Patient Liu Moumou, male, 35 years old, came to our outpatient clinic on June 7, 2011 with the chief complaint of “swelling of lower limbs with increased urinary froth for more than 1 month”. The patient had lower limb edema for unknown reasons 1 month ago, and the urinary routine examination in local hospital showed PRO+++, RBC15/HP, 24-hour urine protein quantification 6.5g, TC6.5mmol/L, TG2.1mmol/L, no abnormal renal function, BP160/105mmHg. (apical type). He was given prednisone 60 mg, Qd, pravastatin 10 mg, Qd, enalapril 10 mg, Qd, dipyridamole 50 mg, Qd, renal rejuvenation 4 capsules, Tid. 1 month later, 24-hour urine protein 6.09 g, BP 145/90 mmHg. The stool is normal. The tongue is dark with white greasy coating, and the pulse is stringent and weak. Western medicine diagnosis: focal segmental glomerulosclerosis (apical type); Chinese medicine diagnosis: edema, identified as: qi deficiency, liver depression, phlegm and stasis blocking the ligaments, kidney ligaments and wind movement, ligament interest into accumulation. The treatment is to benefit the qi to clear the liver and heat, activate the blood to resolve phlegm and disperse nodules. The prescription is as follows: Astragalus membranaceus 50g, Radix Bupleurum Chinense 15g, Fructus Ulmoides 15g, Scutellaria baicalensis 15g, Radix Gardenia jasminoides 15g, Rhizoma Umbellifera 30g, Rhizoma Loxodendron 15g, Rhizoma Ulmoides 15g, Coix lacryma 30g, Trigonella tridentata 15g, Rhizoma Curcuma 15g, Rhizoma Xia Gu Cao 30g, Rhizoma Gastrodiae 30g, Rhizoma Dioscorea 20g, Rhizoma Sclerotium 20g, Rhizoma Chuanxiong 18g, Rhizoma Longmu 30g, Rhizoma Chuanxiu Knee 15g. 28 sachets, decoction in water, followed by prednisone 60mg,Qd, pravastatin 10mg,Qd, enalapril 10mg,Qd, dipyridamole 50mg,Qd. Second consultation (July 2, 2011): The swelling in the lower limbs disappeared, head swelling and pain improved significantly, urine foam decreased, still short of breath and weakness, dry mouth and sticky mouth, tongue and pulse as before. The 24-hour urine protein quantification was 3.79g, urinary routine PRO++, RBC7.05/HP, blood pressure was normal. With the above to remove the raw Longmu, add 15g of Faxia, 50g of Tu Fu Ling, followed by prednisone 60mg, Qd, after taking 5 months, to reduce the original amount of 10% per month to withdraw, Enalapril 10mg, Qd. Third diagnosis (April 29, 2012): the patient except for occasional weakness, heartburn, the rest of no discomfort. The tongue was slightly dark with thin white coating. 24-hour urine protein quantification was 0.11g, blood biochemistry was normal except for slightly low blood calcium (1.98mmol/L). Prednisone had been reduced to 15mg, Qd. with the addition of raw astragalus above to 60g, bile grass 9g, remove the half summer, Yin Chen. To consolidate the therapeutic effect. Focal segmental sclerosing nephritis is one of the very common pathological types of pathological typology. Most cases have hypertension, nephrogenic glycosuria and impairment of renal function once detected. The main factors affecting the prognosis of FSGS are the large amount of proteinuria, hypertension and creatinine at the time of diagnosis and the degree of tubular atrophy and interstitial fibrosis in the renal pathology. The main goal of current FSGS treatment is to reduce urinary protein, strive for remission of NS and delay glomerulosclerosis or interstitial fibrosis. Glucocorticoid therapy is effective in about 50-60% of NS patients with FSGS (including complete remission and partial remission), but the onset of action is slow, and the median remission time for those who are effective is about 4 months, so the author has taken prednisone 1 mg/kg.d (up to 60 mg/d) for 4-6 months as the basic regimen, and only those who are more than 6 months old are called hormone resistant. However, monitoring of side effects and prevention of complications should be emphasized during this period. Chinese medicine should seize the basic pathology of focal segmental glomerulosclerosis and treat it with the main attack point of focal segmental glomerulosclerosis. The pathogenesis of this disease is caused by the spleen and kidney Qi deficiency, liver Qi stagnation, so that the spleen does not transform dampness, the kidney does not transform water, liver loss of drainage, water and dampness in the waterways of the three jiao is not through the regulation, breeding phlegm; and Qi deficiency, blood loss of push transport, liver depression, then Qi stagnation, blood blockage, can form stasis, phlegm, stasis, water intertwined, blocking the kidney complex, and thus rest to the accumulation, treatment to supplement the Qi, dredge the liver and clear heat, blood circulation, elimination of stasis method, so received certain curative effect. In addition, this disease also needs to be treated in the process of Chinese medicine according to the different stages of hormone administration, withdrawal and discontinuation. In the stage of hormone administration, Chinese medicine treatment focuses on the enhancement and reduction of hormones, cytotoxic drugs and immunosuppressive drugs. The treatment is to nourish Yin and lower the fire, clear heat and detoxify or nourish Yin and clear heat and quench the liver and quench the wind, with the formula of Zhi Bai Di Huang Tang combined with Wu Wei Disinfectant Drinking Soup or combined with Liver Quenching Wind Soup plus or minus. In the process of hormone withdrawal and reduction, there is a gradual loss of medicine and fire, Yin injury has not yet recovered, Yin deficiency and Qi, and residual toxicity remains. During the period of hormone withdrawal, the pathological mechanism can be characterized by two aspects, one is the remission of the disease, the positive deficiency has not been restored, the lung and kidney qi (yang) deficiency, patients in this period are often very easy to feel external evil, and cause colds or upper respiratory tract infections, etc. The treatment focuses on the benefit of temperature and kidney, solid surface to protect against evil, the formula to Erxian Tang combined with Yu Ping Feng San plus reduction. Firstly, for those whose condition cannot be relieved despite a full course of hormone, cytotoxic drugs and immunosuppressant treatment, the basic pathological mechanism of spleen and kidney qi (yang) deficiency, stasis and water interconnection, and stasis and accumulation should be grasped, and the methods of tonifying the kidney and opening up the ligaments, resolving stasis and water, and softening and eliminating accumulation should be applied, which may yield certain curative effects. The formula is Zhen Wu Tang and Real Spleen Drink with peach kernel, safflower, Chuanxiong, Yi Mu Cao, Di Long, stiff silkworm, San Ling, Curcuma longa, vinegar turtle nail and raw oyster.