect is slow, the efficacy of consolidation, not easy to repeat. Therefore, based on the combined treatment of Chinese and Western medicine, we can achieve the purpose of complementing each other’s strengths and synergizing the effects.