Objective: To analyze the efficacy of the combination of Huoxue Tongluo Formula and immunosuppressive regimen in the treatment of idiopathic membranous nephropathy. Methods: A prospective analysis was conducted on 96 patients with idiopathic membranous nephropathy from January 2022 to October 2024. The patients were randomly divided into two groups using a random number table: a Western medicine group (treated with immunosuppressive therapy alone) and a Chinese Western medicine group (treated with a combination of blood activating and meridian unblocking formula and immunosuppressive therapy), with 48 cases in each group. After 6 months of treatment, the clinical efficacy, TCM syndrome scores, basic laboratory indicators, and changes in blood lipid levels were compared between the two groups before and after treatment. Results: The total effective rate of the traditional Chinese and Western medicine group was higher than that of the Western medicine group (χ 2=5.897, P=0.015); After treatment, the scores of TCM syndromes related to the main and secondary symptoms in both groups decreased, and the scores in the TCM and Western medicine groups were lower than those in the Western medicine group (t=7.613, 11.086; P<0.001 for both groups); After treatment, albumin levels increased in both groups, with the Western medicine group being higher than the Western medicine group (t=5.934; P<0.001). 24-hour urinary protein quantification (24-hour UTP), blood uric acid, blood creatinine, and urea nitrogen all decreased, with the Western medicine group being lower than the Western medicine group (t=7.940, 2.943, 2.590, 7.482 P<0.001); After treatment, both groups showed a decrease in total cholesterol (TC) and triglycerides (TG), with the Western medicine group being lower than the Western medicine group (t=4.834, 5.989; P<0.001 for both groups). Conclusion: The combination of Huoxue Tongluo Formula and immunosuppressive regimen has a better therapeutic effect on idiopathic membranous nephropathy, which can alleviate patient symptoms, promote elevated albumin, reduce 24-hour UTP, improve renal function levels, and assist in reducing blood lipid levels.