IgA nephropathy is a primary glomerular disease with immunopathological examination of renal biopsies that shows predominantly granular deposits of IgA immune complexes in the glomerular thylakoid region, along with thylakoid cell proliferation, increased stroma, and deposition of electron dense material in the thylakoid region, with hematuria as the main clinical manifestation. The disease can occur at any age, but 80% occurs between 16-35 years of age. It is characterized clinically by recurrent episodes of hematuria, persistent microscopic hematuria and/or proteinuria, and low back pain. Since the cause and pathogenesis of this disease are still unknown, modern medicine still lacks effective treatment and control measures, therefore, people look to TCM to find effective methods for the treatment of IgA nephropathy by using modern scientific research methods and taking advantage of the combination of TCM and Chinese and Western medicine. According to the clinical characteristics of IgA nephropathy, Chinese medicine can classify IgA nephropathy as blood in urine and blood in the blood. In the Nei Jing, it is stated that “if the cell moves heat to the bladder, blood retention and drowning will occur”, and “if the cell is too sad, the cellular ligament will be extinguished, and if the cellular ligament is extinguished, Yang Qi will move internally, which will cause the heart to collapse and the blood to be discharged”. Zhang Zhongjing also pointed out that “if the heat is in the lower jiao, then blood in urine, and also makes the lymphatic flow inaccessible”, “Shao Yin disease, eight or nine days, all the hands and feet are hot, because the heat in the bladder, must also be blood in the stool”. Both believe that the pathogenesis of blood in urine is related to the heat in the lower jiao. In the Tang and Song dynasties, the importance of deficiency evidence was emphasized in understanding the pathogenesis of blood in urine, such as room strain, deficiency loss and deficiency heat. In the Qing dynasty, medical practitioners emphasized the identification and treatment of the symptoms, for example, the treating of blood in urine in the Treatise on Blood Evidence was based on the outline of deficiency and reality and the internal and external factors, “the external cause is the heat of the Sun and Yangming channels in the lower jiao,” and “the internal cause is the heat left in the small intestine by the heart meridian and the blood chamber by the liver meridian,” “The lung is the source of water, the gold is clear, the water is clear, and the water is nimble, so the blood is nimble, and the evidence is originally water sickness, so the treatment of water is the treatment of blood. Therefore, treating water means treating blood”. It is proposed that stopping bleeding, eliminating blood stasis, nourishing blood, and tonifying blood are the four major principles for treating blood. In modern times, it is believed that this disease is mostly a deficiency of the root and the symptoms, and the deficiency is mixed with the reality, and can be treated in stages according to the acute attack and chronic progression, fully reflecting the advantages of Chinese medicine and the combination of Chinese and Western medicine in the treatment of this disease. Clinical manifestations 1. Episodic hematuria This is the most common clinical manifestation for the definite diagnosis of renal biopsy. It usually appears after upper respiratory tract infection (tonsillitis, etc.), acute gastroenteritis, osteomyelitis, peritonitis, herpes zoster and other infections, and occasionally almost simultaneously after vaccination or during strenuous exercise. Some people call this pharyngitis synchronous hematuria. The visual hematuria lasts from a few hours to a few days, usually less than 3 days. It may sometimes be accompanied by mild systemic symptoms such as muscle pain, painful urination and low back pain, and low-grade fever. The urine cell pattern is predominantly deformed, suggesting glomerulonephritic hematuria, but sometimes mixed hematuria is also seen. It is mostly seen in adolescents. After the onset of sarcoid hematuria, the urine red blood cells may disappear, or it may turn into persistent microscopic hematuria. There are recurrent episodes of botrythematuria. 2. Microscopic hematuria with/without asymptomatic proteinuria is mostly found during screening examinations of students and routine health examinations such as military and premarital physical examinations. In the Shenzhen area, due to the increased rate of group physical examinations, a number of patients are often found in unit group physical examinations and then mobilized for kidney biopsy to confirm the diagnosis. It is the main clinical manifestation of IgA nephropathy in children and young adults. Most patients with proteinuria IgA nephropathy present with mild proteinuria and 24-hour urine protein quantification.