Abstract：Objective：To observe the effect of Fuzheng Yishen tang combined with glucocorticoid on the levels of soluble programmed death protein-1(sPD-1) and soluble programmed death protein ligand -1(sPD-L1) in peripheral blood of patients with nephrotic syndrome. Methods： A total of 142 cases of patients with primary nephrotic syndrome were selected and divided into the observation group and the control group according to the random number table method， 71 cases in each group.The control group was routinely treated with glucocorticoid， and the observation group was additionally treated with Fuzheng Yishen tang based on the treatment of the control group. After eight weeks of treatment， the levels of sPD- 1， sPD-L1，serum creatinine(SCr)，blood urea nitrogen(BUN)，creatinine clearance rate(CCr)，albumin(Alb)，endothelin-1(ET-1)， high mobility group box protein- 1(HMGB- 1) in serum and the 24 h urinary protein quantification(24 hUpro) before and after treatment as well as the clinical effect in the two groups were compared； the incidence of adverse reactions in the two groups was analyzed. Results： After eight weeks of treatment， the total effective rate was 92.96% in the observation group， significantly higher than that of 78.87% in the control group(P＜0.05). After treatment， sPD- 1， sPD- L1， SCr， BUN， ET- 1， HMGB- 1 and 24 hUpro in serum in the two groups were decreased when compared with those before treatment(P＜0.05)， and CCr and Alb in serum were increased(P＜0.05). After treatment， sPD- 1， sPD- L1， SCr， BUN， ET-1，HMGB-1 and 24 hUpro in serum in the observation group were lower than those in the control group(P＜0.05)，and CCr and Alb in serum were higher(P＜0.05). During treatment， no serious adverse reactions occurred in the two groups. Conclusions： The therapy of Fuzheng Yishen tang combined with glucocorticoid has definite clinical effect in treating nephrotic syndrome with good safety，which can effectively reduce the inflammatory reactions of patients，down-regulate the levels of sPD-1 and sPD-L1，and improve the kidney function.