To explore the efficacy and safety of tripterygium wilfordii polyglycoside in the treatment of child patients with purpura nephritis.Methods:A total of 96 child patients with purpura nephritis admitted to the pediatric department in our hospital were randomly divided into 2 groups,an experimental group and a control group with 48 cases in each group.The control group received routine treatment.The experimental group was treated with tripterygium wilfordii polyglycoside tablets,1 mg/（kg·d）,3 times after meals on the basis of the control group.Both groups of children were treated continuously for 5 days.The clinical efficacy,4-1 BB/4-1 BBL,immune function,inflammatory factors and safety of the 2 groups were compared.Results:After treatment,the total remission rate of the experimental group was 91.67% higher than that of the control group (72.92%,P<0.05).After treatment,the serum levels of 4-1BBmRNA,4-1BBLmRNA,IgA,IgG,and TNF-in the 2 groups were lower than those before treatment,and the test group was lower than the control group (P<0.05).After treatment,the serum IL-10 level of the test group was higher than that before the treatment,and the IgM level of the control group was lower than that before the treatment.The serum IgM and IL-10 levels of the test group were higher than those of the control group (P<0.05).During the treatment period,there was no statistically significant difference in adverse reactions between the 2 groups (P>0.05).Conclusion:On the basis of conventional treatment,tripterygium wilfordii polyglycoside has better therapeutic effect on child patients with purpuric nephritis,can effectively reduce the level of monocyte costimulatory molecule 4-1 BB/4-1 BBL,rapidly improve clinical symptoms,and has higher safety.