To observe the effect of Xiaokui Yuyang Decoction combined with triple therapy to treat helicobacter pylori positive peptic ulcer．Methods:A total of 90 patients with helicobacter pylori positive peptic ulcer who were admitted to our department in August 2014 to March 2015, were randomly divided into control group and observation group with 45 cases in each. Patients in the both groups were treated with traditional triple therapy including Esomeprazole, Amoxicillin and Carat Enzyme, while patients in the observation group received Xiaokui Yuyang Decoction at the same time for four-course treatment. Clinical curative effect, HP clearing situation, symptom integral, adverse drug reactions and the changes of plasma level of MTL and SS, ulcer recurrence, etc. were observed in the two groups during the 4-week treatment. Results:1) The effective rate of the observation group was 86.67%, and that of the control group was 68.89%, showing statistically significant differences (P<0.05). 2) Symptoms score between the two groups before the treatment indicated no significant difference (P>0.05), but symptom integral score of the observation group was lower than that of the control group after 4-week treatment (P<0.05). 3) For adverse reactions, 15 cases occurred in the control group (33.30%) and5 cases in the observation group (11.1%). The incidence of adverse reaction in the observation group was obviously lower than that in the control group (P<0.05). 4) HP eradicate rate of the observation group was 93.3% and that of the control group was 77.8%. There was statistically significant difference between the two groups (P<0.05). ITT analysis between the two groups of patients showed no statistically significant difference (P>0.05). PP analysis showed that the eradication rate of the observing group was higher than that of the control group and the difference was statistically significant (P<0.05). 5) 4 weeks after the treatment, the plasma MTL level significantly decreased in patients of both the two groups, compared with those before the treatment (P<0.05). The declination of plasma MTL level and increase of the level of plasma SS in the observation group were more significantly than those of the control group (P<0.05). 6) During the one year follow-up, 3 cases in the observation group had ulcer recurrence (6.67%) and 8 cases in the control group (17.8%). The ulcer recurrence of the observation group was obviously lower than that of the control group (P<0.05). Conclusion:Xiaokui Yuyang Decoction combined with triple therapy to treat helicobacter pylori positive peptic ulcer may have significant clinical efficacy, with low HP recurrence rate and no significant adverse reaction, which is worth of promotion.