The first-line drugs for the treatment of nephrotic syndrome are glucocorticoids, mainly including prednisone and methylprednisolone. There are many classes of second-line drugs, commonly used including cyclosporine, tacrolimus, mycophenolate, cyclophosphamide, leflunomide, and rapamycin, etc. These drugs are either expensive or toxic, or new, with unknown long-term toxic side effects. Second-line drugs are generally used in the following cases: 1. first-line drug resistance; 2. first-line drug dependence; 3. first-line drug allergy; 3. serious side effects of first-line drugs that must be discontinued; 4. the need for adolescent growth; 5. serious edema and electrolyte disturbances that require rapid induction of urinary protein relief; 6. family and patient requests. The most used in the first case, which is the most hormone resistant. By hormone resistance, we mean that after a full course of treatment with sufficient hormone, the urine protein has not turned negative. Here, adequate hormone is defined as 2mg/kg.d, not more than 60mg, and some boys with especially large body weight can be no more than 90mg, and it is usually taken in divided doses; a full course of treatment is defined as 4 weeks, but there is still controversy, and some foreign countries think it is 8 weeks; urine protein is defined as the standard of turning negative, and not turning negative, even if it is +, is judged as drug resistance. It is worth noting that some clinical children have factors that affect the conversion of urine protein to negative all the time during adequate hormone therapy, such as the presence of lung infection, skin allergy, etc. Some children have repeatedly applied albumin during severe edema (which can delay the conversion of urine protein), and these children need to be very careful when placing the diagnosis of hormone resistance. According to my clinical experience, these children, after controlling the infection, allergy, or Extending the duration of adequate hormones beyond 4 weeks, proteinuria can be mostly relieved and is in fact not hormone resistant and does not require second-line drugs. If the child has undergone a full course of hormone therapy and the urine protein has not turned negative, and no clinical factors affecting the hormone turn negative have been found, the treating physician will recommend the child to use second-line drugs, which is considered natural in Western medicine, but not in Chinese medicine. This is because these children often have one or more of the following TCM symptoms: 1) Damp-heat: manifested by foul breath, yellow urine, poor night sleep, excessive sweating, red tongue, yellow, thick and greasy coating, and slippery pulse; 2) Blood stasis: dark face and severe hematuria; 3) Yang Qi deficiency: white face, cold hands and feet, white, thick and greasy tongue coating, and even diarrhea, which cannot be relieved by adequate hormone therapy. It is clinically found that if these TCM symptoms improve, urine protein can be reduced or even turn negative. Therefore, for children with poor hormone efficacy, combining TCM treatment with hormone therapy to clear dampness and heat, invigorate blood circulation, remove blood stasis, warm yang energy, and regulate qi, may change hormone resistance to hormone sensitivity. In my clinical work, for some children with kidney disease referred from western hospitals, I usually ask to give several weeks of TCM treatment for observation, for this reason. Second-line drugs are highly toxic and may be avoided if parents and primary care physicians try TCM treatment options before deciding to go on second-line drugs.