Chronic atrophic gastritis (CAG), a prevalent gastric mucosal lesion, is one of the most common diseases of the digestive system. Its clinical management faces dual challenges of low cure rates and high recurrence risks, with a significant potential for progression to malignant lesions, posing a serious threat to patients' health. Notably, CAG has a complex, multifactorial pathogenesis that remains incompletely understood. Current clinical intervention strategies include traditional Chinese medicine (TCM), modern Western medicine, and integrative approaches combining both, demonstrating synergistic advantages in improving clinical symptoms. This article systematically reviews recent domestic studies and discusses the following dimensions: (1) Exploration of etiology and pathogenesis: elucidating core pathogenesis concepts such as "deficiency, stasis, and toxicity"; (2) Therapeutic methods and prescriptions: summarizing characteristic TCM approaches like strengthening the spleen and replenishing Qi, promoting blood circulation and removing stasis, as well as detoxifying and resolving masses; (3) Advances in therapeutic techniques: consolidating clinical research findings on TCM therapies including herbal formulas, acupuncture, and acupoint application; 4) Progress in Western medical diagnostic and treatment technologies. Through a multidimensional analysis, this work aims to provide theoretical foundations and practical insights for the prevention and treatment of this condition.

Chen Wanhong, Qi Hongjun, Feng Lin, Wei Runmin, Ma Fang, Li Changguo. Progress in the Treatment of Chronic Atrophic Gastritis and Precancerous Gastric Lesions in Traditional Chinese and Western Medicine. International Journal of Frontiers in Medicine (2025), Vol. 7, Issue 3: 87-93. https://doi.org/10.25236/IJFM.2025.070312.

[1] Li Junxiang, Chen Jing, Lv Bin, et al. Consensus on Integrated Chinese and Western Medicine Diagnosis and Treatment of Chronic Atrophic Gastritis (2017) [J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 2018, 26(02):121-131. 

[2] Sugano K, Moss SF, Kuipers EJ. Gastric Intestinal Metaplasia: Real Culprit or Innocent Bystander as a Precancerous Condition for Gastric Cancer? [J]. Gastroenterology, 2023, 165(6):1352-1366.e1. 

[3] Wang Ping, Li Peng, Chen Yingxuan, et al. Clinical Management Guidelines for Integrated Gastric Precancerous Lesions in China [J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 2022, 30(03):163-183. 

[4] Liu Fengbin, Li Peiwu, Pan Jinglin, et al. Expert Consensus on TCM Diagnosis and Treatment of Chronic Atrophic Gastritis in Lingnan Region [J]. Journal of Chinese Research Hospitals, 2022, 9(01):2-8. 

[5] Chen Jing, Xu Lei, Cao Zhengmin, et al. Professor Yao Naili’s Experience in Treating Chronic Atrophic Gastritis Based on "Liver Stagnation, Spleen Deficiency, Network Obstruction, and Toxic Damage" [J]. Journal of Tianjin University of Traditional Chinese Medicine, 2022, 41(03):295-299. 

[6] You Shaowei, Zhan Yamei, Wang Wensu, et al. Exploring "Spleen Deficiency with Stagnation" in Chronic Atrophic Gastritis: Inflammation-to-Cancer Transition and Prevention Strategies [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2023, 29(21):188-195. 

[7] Chen Nan, Wang Hongliang, Zhang Dong, et al. Analysis of Professor Huang Bin’s Experience in Treating Chronic Atrophic Gastritis [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2023, 40(12):3163-3167. 

[8] Hou Tongxin, Gao Yu, Zheng Shixing, et al. Discussion on Master Physician Wang Xixing’s Phased Treatment of Chronic Atrophic Gastritis with Intestinal Metaplasia [J]. World Journal of Integrated Traditional and Western Medicine, 2023, 18(07):1319-1322+1328. 

[9] Gao Jing, Fan Shuyue, Ni Yuying, et al. Master Physician Wang Qingguo’s Time-Phase Differentiation-Based Approach to Chronic Atrophic Gastritis [J]. Journal of Changchun University of Chinese Medicine, 2023, 39(07):728-731. 

