Objective To explore the clinical effect of Jianpi Qufeng Zhiyang decoction in the treatment of urticaria patients with spleen deficiency and dampness accumulation type. Methods A total of 72 urticaria patients with spleen deficiency and dampness accumulation type admitted to our hospital from December 2017 to October 2022 were selected as the research objects. According to the random number table method, they were divided into control group and study group, with 36 patients in each group. The control group was treated with conventional western medicine, and the study group was treated with Jianpi Qufeng Zhiyang decoction on the basis of the control group. The clinical efficacy, clinical symptom score, recurrence rate and quality of life improvement of the two groups were compared. Results The total effective rate of treatment in the study group was higher than that in the control group, and the difference was statistically significant (P<0.05). After treatment, the scores of clinical symptoms in the two groups were lower than those before treatment, and those in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). The scores of quality of life in the two groups after treatment were lower than those before treatment, and those in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). The recurrence rate of the study group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Jianpi Qufeng Zhiyang decoction is effective in treating urticaria patients with spleen deficiency and dampness accumulation type, which can effectively relieve clinical symptoms, improve the quality of life of patients, and has a low recurrence rate