Abstract： Objective： To observe the clinical effect of the therapy of modified Kaiwei Jinshi Tang on chronic atrophic gastritis (CAG) infected by helicobacter pylori (Hp) with spleen-stomach weakness syndrome. Methods：A total of 108 patients with CAG infected by Hp were randomly divided into the treatment group and the control group，with 54 cases in each group. Both groups were given quadruple therapy. The control group was additionally treated with domperidone tablets orally， and the treatment group was additionally treated with modified Kaiwei Jinshi tang based on the treatment of the control group. Both groups were treated for 12 weeks. The pathological scores of gastric mucosa， syndrome scores of spleen- stomach weakness and clinical effects in the two groups were observed and compared. Results：The total effective rate was 92.59% in the treatment group and 77.78% in the control group，the difference being significant (P＜0.05). Before treatment， there was no significant difference being found in the comparisons of the scores of chronic inflammatory responses， activity， atrophy and intestinal metaplasia of gastric mucosa between the two groups(P＞0.05). After treatment， the scores of chronic inflammatory responses， activity，atrophy and intestinal metaplasia of gastric mucosa were significantly decreased when compared with those before treatment(P＜0.05)，and the above four scores in the treatment group were lower than those in the control group(P＜0.05). Before treatment，there was no significant difference being found in the comparisons of scores of stomach cavity fullness，preference to stomach compression，torpid intake， sloppy stool，fatigue and lack of strength，shortage of qi and unwillingness to talk and gastric stuffiness after eating between the two groups(P＞0.05)； after treatment， the above seven traditional Chinese medicine(TCM) syndrome scores in the two groups were decreased when compared with those before treatment，and the above seven scores in the treatment group were lower than those in the control group (P＜0.05). Conclusion：The therapy of modified Kaiwei Jinshi Tang based on routine western medicine can further improve the gastric mucosa and TCM syndromes of patients with CAG infected by Hp，with a better effect.