Abstract：Objective：To observe the clinical effect of the therapy of Ziyin Yishen Prescription combined with Telmisartan on the treatment of primary immunoglobulin A (IgA) nephropathy. Methods： A total of 73 patients with primary IgA nephropathy were selected and divided into the observation group and the control group according to random number table method，with 38 and 35 cases in each group respectively. The two groups were given basic treatment after admission；the control group was additionally treated with Telmisartan，and the observation group was additionally treated with Ziyin Yishen Prescription based on the treatment of the control group. The clinical effects， traditional Chinese medicine syndrome scores and biochemical indexes， including 24- hour urinary protein quantitative， serum creatinine (SCr)， blood urea nitrogen (BUN) and IgA， were observed after treatment in the two groups. Results： The total clinical effective rate was 97.37% in the observation group and 80.00% in the control group，the difference being significant (P＜0.05). Before treatment，there was no significant difference in the comparison of the scores of tinnitus and vertigo，waist and knee soreness and weakness，vexation in the five centers，rib pain and afternoon low fever between the two groups (P＞0.05). After treatment，all the above traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and all the scores in the observation group were lower than those in the control group (P＜0.05). Before treatment， there was no significant difference in the comparison of the levels of serum BUN， 24- hour urinary protein，SCr and IgA between the two groups (P＞0.05)；after treatment，the levels of the above indexes in the two groups were decreased when compared with those before treatment (P＜ 0.05)；the levels of the above indexes in the observation group were lower than those in the control group (P＜0.05). Conclusion：The therapy of Ziyin Yishen Prescription combined with Telmisartan has a significant therapeutic effect on the treatment of primary IgA nephropathy，which can effectively enhance the clinical effects，improve kidney function，enhance immunity，and relieve the clinical symptoms of patients.