To investigate the therapeutic effect of Wenshen Qianyang decoction in steroid-resistant nephrotic syndrome(SRNS) and explore its underlying mechanisms.Methods:An SRNS rat model was established through adriamycin injection.Rats were divided into groups receiving different doses of Wenshen Qiyang decoction.Hematoxylin-eosin staining(HE) was used to assess renal pathology; enzyme-linked immunosorbent assay(ELISA) was used to detect renal function biomarkers; TdT-mediated dUTP nick-end labeling(TUNEL) assay was used to detect cell apoptosis，and immunofluorescence was used to detect the expression levels of Yes-associated proteins(YAP) in renal tissues.Real-time quantitative polymerase chain reaction(qRT-PCR) was used to detect the transcription levels of B-cell lymphoma-2-associated X protein(Bax)，B-cell lymphoma-2 gene(Bcl-2)，PODXL-like protein(PODXL)，Ezrin，autophagy-related 5(Atg5)，autophagy-related 7(Atg7)，and microRNA let-7a-5p(let-7a-5p).Western blot(WB) was used to detect YAP protein expression level.Results:Compared with the model group，Wenshen Qianyang decoction-treated rats showed significant alleviation of renal pathological damage(P<0.05)，improved renal function indices(P<0.05)，and reduced apoptosis rate(P<0.05).Wenshen Qianyang decoction down-regulated the expressions of let-7a-5p，pro-apoptotic gene Bax，and autophagy-related genes Atg5 and Atg7(P<0.05)，and up-regulated the expressions of YAP，anti-apoptotic gene Bcl-2，and podocyte injury-related genes PODXL and Ezrin(P<0.05).Conclusion:Wenshen Qianyang decoction ameliorates SRNS by regulating the let-7a-5p/YAP pathway to inhibit podocyte apoptosis，injury，and autophagy.