[10] Li Zhenghong, Li Jing. Insights into Professor Li Jing’s Experience in Treating Chronic Atrophic Gastritis in Middle-Aged and Elderly Women [J]. Hubei Journal of Traditional Chinese Medicine, 2023, 45(09):24-27. 

[11] Sun Jun, Chen Siqing. Selected Insights from Zhang Jize, a Renowned Menghe School Physician, on Chronic Atrophic Gastritis Treatment [J]. Basic Traditional Chinese Medicine, 2023, 2(02):1-4. 

[12] Huang Yuping, Wang Yihui, An Zhentao, et al. Exploring TCM Syndrome Classification of Gastric Precancerous Lesions [J]. China Journal of Chinese Medicine, 2021, 36(02):406-409. 

[13] Zeng Weiwei, Mai Lianren, Zhang Ling. Clinical Observation of Liqi Tongluo Yuwei Decoction in the Treatment of Chronic Atrophic Gastritis [J]. Liaoning Journal of Traditional Chinese Medicine, 2022, 49(3):136-139. 

[14] Zuo Qiaoyun, Fu Yuxian, Wang Qianqian, et al. Clinical Study on Qizhu Jianwei Formula for Chronic Atrophic Gastritis and Precancerous Lesions [J]. Modern Traditional Chinese Medicine, 2024, 44(06):69-75. 

[15] Chang Aifang, Li Jing. Summary of Li Jing’s Application of Qizhu Weiwei Formula for Chronic Atrophic Gastritis with Qi Deficiency and Blood Stasis Syndrome [J]. Clinical Journal of Chinese Medicine, 2022, 14(17):98-100. 

[16] Fei Baoying, Wu Renzhao, Chen Xuan, et al. Efficacy and Mechanism of Yiwei Decoction in Chronic Atrophic Gastritis and Gastric Cancer Induced by N-Methyl-N'-Nitro-N-Nitrosoguanidine in Rats [J]. Chinese Journal of Modern Applied Pharmacy, 2024, 41(16):2176-2183. 

[17] Huang Xiangming, Fan Xinyu, Lu Min. Protective Effect of Qiling Decoction on Chronic Atrophic Gastritis with Intestinal Metaplasia Rats Based on the PI3K/Akt Pathway [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2024, 30(22):79-86. 

[18] Ren Xiaojun, Zhang Manling, Zhao Huihui, et al. Research Progress on Banxia Xiexin Decoction for Chronic Atrophic Gastritis [J]. Liaoning Journal of Traditional Chinese Medicine, 2024, 26(10):65-69. 

[19] Yang Chuqi, Cui Yankun, Li Ji. Clinical Observation of Modified Chaihu Shugan San for Chronic Atrophic Gastritis with Liver-Stomach Qi Stagnation Syndrome [J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2021, 36(01):580-583. 

[20] Zhang Dan, Wei Muxin, Wang Ping, et al. Clinical Efficacy of Huatan Xiaoyu Formula for Precancerous Lesions of Gastric Cancer [J]. Chinese Archives of Traditional Chinese Medicine, 2021, 39(04):241-243. 

[21] Kou Yuan, Wen Xinli, Xue Feng. Clinical Study on Yangwei Qingre Huayu Decoction for Chronic Atrophic Gastritis and Precancerous Lesions [J]. Shaanxi Journal of Traditional Chinese Medicine, 2021, 42(09):1233-1235+1298. 

[22] Ji Zhuangzhuang, Zhao Shuangmei, Qi Xiangzheng. Shao Zuyan’s Experience in Treating Precancerous Gastric Lesions [J]. Liaoning Journal of Traditional Chinese Medicine,2022, 49(01):47-50. 

[23] Zheng Xue, Xiao Youzhi, Wu Mengdie, et al. Mechanism of Medicinal Cake Moxibustion on PTEN-AKT Tumor Suppression Pathway in Rats with Chronic Atrophic Gastritis [J]. Shanghai Journal of Acupuncture and Moxibustion, 2021, 40(12):1500-1508. 

