Objective: To investigate the efficacy of combined Chinese and western medicine in the treatment of children with Henoch-Schonlein purpura nephritis (HSPN) and its effects on immune function, interleukin (IL)-16, and IL-18 expressione. Methods: The clinical data of 91 children with HSPN were retrospectively collected and divided into two groups according to the treatment regimen. Group A (n=45) was treated only with western medicine, while group B (n=46) was treated with combined Chinese and western medicine. The clinical efficacy, traditional Chinese medicine (TCM) syndrome points before and after treatment, immune function indices, urinary indices, levels of IL-16 and IL-18, and the recurrence rate were compared between the two groups. Results: The total effective rate was 95.65% in group B, higher than 75.56% in group A (P<0.05). The TCM scores after treatment in group B was lower than that in group A (P<0.05). The levels of immunoglobulin IgA and IgM after treatment were lower while IgG levels were higher in group B than those in group A (P<0.05); Urinary microalbumin, urinary beta(2) microglobulin, 24 h urine protein elimination, and red blood cells (RBC) in the urine were lower in group B after treatment than in group A (P<0.05). The serum levels of IL-16 and IL-18 in group B were lower than those in group A after treatment (P<0.05). The recurrence rate was 4.35% in group B, lower than 26.67% in group A (P<0.05). Conclusion: Combined regimen of western and Chinese medicine in children showed significant efficacy on improving immune function and reducing recurrence rate and IL-16 and IL-18 levels in patients with HSPN.