Abstract: OBJECTIVE To explore the clinical therapeutic effects of Jiawei Zhenwu Decoction in treating IV stage diabetic nephropathy(DN) due to yang deficiency of spleen-kidney. METHODS 130 cases with DN at stage Ⅳcollected from January， 2014 to June， 2015 were randomly divided into study group and control group， with 65 cases in each group. Conventional therapy were applied to both groups and based on this， patients in the study group were further given Modified Zhenwu Decoction. After the treatment for one month， changes of TCM syndrome scores， fasting blood-glucose(FPG)， urine protein excretion， serum creatinine(Scr)， creatinine clearance rate(Ccr)， systolic blood pressure(SBP) and diastolic blood pressure(DBP) before and after treatment were observed and comparision were made between these two groups to evaluate the clinical efficacy and safety. RESULTS Compared to the control group， there were more evident declines of TCM syndrome scores， FPG， urine protein excretion， Scr， Ccr， SBP and DBP in the study group after treatment， with statistical differences(P<0.05). The total effective rate of study group was 90.77%， which was much higher than that of 67.69% in the control group， and there were statistical differences between two groups(P<0.05). No serious side effects were noticed during the treatment in both groups. CONCULSION Conventional therapy plus Modified Zhenwu Decoction can evidently improve clinical symptoms and kidney function of patients with IV stage DN due to yang deficiency of spleen-kidney， with no side effects.