Objective：To observe the TCM treatment of IgA nephropathyclinical efficacy.Methods：90 patients with IgA nephropathy randomly divided into two groups.Control group of 30 cases，anticoagulant，resistance to infection，Western medicine antihypertensive therapy；≥ 1g/24h 24h urine protein to Tripterygium wilfordii more glucoside 1mg/( kg·d)；Nephrotic syndrome or a large number of proteinuria，to prednisone 1mg/( kg·d) (maximum dosage＜60mg/d)；The illness relapses of 100mg/d，plus cyclophosphamide cumulative 68g withdrawal.Treatment group 60 cases，In the control group therapy basis，Add with TCM syndrome differentiation and treatment，treatment march.The clinical efficacy was observed，24-hour urinary protein quantitative，urine RBC count，creatinine，urea nitrogen，serum uric acid changes.Results：15 cases in treatment group complete remission，powerfully 21 cases，improving 16 cases，invalid 8 cases，The total effective rate was 86.67%；The control group complete remission 4 cases，powerfully 7 cases，improvement in 8 cases，invalid in 11 cases，The total effective rate was 63.33%.Two group total effectiveness comparison，the difference was statistically significant (P＜0.05).The treatment group after the treatment of urine RBC count，24 h urinary protein of quantitative and before treatment，there is a significant difference compared statistical significance (P＜0.01)；Compared with controls，the difference was statistically significant meaning (P＜0.01).And after treatment serum creatinine，blood urea nitrogen，uric acid comparison，difference was statistically significant (P＞0.05).Conclusion：the syndrome differentiation and treatment with western medicine therapy effect is better than pure western medicine therapy.