To observe the clinical efficacy of Jiawei Fangji Huangqi Decoction on primary nephrotic syndrome (PNS) patients, and to analyze the level of microinflammatory state and explore its effect on Angiopoietin-like Protein 3 (ANGPTL3). Methods:A total of 90 cases of PNS patients admitted to our hospital from June 2016 to June 2017 were randomly divided into control group and observation group. The two groups were treated with western medicine of the basic treatment of PNS, including PNS education, PNS diet, anticoagulation, anti-infection, diuretic, hormones and other treatment, while the observation group was added modified Jiawei Fangji Huangqi Decoction on the basis of that. Both groups were treated for 6 weeks as a treatment course. The efficacy, proteinuria excretion rate and the level of inflammation indicators were observed after 3 treatment courses. Results:1) The total effective rate of the two groups was statistically significant (P<005), and the observation group was superior to the control group. 2) After treatment, the uAER of the two groups was improved compared with that before treatment and the improvement rate of the observation group was more significant (P<005). There was no significant difference in serum IL-1β, IL-6, IL-10 and TNF-α between the two groups before treatment. Compared between groups after treatment, the observation group was significantly lower than that of control group (P<005). 4) Compared with the control group, the average concentration of ANGPTL3 in the observation group was higher (P<005), but there was no significant difference in ANGPTL3/Cr concentration between the two groups (P>005). Conclusion:Jiawei Fangjiu Huangqi Decoction can effectively treat PNS. The therapeutic mechanism may be related to the decrease of inflammation level. In addition, the level of ANGPTL3 may be an important index to reflect the prognosis of proteinuria PNS patients after hormone treatment.