To observe the clinical effect of Tangshenkang decoction combined with calcium dobesilate dispersible tablets and Astragalus and Shuxuetong injection in treatment of phase IV diabetic nephropathy.Methods：Ninety six patients with phase IV diabetic renal disease were randomly divided into control group (n=48) and treatment group (n=48). Patients in both groups were given insulin to control blood sugar, telmisartan and nifedipine tablets to control blood pressure, as well as astragalus injection and Shuxuetong injection. Besides, patients in the treatment group were given dispersible tablets and Tangshenkang decoction with calcium dobesilate. The treatment course was 14 days. The changes of clinical symptoms, 24 h urinary albumin excretion, blood lipid and renal function were observed before and after treatment.Results：All indexes and clinical symptom score of patients in both groups after treatment were decreased. The total effective rate of treatment group was 93.75%, while that of the control group was 68.8%, and the difference between the two groups was significant (P<0.05). The main clinical symptom score of patients in both groups were improved after treatment, but the control group had no obvious improvement (P>0.05), while the treatment group showed significant improvement (P<0.05). The main biochemical index of 24 h urinary protein, TC, TG, BUN, Scr were reduced to various degrees after treatment, and the treatment group decreased significantly (P<0.05), while the decrease in the control group was not significant (P>0.05), so there was significant difference between the two groups (P<0.05).Conclusion：Tangshenkang decoction combined with calcium dobesilate dispersed tablets and Astragalus shows definite clinical efficacy in the treatment of phase IV diabetic nephropathy. The therapy can improve clinical symptoms, reduce urinary protein excretion, improve renal microcirculation, promote the recovery of renal function, promote renal blood flow, so as to effectively block or reverse the disease progression, open up a new way for the optimization and combination therapy of diabetic nephropathy.