Abstract： Objective： To observe the effect of Shenyu Yangwei Decoction combined with a chemotherapy regimen of capecitabine plus oxaliplatin (XELOX) on toxic and side effects of chemotherapy and cancer-related fatigue in the treatment of advanced gastric cancer. Methods： A total of 95 cases of patients with advanced gastric cancer were selected and divided into the control group and the observation group by random envelope method， with 47 and 48 cases in each group respectively. The control group was treated with the XELOX regimen， and the observation group was treated with Shenyu Yangwei Decoction and XELOX regimen. Clinical effects， traditional Chinese medicine (TCM) syndrome scores， immune function，toxic and side effects，and cancer-related fatigue (Piper Fatigue Scale) were compared between the two groups. Results： The total effective rate was 97.92% in the observation group， which was higher than that of 87.24% in the control group， the difference being significant (P＜0.05). After treatment， TCM syndrome scores of pain in the stomach cavity， reduction of food intake and abdominal distention，hiccup and belching，marasmus and lack of strength，fear of cold and cold limbs，loose stool， profuse clear urine in the two groups were declined when compared with those before treatment (P＜0.05)， and the above scores in the observation group were lower than those in the control group (P＜0.05). After treatment， the levels of T lymphocytes (CD4+ ) and natual killer cell(NK) in the two groups were elevated when compared with those before treatment (P＜0.05)，and the levels of CD4+ and NK in the observation group were higher than those in the control group (P＜0.05)； the levels of CD8+ were reduced when compared with those before treatment (P＜0.05)，and there was no significant difference in the comparison of CD8+ levels between the two groups (P＞0.05). The incidence of toxic and side effects was 33.33% in the observation group， which was lower than that of 57.45% in the control group， the difference being significant (P＜0.05). After treatment，the scores of affective fatigue，behavioral fatigue，cognitive fatigue， and sensory fatigue in the Piper Fatigue Scale in the two groups were declined when compared with those before treatment (P＜0.05)， and the above scores in the observation group were lower than those in the control group (P＜0.05). Conclusion： Shenyu Yangwei Decoction combined with XELOX regimen for advanced gastric cancer can better enhance clinical effects， and effectively improve patients' TCM syndromes，immune function，toxic and side effects，and the condition of cancer-related fatigue.