Gastric cancer is one of the common malignant tumors in clinical practice. According to the announcement of the World Health Organization, the annual incidence rate of gastric cancer in the world is 13.86/100,000 people, and China is a region with high incidence of gastric cancer, and the annual incidence rate and mortality rate of gastric cancer are more than twice of the world average. Recently, the understanding of Chinese medicine on the etiology and pathogenesis of gastric cancer has been improving, and the understanding of scholars on the etiology and pathogenesis of gastric cancer from various schools of Chinese medicine, especially in the past 10 years, is summarized as follows. 1.Spleen deficiency Jin. Li Dongyuan pointed out that “internal injury to the spleen and stomach hurts its qi”, and Ming Jing Yue also pointed out that “internal injury to the spleen and stomach hurts its qi”. Zhang Jinyue also pointed out that “regurgitation is the result of food being able to enter, but it can be warmed or tonic because of Yang deficiency and cannot be transformed ……”. Many contemporary scholars, through their own clinical practice or experimental research for many years, have also recognized that deficiency of the spleen and stomach is the main etiological mechanism of gastric cancer. For example, Prof. Sun Guizhi suggested that the patient’s spleen and stomach are inherently weak, or due to external cold, excessive consumption of cold food injuring the stomach, or fatigue injuring Yang, resulting in the weakness of Yang Qi in the middle jiao, poor Qi flow, loss of elevation, inability to decompose water and grain, and congestion in the middle jiao, the stomach can not grind food, and food in and out, resulting in regurgitation. Therefore, on the basis of strengthening the spleen and nourishing the stomach, anti-cancer and detoxification is the primary legislation for the treatment of gastric cancer. Through experimental studies, et al. concluded that the formula of strengthening the spleen and benefiting the kidney (composed of Radix et Rhizoma Ginseng, Rhizoma Atractylodis Macrocephalae, Fructus Lycii, Radix et Rhizoma Polygonati, Semen Cuscutae, etc.) had certain inhibitory effects on local tumor recurrence and distant lung metastasis after pre-transplantation gastric cancer in mice, and prolonged survival. Zheng Jian et al. showed that the liver metastasis rate and the mean number of liver metastases in the spleen strengthening herbal medicine group and the Si Jun Zi Tang group were lower than those in the control group (P < 0.05), the mean number of peritoneal implantation metastases in the spleen strengthening herbal medicine group was lower than those in the control group (P < 0.05), and the ascites rate in the spleen strengthening herbal medicine group was lower than that in the control group (P < 0.05), which showed that spleen strengthening herbal medicine had prolonged survival and inhibited metastasis in patients with progressive gastric cancer. The effect of spleen-strengthening herbs on patients with progressive gastric cancer was shown to prolong survival and inhibit recurrence. 2. Phlegm node Yuan. Zhu Danxi firstly pointed out that tumor is related to phlegm, and it is written in "Danxi Xinfa" that "anyone who has lumps on the body, in the middle and under the body is mostly phlegm", and it is also said that "phlegm is a thing that flows unpredictably, so it is harmful, from the top to the top, from the bottom to the spring, and with the rise and fall of the gas, all around the body inside and outside, and all the five organs and six bowels have "The wide scope and mobility of its pathogenesis are quite similar to modern medicine's tumor's irregular location and easy metastasis, and the idea of "eliminating phlegm and dispersing nodules" was proposed to treat stomach cancer. He also proposed the idea of "eliminating phlegm and dispersing nodules" to treat gastric cancer. Jing Yue Quan Shu play also pointed out that "diaphragm is between the chest, diaphragm and stomach, or phlegm ...... blocked, food into the stomach can not be reached and vomit, gradually to food under the vomit and stomach regurgitation carry on", clearly phlegm node is an important pathological factors of stomach regurgitation (gastric cancer). Therefore, the treatment should follow the principle of "Disperse the knot" in Nei Jing. Many contemporary scholars have also researched and discussed the relationship between tumor and phlegm. According to Wei Pinkang, internal obstruction of phlegm is the most basic pathological link of gastric cancer, and eliminating phlegm and dispersing nodules is the basic rule for treating gastric cancer. The method of soothing the liver and stomach to eliminate phlegm and dispersing nodules, the method of strengthening the spleen and kidney to eliminate phlegm and dispersing nodules, the method of nourishing Yin and detoxification to eliminate phlegm and dispersing nodules, and the method of activating blood stasis to eliminate phlegm and dispersing nodules have been clinically concluded. 