Abstract: OBJECTIVE To observe the effects of Yishen Huoxue decoction on intestinal microecology in patients with chronic kidney disease stage Ⅴ (CKD5). METHODS The non-dialysis patients in Lishui People's Hospital with deficiency of spleen and kidney qi and obstruction of dampness and blood stasis were randomly divided into two groups: 45 cases for the treatment group and 38 cases for the control group. The control group received routine treatment while the treatment group was given modified Yishen Huoxue decoction on the basis of routine treatment. After 8 weeks， blood samples and fecal samples of CKD patients were collected， and lactobacillus， bifidobacterium and escherichia coli， bacterial concentration of enterococcus faecalis in feces were detected by PCR. Routine biochemical parameters， including hemoglobin (Hb)， total protein (TP)， albumin (Alb)， serum creatinine (Scr)， blood urea nitrogen (BUN) and so forth were measured by automatic biochemical analyzer. ELISA method was used to detect the concentration of microinflammatory indexes. The changes of main symptom scores， renal function， microinflammatory indexes and intestinal microecology before and after treatment in the two groups were analyzed. RESULTS After treatment， the level of Scr and BUN in the treatment group decreased， along with the concentrations of hypersensitive c-reactive protein (hs-CRP)， interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) (P<0.05)， which were significantly different from those in the control group (P<0.05， P<0.01). Main symptom scores in the two groups both decreased (P<0.05)， but the treatment group was superior to the control group (P<0.05，P<0.01). In the treatment group， the concentration of beneficial bacteria such as lactobacillus and bifidobacterium significantly increased (P<0.05)， while the harmful bacteria in the intestinal tract such as escherichia coli and enterococcus faecalis significantly decreased (P<0.05)， which were significantly different from those in the control group (P<0.05， P<0.01). CONCLUSION Tonifying the spleen and kidney and unblocking the bowels and discharging turbidity on intestinal microecology can conspicuously improve CKD patients' intestinal microecological disorder and their clinical symptoms， protect the renal function and improve the microinflammatory state with remarkable effects.