Abstract：Objective：To observe the clinical effect of Qizhi Yishen Capsules combined with Alprostadil on diabetic kidney disease (DKD) and the impact on renal microcirculation. Methods：A total of 90 cases of early-stage DKD patients were selected and divided into the control group and the treatment group according to the random number table method， with 45 patients in each group. The control group was treated with Alprostadil，and the treatment group was additionally treated with Qizhi Yishen Capsules based on the treatment of the control group. Clinical effects，kidney function [serum creatinine (SCr)，blood urea nitrogen (BUN)， and 24-hour urinary protein quantification (24-hour Upro)]， renal microcirculation indicators [endothelin-1 (ET-1)， thromboxane B2 (TXB2)， and nitric oxide (NO)]， and adverse reactions were compared between the two groups. Results： The total effective rate was 95.56% in the treatment group and 77.78% in the control group，with significance in the difference (P＜0.05). After treatment，the levels of serum SCr， BUN， and 24-hour Upro in the two groups were decreased when compared with those before treatment (P＜0.05)，and each kidney function indicator in the treatment group was lower than that in the control group (P＜0.05). After treatment， the levels of ET-1 and TXB2 in the two groups were declined when compared with those before treatment (P＜0.05)， and the levels of NO were increased when compared with those before treatment (P＜0.05)； the levels of ET-1 and TXB2 in the treatment group were lower than those in the control group (P＜0.05)； the level of NO in the treatment group was higher than that in the control group (P＜0.05). The incidence of adverse reactions was 13.33% in the treatment group and 17.78% in the control group，with no significance in the difference (P＞0.05). Conclusion：Qizhi Yishen Capsules combined with Alprostadil can effectively improve kidney function，renal microcirculation， and clinical effects in treating DKD patients.