Objective To observe the characteristics of TCM syndrome evolution of diabetic nephropathy（DN）.Methods Totally 301 cases of DN were included and received basic treatment and TCM intervention. The syndromes of all patients were investigated at three time points

i. e. starting point of observation

three months later and six months later. The symptoms including seven-group syndromes and 29 symptoms

tongues and pulses were collected with DN TCM Syndromes Questionnaire. The syndromes were identified with factor analysis and the syndrome evolution was analyzed with transition probability analysis. Results There were 8

10 and 9 syndrome factors in 301patients at three time points respectively. The first common factor syndrome at the starting point was similar to yang deficiency syndrome. At the 1st time point

44. 19% of the patients were still similar to yang deficiency syndrome and18. 60% of the patients transformed to phlegm-damp syndrome. The patients with yang deficiency syndrome at the 1st time point transformed to yang-deficiency phlegm-damp syndrome at the 2nd time point. The syndromes of other common factors were different at different time points as well

partially continuing the previous syndromes or transforming to other syndromes. Conclusion Although DN patients are with various syndromes

there is certain regularity.Yang deficiency syndrome has a tendency to transform to yang-deficiency phlegm-damp syndrome. Yin deficiency syndrome has a tendency to transform to qi-deficiency yin-deficiency yang-deficiency syndrome. Qi deficiency syndrome has a tendency to transform to qi-deficiency phlegm-damp damp-turbidity syndrome. Blood stasis syndrome is relatively stable.