To explore the clinical effect of Shenqi Erzhi Prescription（参芪二至方）combined with tacrolimus in the treatment of immunoglobulin A（IgA）nephropathy.

In this study，144 patients with IgA nephropathy（admitted from April 2020 to June 2023）were divided into Western medicine group（72 cases，tacrolimus）and comibined traditional Chinese medicine group（72 cases，Shenqi Erzhi Prescription combined with tacrolimus）. Two cases fell off during the treatment. Three cases fell off in the Western medicine group，and the data of each group was observed，including the treatment effect，the changes of TCM syndrome scores（thirst and drinking，shortness of breath，fatigue，dysphoria in chestpalms-soles，spontaneous sweating，etc.），the levels of blood creatinine（SCr），blood urea nitrogen（BUN），24 h urinary protein quantitative changes，complement C3 and IgA，interleukin-6（IL-6）and interleukin-17（IL-17）and other indexes changes before and after treatment in each group and adverse reactions.

The total effective rate of the comibined traditional Chinese medicine group was significantly higher than that of Western medicine group（P<0.05）. Before treatment，TCM syndrome scores，renal function related indexes（SCr，BUN，24 h urinary protein quantitative），the levels of complement C3，IgA，IL-6 and IL-17 were not significant in two groups（P>0.05）. After treatment，TCM syndrome scores，renal function related indexes（SCr，BUN，24 h urinary protein quantitative），the levels of IgA，IL-6 and IL-17 were significantly decreased in two groups，and complement C3 was increased. And these results were all lower in the comibined traditional Chinese medicine group than those in the Western group，and the complement C3 index was higher than that in the Western group（P<0.05）. The rate of adverse reactions in the comibined traditional Chinese medicine group was lower than that in the Western medicine group（P<0.05）.

Shenqi Erzhi Prescription combined with tacrolimus has a significant effect in the treatment of IgA nephropathy，with improved clinical symptoms，renal function and immune function，less adverse reactions，and it is a safe and reliable treatment.