Abstract: Objective To investigate the effects of total glucosides from paeony(TGP)on the expression of inflammatory factors and serum neutrophil gelatinase-associated lipocalin(NGAL),Toll-like receptor 4(TLR4)and myeloid differentiation factor 88(MYD88)in maintenance hemodialysis(MHD)patients.Methods A retrospective analysis was done for 75 MHD patients admitted to the Qingbaijiang District people’s Hospital from June 2017 to June 2019,and divided into total TGP group(n=38)and conventional treatment groups(n=37)according to different treatment methods.The renal function indexes,inflammatory factor levels(IL-6,CRP,TNF-α,NGAL),oxidative stress(GSH-PX,SOD,MDA),TLR4 and MYD88 expression and adverse events were compared between the two groups.Results After treatment,the Scr and mean weekly dehydration volume in the TGP group were lower than those in the conventional treatment group;the daily urine volume,GSH-PX,SOD were higher than those in the conventional treatment group;and the NGAL,IL-6,CRP,TNF-α,MDA levels were lower than those in the conventional treatment group(P<0.05).The TLR4 and MYD88 mRNA levels in the TGP group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusions Total glucosides from peony can reduce the level of NGAL in maintenance hemodialysis patients and improve the microinflammation state,which may be achieved through the influence of oxidative stress or TLR4/MYD88 pathway protein expression.