Abstract: Objective To investigate the effectiveness of total glucosides of Tripterygium Wilfordii and Tripterygium Wilfordii Hook in the treatment of membranous nephropathy and the prognosis.Methods 76 patients with membranous nephropathy treated in our hospital in January 2016-2017 December were selected to be divided into the observation group and the control group,with 38 cases in each group.The control group was treated with tripterygium glycosides,and the observation group was treated with total glucosides of Tripterygium wilfordii combined with tripterygium glycosides.The efficacy,adverse reactions and prognosis of the 2 groups were compared.Results The total effective rate in the observation group and control group was 84.21% (32/38) and 57.89% (22/38) respectively (P<0.05). Before treatment, the levels of serum albumin, urine protein, blood leukocyte, cholesterol, alanine aminotransferase and creatinine levels were comparable between the two groups (P>0.05). After treatment, the serum albumin in the observation group was significantly higher than that in the control group (P<0.05). The urine protein quantity, cholesterol and blood leukocyte were significantly lower in the observation group than those in the control group (P<0.05), while the alanine aminotransferase and creatinine showed no significant difference between two groups (P>0.05). The results of Cox regression analysis revealed that hypertension, hyperanic creatinine, glomerular sclerosis and massive proteinuria were the main factors affecting the prognosis of patients with membranous nephropathy (P < 0.05). In the absence of these symptoms, the incidence of total adverse reactions in the observation group was significantly lower than that in the control group (7.89% vs 26.32%) (P<0.05).Conclusions The effectiveness of total glycosides of Tripterygium wilfordii combined with tripterygium glycosides in the treatment of membranous nephropathy is better than that of Tripterygium wilfordii alone, with less adverse reactions. The prognosis of the treatment is better for the patients having no hypertension, high blood creatinine, glomerulosclerosis and massive proteinuria.