[24] Rong Hua, Fu Yongmin, Du Xu. Clinical Efficacy of Danshi Jianpi Decoction Combined with Acupuncture for Chronic Atrophic Gastritis and Precancerous Lesions [J]. Global Traditional Chinese Medicine, 2023, 16(04):765-768. 

[25] Zhu Jingru, Gan Huijuan. Perspectives on Emotional Therapy for Preventing Precancerous Gastric Lesions [J]. Fujian Journal of Traditional Chinese Medicine, 2020, 51(04):60-62. 

[26] Shui Diankui, Qin Lingna, Wang Lin. Observing the Clinical Efficacy of Lizhong Tongluo Huazhuo Decoction Combined with Acupoint Thread Embedding for Chronic Atrophic Gastritis with Intestinal Metaplasia Based on the "Qi Circulation" Theory [J]. Lishizhen Medicine and Materia Medica Research, 2021, 32(05):1162-1166. 

[27] Wang Xiangyang. Clinical Observation of Weishu Mixture Combined with Acupuncture for Spleen-Stomach Damp-Heat Type Chronic Atrophic Gastritis [J]. Western Journal of Traditional Chinese Medicine, 2022, 35(05):116-119. 

[28] Wu Can, Deng Xingxing, Luo Yanwen, et al. Effects of Acupuncture Combined with Modified Xiangsha Liujunzi Decoction on Histology, Symptoms, and Efficacy for Chronic Atrophic Gastritis with Spleen-Stomach Deficiency Syndrome [J]. Chinese Archives of Traditional Chinese Medicine, 2022, 40(07):185-188. 

[29] Botezatu, A., Bodrug, N. Chronic Atrophic Gastritis: An Update on Diagnosis [J]. Medicine and Pharmacy Reports, 2021, 94(1):7-14. 

[30] National Clinical Research Center for Digestive Diseases (Shanghai), National Alliance for Early Cancer Prevention and Treatment of the Digestive Tract, Helicobacter pylori Group of the Chinese Society of Gastroenterology, et al. Expert Consensus on the Management of Gastric Mucosal Precancerous Conditions and Lesions in China (2020) [J]. Chinese Journal of Digestion, 2020, 40(11):731-741. 

[31] Fang Hui, Li Xueliang. Changes in Red Blood Cell Immune Function Before and After Helicobacter pylori Eradication in Patients with Chronic Atrophic Gastritis [J]. Chinese Journal of Clinical Gastroenterology, 2021, 33(02):83-86. 

[32] Li Hongxia, Liu Fushan. Integrated Traditional Chinese and Western Medicine Treatments for Chronic Atrophic Gastritis [J]. Medical Information, 2022, 35(11):29-32. 

[33] Liao Lili, Yang Baijing. Clinical Observation of Integrated Traditional Chinese and Western Medicine Therapy for Chronic Atrophic Gastritis with Helicobacter pylori Infection [J]. Chongqing Medicine, 2017, 46(29):4164-4165+4168. 

[34] Li Yajing, Liu Junhong, Lai Xueqian, et al. Research Progress on Integrated Chinese and Western Medicine Treatments for Liver-Stomach Disharmony-Type Chronic Atrophic Gastritis [J]. China Modern Doctor, 2023, 61(34):106-109. 

[35] Hu Jingyan. Effects of Weifuchun Combined with Quadruple Therapy on Gastrointestinal Hormones and Immune Function in Patients with Chronic Atrophic Gastritis [J]. The Journal of Medical Theory and Practice, 2021, 34(6):956-958. 

[36] Lv Anding, Du Qiupeng, Jing Zhuchun. Efficacy Analysis of Banxia Xiexin Decoction Combined with Quadruple Therapy for Precancerous Lesions of Chronic Atrophic Gastritis [J]. Clinical Journal of Traditional Chinese Medicine, 2024, 36(06):1139-1143. 

[37] Xu Yapei, Li Bolin, Xu Weichao, et al. Efficacy and Effects of Yiyi Huazhu Jiedu Formula Combined with Viadestin Tablets on Ki-67 Protein Expression in Chronic Atrophic Gastritis and Precancerous Lesions [J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2021, 30(36):4018-4022.