Abstract：Objective：To observe the efficacy of Fuzheng Huayu Sanjie Prescription combined with Capecitabine plus Oxaliplatin （XELOX） regimen chemotherapy for advanced gastric cancer. Methods：A total of 106 patients with advanced gastric cancer admitted to Yiwu Central Hospital from January 2022 to December 2024 were selected and randomly divided into an observation group and a control group using the random number table method，with 53 cases in each group. Ultimately， 51 cases were included in the observation group （2 excluded） and 50 cases in the control group （3 excluded）. The control group received XELOX regimen chemotherapy，while the observation group was treated with Fuzheng Huayu Sanjie Prescription during XELOX regimen chemotherapy. After four cycles of treatment，clinical efficacy and incidence of adverse reactions were compared between the two groups. Changes in traditional Chinese medicine syndrome scores of qi deficiency and blood stasis syndrome， serum pepsinogen [pepsinogenⅠ （PGⅠ）， pepsinogen Ⅱ （PG Ⅱ ）]， serum tumor markers [carbohydrate antigen 199 （CA199）， carbohydrate antigen 125 （CA125）， carcinoembryonic antigen （CEA）， matrix metalloproteinase-2 （MMP-2）]， and cellular immune function indices （T lymphocyte subsets CD3+ ， CD4+ ， CD8+ ， CD4+/CD8+ ratio） were compared before and after treatment. Results：The overall response rate was 70.59%（ 36/51） in the observation group and 46.00%（ 23/50） in the control group， the difference being significant （P＜0.05）. After treatment， traditional Chinese medicine syndrome scores for primary and secondary symptoms， as well as total scores of qi deficiency and blood stasis syndrome， decreased in both groups （P＜0.05）， with lower scores in the observation group （P＜0.05）. Serum PGⅠ and PGⅡ levels increased in both groups after treatment，with higher levels in the observation group （P＜0.05）. Serum CA199， CA125， MMP-2， and CEA levels decreased in both groups （P＜0.05）， with lower levels in the observation group （P＜0.05）. CD3+ ， CD4+ ， and CD4+/CD8+ ratio increased in both groups （P＜0.05）， while CD8+ levels decreased （P＜0.05）. The observation group showed higher levels of CD3+ ， CD4+ ， and CD4+/CD8+ ratio （P＜0.05） and lower CD8+ levels （P＜0.05） than the control group. The incidence of adverse reactions was 31.37% （16/51） in the observation group， significantly lower than that of 56.00% （28/50） in the control group （P＜0.05）. Conclusion： Fuzheng Huayu Sanjie Prescription combined with XELOX regimen chemotherapy demonstrates good efficacy in treating advanced gastric cancer， alleviating symptoms， promoting pepsinogen secretion， improving immune function， and reducing adverse reactions caused by chemotherapy.