Objective:To observe the clinical efficacy of “Yiqi Huaju Granules” and western medicine for the treatment of metabolic syndrome coupled with microalbuminuria  Methods:One hundred cases with were randomized into treatment group and control group, with 50 cases in each group. The treatment group was treated with western medicine and “Yiqi Huaju Granules”, and the control group was treated with western medicine and placebo, with the course of 12 weeks. The negative conversion ratio of microalbuminuria was observed, and the indicators of urine (MA, UACR, 24 hTP, urinary transferring and β,2, microglobulin), signs indicators (BMI, WHR, SBP, DBP, MAP), and blood sugar (FPG, 2 hPPG, HbA1c, HOMA-IR) and blood fat (TC, TG, LDL, HDL) were compared  Results:①All of the 100 subjects completed the clinical study. ②The total negative conversion rate of MA was 28.00% in the treatment group and was 10.00% in the control group, with a difference between the two groups (P,<,0.05). ③After treatment, there were significant differences in the levels of MA, UACR, 24 hTP and urinary β,2, microglobulin between the two groups (P,<,0.05). ④After treatment, there were significant differences in the levels of BMI, WHR, SBP and MAP between the two groups (P,<,0.05). ⑤After treatment, there were significant differences in the levels of FPG, 2 hPPG, HbA1c and HOMA-IR between the two groups (P,<,0.05). ⑥After treatment, there were significant differences in TG level between the two groups (P,<,0.05)  Conclusion:Combined “Yiqi Huaju Granules” and western medicine is effective to control the progress of the disease, enhance the insulin sensitivity and reduce central obesity in metabolic syndrome coupled with microalbuminuria.