The invention relates to a long pepper extract, a preparation method and a medicine combination thereof. The long pepper extract mainly contains methyl piperate and seven piperlongumine compounds, namely, peperlomguminine, piperine, decadiene amide, pepper nonine alkali, quinia, octadecyl triene amide and eicosatriene amide; by weight percentage, the total weight of the eight compounds accounts for 29.07-87.80 % of the total weight of the long pepper extract, wherein, peperlomguminine accounts for 0.95-3.43 % of the total weight of the long pepper extract, piperine accounts for 14.52-42.78 %, methyl piperate 0.82-3.11%, decadiene amide 1.36-4.27%, pepper nonine alkali 2.96-8.03%, quinia 1.04-3.26%, octadecyl triene amide 3.17-10.94% and eicosatriene amide 4.25-12.42%. The invention also provides the preparation method of the long pepper extract, the medicine combination and the application thereof.