【Abstract】Objective To explore the clinical efficacy of Haikun Shenxi Capsule combined with sulodexide in the treatment of elderly patients with early diabetic nephropathy, and provide reference for its clinical application. Methods From January 2018 to March 2019, 81 elderly patients diagnosed as early diabetic nephropathy in 2 departments of the Affiliated Hospital of Hebei University were selected as the objects of observation. All patients were clearly diagnosed as stage III diabetic nephropathy. They were divided into 3 groups on average by random number method: 27 cases in Haikun Shenxi group (treated with Haikun Shenxi capsule alone), 27 cases in sulodite group (treated with sulodite alone) and 27 cases in combination group were treated with Haikun Shenxi capsule and sulodette. After 8 weeks of treatment, the clinical efficacy, renal function, renal injury, cytokines and other related indicators of the three groups were compared.Results The difference of total effective rate among the three groups was statistically significant (P<005). The total effective rate of combined group was higher than that of Haikun Shenxi group and sulodette group (P<005). There was no significant difference in bun and SCR between the three groups before and after treatment (P>005). 24 hours after treatment, UTP, UAER, mAb, β 2 mg and Cys C in the three groups were significantly lower than those before treatment (P<005). 24 hours after treatment, UTP, UAER, mAb, β 2 mg and Cys C in the combined group were lower than those in Haikun Shenxi group and sulodette group (P<005). After treatment, 24 hours UTP, UAER and β 2 mg in Haikun Shenxi group were lower than those in sulodette group (P<005). After treatment, VEGF, ACE and IGF1 were significantly lower in the three groups than before (P<005). After treatment, VEGF, ACE and IGF1 in the combined group were lower than those in Haikun Shenxi group and sulodette group (P<005); IGF1 in Haikun Shenxi group was lower than that in sulodette group (P<005). Conclusion Haikun Shenxi Capsule combined with sulodide has a better clinical effect on the elderly patients with early diabetic nephropathy. It can effectively reduce proteinuria, improve renal microcirculation, delay renal injury, and reduce the level of cytokines, which can be used in clinical practice. 