To investigate the distribution characteristics of traditional Chinese medicine(TCM) syndromes and their influencing factors in idiopathic membranous nephropathy(IMN).Methods:The basic information，laboratory indicators，and TCM symptoms of the patients who visited the Nephrology Department of Xiyuan Hospital of China Academy of Chinese Medical Sciences and the Third Hospital of Hebei Medical University from October 2017 to October 2019 were collected by the cross-sectional survey and analyzed for TCM syndrome differentiation.The TCM syndrome distribution of IMN and the influencing factors were analyzed.Results:Among the TCM syndromes of IMN in 276 IMN cases，deficiency syndrome accounted for 19.57%，excess syndrome for 10.87%，and deficiency-excess in complexity syndrome for 69.57%.Deficiency syndromes were ranked as follows：qi deficiency in the spleen and the kidney syndrome>yang deficiency in the spleen and the kidney>yin deficiency in the liver and the kidney syndrome>qi deficiency in the lung and the kidney syndrome>qi and yin deficiency syndrome.Excess syndromes were ranked as follows：dampness-heat syndrome>dampness and blood stasis syndrome>water-dampness syndrome>blood stasis syndrome.The proportion of yin deficiency in the liver and the kidney syndrome in patients with the course of disease>2 years was significantly higher than that with the course of disease<2 years(26.39% vs 12.07%).The proportion of dampness and blood stasis syndrome in overweight patients was significantly higher than that in patients with normal weight(41.96% vs 19.23%).The proportions of qi deficiency in the spleen and the kidney syndrome(55.15% vs 34.55%) and blood stasis syndrome(31.40% vs 17.82%) in patients with plasma albumin<30 g/L were significantly higher than those in patients with plasma albumin>30 g/L.The proportions of yin deficiency in the liver and the kidney syndrome(27.27% vs 13.09%) and qi deficiency in the lung and the kidney(20.00% vs 7.33%) in patients treated with glucocorticoid were significantly higher than those in patients with non-glucocorticoid treatment.All the above differences were statistically significant(P<0.05).Conclusion:TCM syndromes of IMN are complex and dominated by deficiency-excess in complexity syndrome.The basic pathogenesis is attributed to the deficiency in the spleen and the kidney，and on this basis，there are pathologic products such as water，dampness，heat，phlegm，blood stasis，and mixed dampness and blood stasis.The course of the disease，body weight，plasma albumin，and the use of glucocorticoid were the factors influencing the distribution of TCM syndromes of IMN.