Objective To observe the effect of Huangqi Jianzhong decoction in the treatment of chronic urticaria of spleenstomach defciency cold type. Methods From June 2022 to January 2023, 60 patients with chronic urticaria of spleen and stomach defciency cold type admitted to our hospital were selected as the research objects. According to the random grouping method, they were divided into routine group and study group, with 30 patients in each group. The routine group was treated with conventional western medicine, and the study group was treated with modified Huangqi Jianzhong decoction. The clinical treatment effect, clinical symptom score, quality of life and sleep quality were compared between the two groups. Results The total e?ective rate of clinical treatment in the study group was 93.33%, which was higher than 70.00% in the conventional group (P<0.05). After treatment, thescores of clinical symptoms in the study group were lower than those in the routine group (P<0.05). After treatment, the scores of quality of life in the study group were higher than those in the routine group (P<0.05). After treatment, the sleep quality score of the study group was better than that of the conventional group (P<0.05). Conclusion For patients with chronic urticaria of spleen and stomach deficiency cold type, modified Huangqi Jianzhong decoction is helpful to improve the clinical symptoms and quality of life of patients, improve the sleep quality and clinical treatment e?ect of patients, and the application e?ect is better.