To investigate the clinical effect of Huanglian Qingjie Granule combined with improved combination therapy on spleen and stomach damp-heat type patients with chronic gastritis whose eradication of Helicobacter pylori (Hp) failed.

The research subjects were 82 patients with chronic gastritis of the spleen and stomach damp-heat type who failed the initial eradication of Hp and were admitted to Zhengzhou Hospital of Traditional Chinese Medicine from January 2023 to April 2025. They were divided into two groups according to a randomized, parallel controlled design: the control group and the treatment group, with 41 patients in each group. The control group was treated with modified double therapy, and the treatment group was treated with Huanglian Qingjie Granule on the basis of the control group. Both groups were treated for 1 month. The clinical efficacy of the two groups was compared. The Hp clearance of the two groups was compared one month after treatment. The TCM syndrome scores of the two groups were compared before treatment and one month after treatment. The levels of inflammatory factors were compared between the two groups before and 1 month after treatment.

Compared with the control group, the total effective rate was significantly higher in the treatment group (P < 0.05). Compared with control group, Hp clearance rate in treatment group was significantly higher (P < 0.05). Compared with the control group, the main symptom score and secondary symptom score of TCM syndrome score were significantly decreased in the treatment group one month after treatment (P < 0.05). Compared with the control group, the levels of tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β) were significantly decreased in the treatment group one month after treatment, and the level of interleukin-10 (IL-10) was significantly increased in the treatment group (P < 0.05).

The combination of Huanglian Qingjie Granules and the modified dual therapy can effectively enhance the clinical efficacy of patients with chronic gastritis of spleen and stomach damp-heat type who have failed Hp eradication, increase the Hp eradication rate of patients, improve their TCM syndrome score and inflammatory factor levels, and can be widely applied in clinical practice.