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Qiditangshen Granules (QDTS) is a traditional Chinese medicine (TCM) compound prescription used for the treatment of diabetic nephropathy (DN) and diabetic kidney disease (DKD). The formulation is composed of multiple herbs, including *Astragalus propinquus*, *Rehmannia glutinosa*, *Euryale ferox*, *Cornus officinalis*, *Whitmania pigra*, *Rheum officinale*, and *Hedyotis diffusa*, with active components including quercetin and β-sitosterol. Developed based on the theories of Jingyue Zhang, a famous doctor of the Ming Dynasty, QDTS has been shown to reduce proteinuria in DN patients. Its proposed mechanisms of action are multifactorial, involving the modulation of gut microbiota and bile acid profiles, activation of renal autophagy by targeting the AMPK, SIRT1, and mTOR pathways, and improvement of insulin sensitivity through regulation of Insulin Receptor Substrate 1 (IRS-1) phosphorylation.
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