Objective To investigate the influence of spleen-kidney yang deficiency in type 2 diabetic nephropathy patients by Zhenwu Tongmai decoction. Methods 65 Spleen-kidney yang deficiency of type 2 diabetic nephropathy（4 stage） patients were randomly assigned to two groups. Patients in the control group（n=34） were given conventional antidiabetic treatment， patients in the treatment group（n=34） plus Zhenwu Tongmai decoction. 8 weeks after treatment， the changes of blood pressure， blood glucose， blood lipids， blood electrolytes， Serum creatinine（Scr）， morning micro urinary albumin（UMA）， TCM syndrome， and symptom scores and clinical efficacy were observed. Results After intervention， in treated groups， diastolic pressure（DBP）， fasting plasma glucose（FBG）， cholesterol（TC）， triglyceride（TG）， UMA were significantly decreased compared with the control group（P<0.05）， compared with before treatment， high density lipoprotein cholesterol（HDL） were significantly increase in treated group（P<0.05）. Serum creatinine was less significantly decreased compared with the control group. After treatment， symptom scores decreased in both two groups compared with before treatment（P<0.01）， and both of them in treated group were better than in control group（P<0.05）. Conclusion Zhenwu Tongmai decoction had better effect on improving risk factors in spleen-kidney yang deficiency of type 2 diabetic nephropathy patients. and improved the clinical symptoms and overall efficiency of clinical treatment.