Abstract： Objective： To observe the clinical effect of the therapy of Zuogui pills combined with western medicine on patients with early kidney damage from hypertension with syndrome of kidney essence insufficiency. Methods： A total of 100 patients were divided into the observation group and the control group， 50 cases in each group according to random number table method. Both groups were treated with irbesartan tablets orally，and amlodipine benzenesulfonate tablets were added if the blood pressure was not up to standard. The observation group was additionally treated with modified Zuogui pills. Both groups were treated for twelve weeks. The levels of β2 microglobulin(β2-MG)，urinary N-acetyl-β-glucosaminosidase (NAG)，urinary microalbumin(mAlb) and blood cystatin C(CysC) were detected before and 12 weeks after treatment，and the score of kidney essence insufficiency was assessed. The blood pressure was measured every day and blood pressure compliance was recorded. Results： After treatment， the levels of β2- MG， NAG， CysC and mAlb in both groups were decreased when compared with those before treatment(P＜0.01)；the above levels in the observation group were lower than those in the control group(P＜0.01). The scores of kidney essence insufficiency in both groups were decreased when compared with those before treatment(P＜0.01)， and the above score in the observation group was lower than that in the control group(P＜0.01). During treatment， the blood pressure compliance rate was 89.60% in the observation group and 83.67% in the control group，the difference being significant(P＜0.01). Conclusion：On the basis of the conventional western medicine， the additional application of modified Zuogui pills can effectively protect the kidney function， control blood pressure and alleviate clinical symptoms in the treatment of patients with early kidney damage from hypertension with syndrome of kidney essence insufficiency.