Abstract: Objective To explore the clinical efficacy of Shenshuai Mixture plus colonic dialysis in patients with chronic kidney disease stage 4 (CKD4). Methods A total of 90 patients with CKD stage 4 (spleen and kidney Qi deficiency syndrome) were hospitalized from December 2018 to December 2020. There were 46 males and 44 females with an average of (48.9±10.5) (31-84) years. They were randomized into three groups of control (group A, basic treatment), colon dialysis (group B, basic treatment plus colon dialysis) and colon dialysis plus Shenshui Mixture (group C, basic treatment plus colondialysis plus Shenqi Shenshui Mixture orally. Colon dialysis was offered twice weekly for 6 months. Renal function, electrolytes and hemoglobin and changes in TCM syndromes were recorded. Results Total effective rates of groups A, B and C were 55.17%, 79.31% and 96.42% respectively;effective rates of groups A, B and C differed greatly (χ²=13.747, P=0.001) and group C had a significant curative effect. It was better than group A (χ²=13.086, P=0.001), efficacy was significantly better in group C than that in group B (χ²=3.875, P=0.049) and efficacy better in group B than that in group A (χ²=3.835, P=0.05); No significant improvement occurred in TCM syndromes among groups A, B and C (P>0.05). TCM syndrome showed no significant improvement (P>0.05). As compared with pre-treatment, sour back/knee, lassitude, anorexia, nausea, vomiting, dry stool and edema improved greatly (P<0.05). Clinical symptoms improved more in group C than group A/B (P<0.05, P<0.01);The values of serum creatinine (Scr), blood urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) declined after treatment (P<0.05). And Scr and eGFR were better in group C than group A/B (P<0.01) and group A better than group B (P<0.05). The level of hemoglobin (Hb) rose in group B/C group (Hb) after treatment (P<0.05). Effiacy was better in group C than that in group A/B (P<0.05). However, no significant difference existed between groups A and B. And there was no significant difference in electrolyte (K/P) or albumin (Alb) before and after treatment (P>0.05). Conclusion In patients with stage CKD4, Shenshuai Mixture plus colon dialysis can improve renal function, delay the progression of renal disease and improve body fatigue. Wider clinical popularization is worthy.