Autosomal dominant polycystic kidney disease (ADPKD), which used to be called adult congenital polycystic kidney. The kidney of ADPKD resembles a nesting cystic lump. I suggest that we can explore the treatment of ADPKD from the treatment of phlegm disease in Chinese medicine based on many years of clinical experience. And achieved relatively good results. I, the etiology of the disease mechanism “Jing Yue Quan Shu”: “phlegm that is the human fluid, all non-water and grain of the transformation, and not the non-transformation of the genus. But the transformation of its right, the form is strong, the Ying and Wei full, and phlegm are blood; if the transformation is not its right, the internal organs disease, fluid defeat, and blood is phlegm”. According to Chinese medicine, phlegm disease is due to external and internal injuries and other causes of the body’s Qi and blood imbalance, water and grain gasification is not normal, the fluid defeated and gathered as phlegm. The clinical manifestations of phlegm disease are very complicated, and there are different manifestations of wind phlegm, cold phlegm, damp phlegm, fire phlegm, gas phlegm, depressed phlegm, food phlegm and so on, and there are also different manifestations due to different meridians of the internal organs where they are located. For example, “phlegm accumulation in the kidney is associated with soreness and weakness of the feet and knees, strong pain in the back, cold paralysis in the limbs and bone pain” (Introduction to Medicine). The nest sac lump is a phlegm disease, and Danxi believes that “phlegm carries blood stasis and thus becomes a nest sac”. According to Li{, damp phlegm “if it is accompanied by food stasis and blood stasis, it becomes a nest sac mass”. Since the kidney of ADPKD resembles a nest sac mass, Prof. Wei Lianbo believes that ADPKD can be treated according to the evidence-based treatment of phlegm disease in Chinese medicine. When ADPKD develops into “nesting cystic mass”, it is already at an advanced stage. Patients are usually over 35 years old, and ultrasound shows polycystic lesions in kidney, liver, spleen and pancreas. Most of the patients have the manifestation of deficiency of both spleen and kidney. And the nest cystic mass is a real evidence, which is phlegm and stagnant disease evil. Treatment should pay attention to eliminating the evil without harming the positive and supporting the positive without hindering the evil. For nest sac masses, the method of strengthening the spleen and resolving phlegm is used. Danxi proposed two main points for treating phlegm: “treating qi” and “avoiding profit”. “good at treating phlegm is not treating phlegm but qi, qi is smooth then all the fluids also with the qi and smooth. “Where the treatment of phlegm with a lot of sharp drugs, resulting in spleen qi deficiency, phlegm is easy to produce and more”. These two points are very important in the treatment of this disease. The main formula for strengthening the spleen and resolving phlegm in this disease was selected from Zhu Danxi’s Er Chen Tang and Er Shu Wan and the combined formula of Ling Gui Zhu Gan Tang with reduction (Han Xia, Fu Ling, Chen Pi, Gan Cao, Bai Shu, Cang Shu, Xiang Shen, Gui Zhi, Du Zhong, Niu Knee, Yu Jin, White Mustard Seed, Chicken Nei Jin). Er Chen Tang is a general formula for treating phlegm recognized by later generations. “Er Chen Tang all over the phlegm treatment tube, such as to go down plus lead down medicine, on top plus lead up medicine” (“Dan Xi Xin Fa”). Erzhu Wan is Danxi’s formula for treating damp phlegm, in which Atractylodes macrocephala is recognized as the main medicine for strengthening the spleen; Cangzhu is used exclusively by the ancients to treat phlegm with blood stasis to form nesting sacs, and is considered to be extremely effective and wonderful in moving phlegm on one side. The aromatic herb is commonly used in Danxi’s formula for treating phlegm, and can “benefit the three jiao, solve the six depressions, …… and pass through the twelve meridians of qi, …… is the chief division of qi disease.” (The Compendium of Materia Medica). This formula removes the white peony from the Er Shu Wan, and adds Yu Jin, white mustard seeds, and chicken internal gold. The reason is that yujin activates blood circulation and resolves blood stasis, and also moves qi to relieve depression; white mustard seed is the main medicine for treating stubborn phlegm and old phlegm; chicken neijin has the function of transporting spleen and eliminating accumulation. The use of stasis-breaking drugs should be avoided to prevent bleeding of cysts. For the support of Zheng, natural Cordyceps is mainly used. Cordyceps is sweet and warm in nature, “secreting the essence and benefiting the qi, and specifically nourishing the vital gate.” (Pharmacognosy), it can stop bleeding and dissolve phlegm. For patients with chronic renal failure, Cordyceps does not have the disadvantages of some other warm tonic drugs that help dampness and generate heat and blood and increase azotemia. The therapeutic effect of Cordyceps on chronic renal failure has been basically recognized. Dihuang and other nourishing and phlegm-producing drugs are contraindicated in the phlegm sector and should be avoided as much as possible. In addition, our experience, chronic renal failure patients should not be long-term use of warm tonic steep medicine, especially should not be used cinnamon, sapodilla, bone marrow and other large pungent and hot products, this experience also applies to the disease of chronic renal failure patients. Third, the clinical experience of treating phlegm disease to treat the gas and avoid profit two points, “good at treating phlegm is not to treat phlegm but to treat the gas, the gas is smooth then all the fluids also with the gas and smooth carry on. “Where the treatment of phlegm with diuretics more, to spleen qi deficiency, phlegm is easy to produce and more”, the treatment of this disease is very important. The first thing is to avoid diuretics. According to research, cysts mainly originate from different segments of renal tubules, and the composition of cyst fluid is different from either plasma or urine, but its sodium and chloride concentrations vary from 20 mmol/L to 160 mmol/L, indicating that the secretion and reabsorption capacity of cyst epithelium is related to the type of renal tubular cells from which the cysts originate. Since the renal tubular epithelium also has the transport function of renal tubular cells, the use of diuretics may increase the intracapsular fluid, so Prof. Wei advocates avoiding the use of Chinese and Western diuretics, including lithotropic and laxative drugs, such as moneywort, to treat this disease in order to avoid making the cysts increase in size. As for the treatment of qi, it is also very important because patients with this disease often have back and abdominal pain and need to add qi analgesics. In addition, the disease is often complicated by stones, and diuretics are often needed to help the stones to be discharged, while diuresis is contraindicated. In the treatment of phlegm disease in Chinese medicine, there is a saying of “getting out the phlegm nucleus”, whether this is the “phlegm nucleus” and whether it is related to the treatment of phlegm is to be studied.