Objective： To observe the clinical effect of the combination use of Shaoyao Gancao Decoction and Clostridium Butyricum Powder in adjuvant treatment of elderly gastric ulcer. Methods：A total of 120 elderly patients with gastric ulcer admitted to the Hangzhou Ninth People's Hospital from November 2020 to November 2023 were selected as the research objects and divided into the study group（64 cases） and the control group （56 cases） according to the random number table method. The control group was treated with conventional quadruple therapy combined with Clostridium Butyricum Powder， and the study group was treated with Shaoyao Gancao Decoction on the basis of treatment in the control group. Both groups were treated for four weeks. The ulcer condition （area of thick moss at the bottom of the ulcer，area of mucosal congestion around the ulcer and area of regenerative epithelium around the ulcer）， changes of intestinal flora （Enterococcus，Bifidobacterium，Lactobacillus and Enterobacter），levels of serum gastric hormone [trefoil factor （TFF1）， motilin （MTL） and gastrin （GAS）] and expression levels of p38 MAPK mRNA and NF-κB mRNA were compared before and after treatment between the two groups. The incidence of adverse reactions in the two groups during treatment were observed. Results：After treatment，the area of thick moss at the bottom of the ulcer， area of mucosal congestion around the ulcer and area of regenerative epithelium around the ulcer in the two groups were reduced when compared with those before treatment （P＜0.05）， and the above three areas in the study group were less than those in the control group （P＜0.05）. After treatment， the number of Enterococcus， Bifidobacterium， Lactobacillus and Enterobacter in the two groups was elevated when compared with that before treatment （P＜0.05），and the number of Enterococcus，Bifidobacterium，Lactobacillus and Enterobacter in the study group was respectively higher than that in the control group （P＜0.05）. After treatment，the levels of TFF1，MTL and GAS in the two groups were down-regulated when compared with those before treatment （P＜0.05）， and the above three levels in the study group were lower than those in the control group （P＜0.05）. After treatment，the expression levels of p38 MAPK mRNA and NF-κB mRNA in the two groups were dwindled when compared with those before treatment（ P＜0.05），and the above two levels in the study group were lower than those in the control group（ P＜0.05）. There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： The therapy of Shaoyao Gancao Decoction combined with Clostridium Butyricum Powder can improve the symptoms of elderly patients with gastric ulcer，accelerate the recovery of ulcer，and regulate and promote the balance of gastric hormones and intestinal flora，which may be related to the regulation of p38 MAPK/ NF-κB pathway expression in the body.