The patient, 66Y, male, was admitted to the hospital with recurrent dry mouth and excessive drinking for 19 years and foamy urine for more than 3 years. 19 years ago, the patient developed dry mouth and excessive drinking with no obvious cause, and was diagnosed as “type 2 diabetes” after checking fasting blood glucose of 14 mmol/L. He was given gliclazide, metformin, bactrim and other drugs to lower blood glucose successively, but his blood glucose was okay at first, and then gradually increased due to He was given gliclazide, metformin, bactrim and other drugs to lower his blood sugar. Three years ago, the patient found foamy urine, which was diagnosed as “diabetic nephropathy” by a foreign hospital, but no attention was paid to it. His fasting blood glucose is usually 10~12mmol/L and his postprandial blood glucose is not measured. He had a dry mouth, blurred vision, intermittent claudication, swelling of the lower limbs, frothy urine, sleepiness, and dry stools. Physical examination: BMI: 28.78 BP: 140/90 mmHg, clear consciousness, obese shape, bilateral dorsalis pedis artery pulsations exist, normal vibration and pinprick sensation on the dorsal aspect of the big toe, 10g fine filament (-), bilateral knee reflexes are not elicited. The tongue is light and fat with thin coating, and the pulse is stringent and smooth. Vascular ultrasound: bilateral carotid and lower extremity arteriosclerosis with plaque formation. Fundus examination: stage IV diabetic retinopathy in both eyes. MALB/CREA-U 1789.63mg/g at admission; blood creatinine 112umol/L. Diabetic nephropathy is one of the common and serious complications of diabetes mellitus. Its incidence accounts for about 35-40% of diabetic patients. It is the main cause of end-stage renal failure. It seriously affects the survival and quality of life of patients. Diabetic nephropathy can generally be divided into 5 stages: ultrafiltration stage, silent stage, microproteinuria stage, clinical proteinuria stage and uremic stage. Stage I and II are pre-clinical, without any clinical manifestations, and laboratory tests are difficult to find abnormalities, only some pathological changes, so it is difficult to find the disease through simple examination. The clinical manifestations of stage III patients are not very obvious and easy to be ignored, and laboratory tests show an increase in “microalbumin (MALB/CREA-U)”. Stage IV disease progresses rapidly, with large amounts of proteinuria and nephrotic syndrome appearing within three or four years. If this stage is not treated actively, it will enter stage V of diabetic nephropathy, which will lead to renal failure and require dialysis or kidney transplantation, and the rate of disability and death will increase significantly. Therefore, diabetic nephropathy should be detected, diagnosed and treated as early as possible. From this patient’s case, we can see that it was the neglect of early treatment of diabetes that caused the patient to progress to the late stage of diabetes. In addition to severe diabetic nephropathy, the patient also had diabetic fundopathy and diabetic peripheral neuropathy and diabetic peripheral vascular disease. After admission, the patient was given diabetic education, western medicine to lower glucose, blood pressure and diuresis, and Chinese medicine to improve the vital energy and nourish yin, invigorate blood circulation and remove blood stasis. Root, Atractylodes macrocephala, Zelenia, Deer’s root. For the treatment of diabetic nephropathy, good glycemic control is emphasized first. Diabetes education should also be repeatedly provided to patients. For example: 1. Strictly control blood pressure, try to keep it below 130/80mmHg; 2. Strictly control the protein content in the diet, 0.6-0.8g/kg/day, and choose high-quality protein such as fish; 3. Strictly control blood sugar to slow down the development of microalbuminuria to clinical proteinuria; 4. Avoid taking drugs that are damaging to the kidneys; 5. Exercise properly and maintain 5. proper exercise and maintenance of ideal body weight; 6. prohibition of smoking. In the early stage of the disease, only the increase of microalbuminuria is the main clue, and the treatment at this stage is extremely important. Chinese medicine treatment of this disease, especially for clinical proteinuria, pay attention to the spleen and kidneys to start. This is because of the prolonged course of diabetes, the qi and yin are injured, and the disease affects both spleen and kidney. According to the theory of Chinese medicine, the spleen belongs to the hexa-earth, which is responsible for eliminating and transferring the essence to the lungs, and the kidney belongs to the kan-water, which is responsible for hiding the essence and draining the turbidity, and the kidney fails to seal the dormancy, the lower element is not consolidated, the essence seeps down, the foam in the urine increases, and the clinical protein in the urine increases. Therefore, the treatment is based on strengthening the spleen and kidney, and the medication can be used to strengthen the spleen and kidney to consolidate the root, and at the same time, the patient can be given Che Qian Zi, Ze Xie, and Zu Zu, etc. to facilitate dampness and drain turbidity; Dan Shen, Ze Lan, and Chuan Xiong, etc. to activate blood circulation and remove blood stasis. The combination of Chinese and Western medicine has good clinical efficacy in the stage of microproteinuria and clinical proteinuria in diabetic nephropathy. One week after admission, the patient’s dry mouth and excessive drinking were obviously reduced, walking endurance was improved, swelling of the lower limbs all subsided, foamy urine in urine was reduced, nausea was possible, sleep was peaceful, and stools were still dry. At this time, the 24h urine protein quantification was 3.523g, which was significantly less than before admission. The swelling of the lower limbs subsided, so the diuretic was stopped. The rest of the treatment remained unchanged, plus the use of homemade Chinese medicine to retain the enema laxative, drugs such as: Fu Ling, June snow, system rhubarb, calcined oyster, etc.. Chinese medicine believes that diabetic nephropathy is a deficiency, patients often have damp-heat, stasis, phlegm and turbidity gathered in the body at the same time, serious cases can cause urea nitrogen, creatinine rise. Therefore, clinical treatment should not only treat the root cause, but also pay attention to treating the symptoms, focusing on the application of Chinese medicines that can help detoxify dampness, reduce phlegm and eliminate blood stasis. At the same time of internal consumption, Chinese herbal medicine retains enema can often play a half-hearted effect. The formula uses rhubarb to drain turbidity from the internal organs, remove blood stasis and create new, accelerate the excretion of nitrogen, inhibit the decomposition of nitrogen, improve kidney function, and promote the excretion of endotoxins; calcined oyster is soft, astringent and astringent, rich in calcium carbonate, which can promote calcium intake in the intestine, improve intestinal osmotic pressure, and accelerate the excretion of toxins; June snow, Tu Fu Ling clear heat and dampness, blood detoxification, play a synergistic effect, improve blood supply to the kidneys, reduce kidney damage The patient was admitted for 14 days. The patient was admitted to the hospital 14 days, no swelling of the lower extremities, urine foamy urine significantly reduced, can, sleep well, stool regulation. After treatment, the patient’s symptoms were significantly reduced, and the blood sugar control was stable, so he was discharged from the hospital. Followed by Chinese herbal soup (above + tiger scepter, black soybean, white lentil, made rhubarb). After three months follow-up, 24-hour urine protein quantification without rebound, stable glycemic control. Diabetic nephropathy is a common complication of diabetes mellitus, and its treatment with late dialysis and kidney transplantation brings great physical pain and mental torture to patients. The key to the treatment of diabetic nephropathy is to protect kidney function by treating the reversible stage of early nephropathy. Chinese medicine has great flexibility and individual differences in the treatment of diabetic nephropathy. By combining evidence and disease identification, evidence-based treatment and specific prescriptions and medicines, and combining pharmacotherapy with other therapies, it can better control the disease, delay its progress and improve kidney function.