Summary of case history,　The patient was admitted to the hospital due to repeated edema of both lower extremities. The auxiliary examination: Scr 86umol/L, urine protein 3+, renal puncture pathological examination, and the diagnosis of "stage II membranous nephropathy". After treatment with tacrolimus, prednisone, mycophenolate mofetil and other related drugs, the edema and proteinuria did not improve significantly, and the symptoms recurred; , The initial symptoms were occasionally repeated, and then gradually stabilized, the edema disappeared, and the proteinuria was basically normal.,Diagnosis of TCM,　edema disease (syndrome of spleen deficiency with damp heat and blood stasis),Western medicine diagnosis,　stage Ⅱ membranous nephropathy.,Intervention measures,　In the past, he had been given oral treatment such as "prednisone 70 mg qd, mycophenolate mofetil 0.75 g bid", and related symptoms such as edema and proteinuria appeared repeatedly. Diagnosed with membranous nephropathy after renal biopsy, "tacrolimus 1.5 mg bid, prednisone 30 mg qd" was given. After the first diagnosis and treatment in our hospital, it was considered to be edema disease (spleen deficiency and damp-heat with stasis syndrome). Traditional Chinese medicine prescribed the method of clearing away heat and removing dampness, strengthening the spleen and promoting blood circulation. The western medicine prescribed "prednisone 5mg qd, tacrolimus 1.0mg bid, Calqi D 0.6g qd, atorvastatin calcium 20mg qn" and other comprehensive treatments. The second and third consultations are considered to be spleen-kidney deficiency and blood stasis syndrome after syndrome differentiation, and the treatment is based on the method of strengthening the spleen, nourishing the kidney and removing blood stasis; the western medicine treatment plan is the same as before. During the treatment, the condition recurred, but the general trend was stable. After that, the patient had regular follow-up visits every three weeks, and the doses of prednisone and tacrolimus were gradually reduced. After one and a half years, tacrolimus and prednisone were gradually discontinued. In the future, regular follow-up visits will be conducted every four weeks, and the treatment based on the original prescription will continue to be treated based on syndrome differentiation, taking into account both the symptoms and the symptoms.,Efficacy outcome,　After the patient was diagnosed with membranous nephropathy, according to the relevant clinical diagnosis and treatment plan, the patient only used western medicine for nearly 3 years, and the symptoms such as edema and proteinuria persisted, so it could be considered as refractory membranous nephropathy. After the first diagnosis of TCM syndrome differentiation and treatment with western medicine, the symptoms of edema disappeared, but proteinuria was still seen. After the second and third consultations, the urine protein was high and low, and occasionally repeated. After nearly a year and a half of combined treatment with traditional Chinese and Western medicine (prednisone and tacrolimus were discontinued in the past year and a half), the proteinuria was gradually reduced to total urine protein/creatinine ratio (TPCR): 0.86g /g•Cr, Urinary Albumin To Creatinine Ratio (ACR): 0.66g/g•Cr, after that, only treated by TCM syndrome differentiation, and the proteinuria is basically normal.