3.Blood stasis Ming. Gong Xin's "Ancient and Modern Medical Guide" has recorded that "where there is an obstruction under the food, and the pain is slightly caused by the sensation of bending and flexing, there must be dead blood", and that "if there is a lump in the belly and abdomen, there must be blood in the form", which shows that the ancient people had recognized the relationship between blood stasis and lumps. According to the theory of Chinese medicine, the spleen is responsible for transportation and transformation, and the stomach is responsible for intake and absorption; the spleen should ascend to be healthy, and the stomach should descend to be harmonious. For example, Professor Jiang Wenzhao believes that the stomach is a part of the internal organs and is used to promote the flow of Qi and Blood stagnation is a major factor in the development of gastric cancer, and Qi stagnation, turbidity obstruction and blood stasis are the general factors in the formation of tumor, among which Qi stagnation can be caused by Qi deficiency, Qi solidity and Qi depletion; turbidity obstruction can be caused by dampness, phlegm, drinking turbidity and stasis; blood stasis is formed by stagnation, stagnation and stasis. Wang Yinping et al. concluded that by repairing the damage of gastric vascular endothelial cells and inhibiting their proliferation, blood stasis may effectively improve the state of tissue ischemia and hypoxia, and inhibit the formation of tumor neovascularization. Lin Yifan et al. found that spleen deficiency and blood stasis may be one of the important promoting factors in the development of gastric cancer and precancerous lesions, and that the treatment of strengthening the spleen and resolving blood stasis with the addition of Si Jun Zi Tang (9 g each of Dang Ginseng, Bai Zhu and Fu Ling, 8 g each of Wu Ling Li and Chuan Xiong, 6 g each of Bai Hua Shi Tong Cao and Gan Cao) could effectively inhibit the development of gastric cancer and precancerous lesions induced by MNNG in rats. In an experimental study, Li J [8] et al. found that the inhibition rate of stomach cancer MGC- 803 cells was significantly higher in the stomach stomach anti-tumor punch (composed of raw astragalus, ginseng, white flowered snake tongue herb, cao he che, panax quinquefolium, and sumac) than in the blank control group, and the expression levels of tumor metastasis adhesion protein CD63 and thrombin-sensitive protein were lower in the stomach anti-tumor punch group than in the blank serum group, while the expression levels of tumor metastasis inhibition adhesion proteins such as CD63 and thrombin-sensitive protein were lower in the stomach anti-tumor punch group than in the blank serum group. The expression levels of tumor metastasis adhesion proteins such as CD63 and thrombin-sensitive protein were lower than those of the blank serum group, while the expression levels of tumor metastasis inhibiting adhesion proteins such as CD9 were higher than those of the blank serum group. 4.Cancer toxin Qing. It is stated in the Jinjian of Medicine that "heat nodes that do not disperse burn the fluids ...... the cardia is dry, the path of incorporating water and grain is narrow, so food cannot go down, which is choking; the pylorus is dry, the path of releasing decay is narrow, so food goes in and out, which is turning over the stomach." It can be seen that tumors can be formed by internal heat toxicity, because blood will condense when it meets heat, and fluid will burn when it meets fire, and phlegm can be formed by blocking the meridians and internal organs. According to Prof. Zhou Zhongying, cancer toxin is the key to the development of cancer; cancer toxin can either be directly external or internal due to the dysfunction of internal organs; cancer toxin blockage and perverse pathology can induce phlegm, blood stasis, dampness, heat toxin and other pathological factors, and deplete qi and harm yin. He believed that the treatment of cancer should be based on the basic method of "anti-cancer and detoxification". Yang JK et al [10] showed that the administration of the Chinese medicine Gastrointestinal An (composed of 12g of Radix et Rhizoma Ginseng, 12g of Atractylodes Macrocephala, 30g of Poria, 30g of Red Vine, 9g of Xia Ku Cao, 30g of Sarsaparilla, and 9g of Green Calyx Plum) to patients after radical surgery for gastric cancer could effectively reduce the recurrence of metastasis after surgery, prolong the survival time with tumor, and improve the survival rate and quality of life. Li Baoyuan et al. showed that the regulatory effects of the Chinese herbal medicine Bailong Tablet (Baiying, Lungwort, Angelica, etc.), which mainly clears heat and detoxifies toxins, on oncogenes and oncogenes are basically similar to and better than HMBA, a differentiation-inducing agent. 22 cases, 8 stable cases and 3 deteriorating cases, with an overall effective rate of 68.6% (P < 0.05). 