Abstract： Objective： To observe the effect of enema with Jianpi Liqi Decoction combined with moxibustion on ginger on intestinal flora and intestinal barrier function in patients after radical gastrectomy. Methods： A total of 157 patients undergoing radical gastrectomy in the People's Hospital of Jiangshan from August 2020 to August 2024 were divided into control group（52 cases），observation group A（52 cases）and observation group B（53 cases） by computer random number grouping method. The control group received conventional postoperative treatment， the observation group A was additionally treated with moxibustion on ginger based on the treatment of the control group，and the observation group B was additionally treated with enema with Jianpi Liqi Decoction combined with moxibustion on ginger based on the treatment of the control group. All groups were treated for two weeks. Traditional Chinese medicine syndrome scores， intestinal flora（Enterococci， Enterobacteria， Lactobacilli， Bifidobacteria）counts， and intestinal barrier function indicators [D-lactic acid， diamine oxidase（DAO）， endotoxin（ET）] levels among the three groups were compared before and after treatment. The incidence of adverse reactions were recorded in all three groups. Results： After treatment，the primary and secondary symptom scores and total traditional Chinese medicine syndrome scores in all three groups were decreased when compared with those before treatment（P＜0.05）. The observation group A and observation group B had lower primary and secondary symptom scores and total traditional Chinese medicine syndrome scores compared to the control group（P＜0.05）， and the observation group B had lower scores compared to the observation group A（P＜0.05）. After treatment，the counts of Enterococci and Enterobacteria in all three groups were reduced when compared with those before treatment（P＜0.05），and the counts of Lactobacilli and Bifidobacteria were increased when compared with those before treatment（P＜0.05）. The observation group A and observation group B had lower counts of Enterococci and Enterobacteria compared to the control group（P＜0.05），and the observation group A and observation group B had higher counts of Lactobacilli and Bifidobacteria compared to the control group（P＜0.05）； the observation group B had lower counts of Enterococci and Enterobacteria compared to the observation group A（P＜ 0.05）， and the observation group B had higher counts of Lactobacilli and Bifidobacteria compared to the observation group A（P＜0.05）. After treatment，the levels of D-lactic acid，DAO，and ET in all three groups were reduced when compared with those before treatment（P＜0.05）. The observation group A and observation group B had lower levels of D-lactic acid，DAO，and ET compared to the control group（P＜0.05），and the observation group B had lower levels compared to the observation group A （P＜0.05）. The incidence of adverse reactions in the control group， the observation group A， and the observation group B were 1.96%（1 / 51）， 3.92%（2 / 51）， and 9.80%（5 / 51）， respectively，with no significant difference among the three groups（P＞0.05）. Conclusion：Enema with Jianpi Liqi Decoction combined with moxibustion on ginger can regulate intestinal flora and improve intestinal barrier function in patients after radical gastrectomy，with high treatment safety.