Objective Compared with full-dose glucocorticoid,to evaluate the effect of hydroxychloroquine combined with half-dose glucocorticoid in the treatment of IgA nephropathy in reducing urinary protein and protecting renal function,as well as the incidence of adverse reactions. Methods From June 2020 to January 2022,patients with IgA nephropathy whose baseline urinary protein excretion>1 g/d and baseline estimate glomerular filtration rate>15 mL/min were enrolled and randomly divided into hydroxychloroquine combined with half-dose glucocorticoid(Q+G)group and full-dose glucocorticoid(G)group. Each patient in Q+G group was given oral hydroxychloroquine and oral prednisone at a dose of 0. 5 mg/(kg·d). Each patient in G group was given prednisone at a dose of 1 mg/(kg·d). The changes in 24-hour urine protein quantification between the two groups at 2,4 and 6 months of treatment were compared;the proportions of 24-hour urine protein decreased by more than 30%,24-hour urine protein decreased to less than 1 g,estimate glomerular filtration rate decreased >30% and adverse reactions within 6 months were compared between the two groups. Results Fourty-nine cases were enrolled in Q+G group and 46 cases in G group. There was no significant difference in the 24-hour urine protein changes between the two groups at 2,4 and 6 months of treatment. The proportion of 24-hour urine protein decreased by 30%,the proportion of the 24-hour urine protein decreased to below 1 g and the proportions of patients whose estimate glomerular filtration rate decreased by >30% within 6 months between the two groups were not significantly different. The proportion of adverse reactions in Q+G group was lower than that in G group. Conclusions Hydroxychloroquine combined with half-dose glucocorticoid has similar effects in reducing urinary protein and protecting renal function and lowering incidence of adverse reactions compared with full-dose glucocorticoid therapy in the treatment of patients with IgA nephropathy whose urinary protein excretion > 1 g/d.