5. Emotional and mental. In Li Zhongzhi's "Essential reading of medical science", it is said that "the loss of qi and blood, combined with grief and anxiety, the spleen and stomach are injured, the blood is gradually depleted, the depressed qi produces phlegm ...... and choking is also caused by", and it is pointed out that "the situation is not even, what is sought is not achieved, deep feelings It is difficult to cure the problem with good medicine". Contemporary Professor Liu Jiaxiang also believes that excessive worrying and emotional disorders are one of the important pathogenic mechanisms of stomach cancer. The long-term effect of undesirable emotional factors may cause stagnation of qi and loss of blood flow, resulting in internal stasis of blood; damage to the spleen and stomach, failure to transform stored grain, accumulation of heat and depletion of gastric yin, and depletion of qi and depression for a long period of time, resulting in depletion of qi and injury to yang, resulting in deficiency of spleen and stomach yang and damage to kidney yang over time, resulting in choking and regurgitation of stomach. In general, qi stagnation can appear in any stage of gastric cancer, and phlegm and gas interruptions mostly appear in the middle and late stages of gastric cancer. If the mood is cheerful and optimistic, the qi will flow smoothly, which is conducive to the improvement of disease and recovery of stomach function; if the mood is depressed, the body's qi will be stagnant and the cancer will tend to deteriorate due to further stagnation of qi. Therefore, cheerful and optimistic spirit can improve immune function and inhibit the progress and metastasis of gastric cancer. Ming Jing Yue Quan Shu said that "excessive drinking hurts wine and dampness, or indulging in cold and raw food defeats its true yang" and causes regurgitation; in the Law of Medical Doctors, it is pointed out that "excessive drinking and rolling wine will lead to diaphragm disease". It can be seen that hunger and satiety, indulging in oral pleasures, will damage the spleen and stomach. Prof. Sun Guizhi believes that excessive eating of cold and raw food, cold accumulation in the middle palace, stagnation of qi and blood, cold pain in the stomach and epigastrium; or excessive eating of fatty, sweet, spicy and spicy food, excessive drinking of strong wine, damage to the spleen and stomach, internal growth of dampness and heat, depletion of fluid, phlegm and gas, gradually become lumps; or excessive eating of sticky and difficult to dissolve things, accumulation in the middle palace, dampness and phlegm, damage to the spleen and stomach, injury to the spleen without grinding, injury to the stomach without lowering, loss of spleen health, ascending and clearing, loss of stomach and lowering conduction, congestion in the middle jiao, gradually become lumps. For example, in an experimental study, Liu Xing et al. found that allicin had a significant inhibitory effect on the proliferation of human gastric cancer cell lines SGC-7901 and BGC-823, inhibiting mitosis-promoting factor (MPF) activity by downregulating the expression levels of CDC2 and CyclinB proteins, causing the damaged cells to be blocked in the G2/M phase of the cell cycle and increasing the repair of damaged DNA and reducing chromosomal defects. Inhibiting mitosis-promoting factor (MPF) activity, which can block the damaged cells in the G2/M phase of the cell cycle, increase the repair of damaged DNA, reduce chromosomal aberrations, and prevent cells from mutating and proliferating due to the damage, thus preventing gastric cancer. Therefore, its pathogenesis is a comprehensive reflection of multiple pathological processes intertwined together, but spleen and stomach deficiency is the main line shared by all pathogenesis. Clinically, gastric cancer patients show both the side of deficiency of positive energy and the side of real evil that is difficult to go away, and cancer toxicity is easy to accumulate, spread and metastasize. Therefore, in treating gastric cancer, Chinese medicine scholars have been focusing on the combination of supporting positive energy and eliminating evil, especially on the regulation of deficiency of spleen and stomach, so that the body functions can be balanced, which on the one hand can promote the body to adapt to the new internal environment and reduce the damage brought by surgery, radiotherapy and chemotherapy to the body, and on the other hand can enhance and improve the immune system of the body. On the other hand, it can enhance and improve the immune ability of the body, which can slow down the growth of tumor and even shrink it. However, the above-mentioned etiology and pathogenesis of gastric cancer are only the summaries of our experience in clinical work, and most of the reports are the results of single-center and small-sample studies, and there is a lack of large-sample and multi-center clinical and animal experimental studies to make them more accurate and standardized, and to be in line with the world medicine. It is still very difficult to find the entry point of Chinese and Western medicine precisely through clinical and experimental research, so we must continue to make unremitting efforts in Chinese medicine and combined Chinese and Western medicine.