Objective To systematically evaluate the efficacy and safety of modified Huangqi Jianzhong Decoction（黄芪建中汤） in the treatment of gastric ulcer of spleen and stomach deficiency-cold type. Methods Randomized controlled trial of modifed Huangqi Jianzhong Decoction in the treatment of gastric ulcer was screened in WanFang database

Pubmed

VIP

CochraneLibrary and China knowledge Network（CNKI） from the date of establishment to October 1

2019. Cochrane manual was used to evaluate whether there were risks of bias

GRADEprofiler 3.6.1 software was used to grade the results

Egger′s test was used to study whether there was publication bias in the results of more than 10 articles

and RevMan5.3 software was used to analyze the unrecovered rate

ulcer healing condition

curative rate

total effective rate

Helicobacter pylori（HP） clearance rate

recurrence rate and the incidence of adverse reactions for meta-analysis. Results A total of 17 related research literature were enrolled

including 1692 patients（Modified Huangqi Jianzhong Decoction group with 849 cases

western medicine triple therapy group with 843 cases）. The results of meta-analysis showed that compared with the routine western medicine triple therapy group

modified Huangqi Jianzhong Decoction group has more remarkable effect in the clinical curative rate in gastric ulcer [RR=1.42

95%CI（1.27

1.59）

P<0.01]

the total effective rate of gastric ulcer（cured + markedly effective + effective） rate [RR=1.21

95%CI（1.17

1.27）

P<0.01]

the healing of the ulcer surface [MD=1.48

95%CI（1.24

1.72）

P<0.01]

the unrecovered rate of gastric ulcer [RR=0.30

95%CI（0.21

0.42）]

P< 0.01]

the incidence of adverse reactions [RR=0.27

95%CI（0.09

0.78）

P=0.02] and the recurrence rate [RR=0.30

95%CI（0.21

0.43）

P<0.01] are lower. However

in terms of HP clearance rate [RR=0.93

95%CI（0.80

1.09）

P=0.37]

there was no statistically significant difference between the modified Huangqi Jianzhong Decoction group and the western medicine triple therapy group. According to GRADE evaluation criteria

the evidence of three outcome indicators including unrecovered rate

curative rate

and total effective rate were of medium quality

evidence of three outcome indicators including recurrence rate

HP clearance rate and ulcer surface healing were of low quality. Outcome indicator evidence of adverse reaction rate is of very low quality. Conclusion Modified Huangqi Jianzhong Decoction in the treatment of gastric ulcer of spleen and stomach deficiency-cold type is better than that of routine triple therapy of western medicine in curative rate

effective rate and ulcer healing condition

and the unrecovered rate

the incidence of adverse reactions

and the recurrence rate are lower.