Diagnosis of atrophic gastritis and gastric precancerous lesions: Both atrophic gastritis and gastric precancerous lesions are Western medical terms, and their main clinical manifestations are vague discomfort, fullness, or pain in the stomach and epigastric region, belching, fatigue, poor appetite, emaciation, and anemia. Its diagnosis mainly relies on endoscopy and pathological examination. At present, hospitals with different levels and equipment conditions are equipped with four types of endoscopes: ① ordinary endoscopy, which can only classify atrophic gastritis into mild, moderate and severe according to the degree of atrophy of the gastric mucosa. ② Magnification endoscopy, which can observe the fine structure of the gastric microconcavity and the degree of atrophy and intestinalization. ③Narrow wave imaging branching can clearly observe the capillary morphology and mucosal structure of the mucosal surface. ④Laser confocal endoscopy can magnify the figure 1000 times and can observe the mucosa at the cellular level, and with mucosal staining and other branching, it has high consistency with pathological examination. Gastric precancerous lesions are mucosal lesions with the possibility of malignant transformation, including atrophy, intestinal epithelial chemosis and heterogeneous hyperplasia (such as intraepithelial neoplasia). Heteroplasia mostly occurs on the basis of atrophy and intestinal chemosis, and is closely related to gastric cancer. Since lesions such as atrophy are not uniformly distributed in the stomach, attention should be paid to the site, number and depth when the physician clamps the pathological specimen, otherwise it is easy to miss the diagnosis. Gastric intraepithelial neoplasia, atypical hyperplasia and heterogeneous hyperplasia are often referred to as synonymous in pathology reports. Gastric intraepithelial neoplasia is divided into low-grade endothelial neoplasia and high-grade endothelial neoplasia. Low-grade endothelial neoplasia refers to structural and cytological abnormalities of the gastric mucosal epithelium confined to the lower part of the epithelium and corresponds to mild to moderate heterogeneous hyperplasia, which is partly an inflammatory response of the gastric mucosa and can be reversed with treatment. In contrast, high-grade intraepithelial neoplasia corresponds to severe heterotypic hyperplasia and carcinoma in situ of the gastric mucosa. It is generally believed that low-grade intraepithelial neoplasia takes about 10 months to 4 years, and high-grade intraepithelial neoplasia takes 4 months to 4 years to transform into gastric cancer easily. It should be taken seriously. Regarding the treatment of atrophic gastritis and gastric precancerous lesions: Western medicine mostly adopts symptomatic treatment, eradication of H. pylori infection (triple or quadruple therapy), gastric mucosal protection, supplementation of antioxidant vitamins (mainly vitamin E, vitamin C, and β-carotene, known as the antioxidant triad), and application of cyclooxygenase 2 (cox-2) inhibitors, etc. The treatment of atrophic gastritis and gastric precancerous lesions in TCM is based on the combination of disease, evidence and symptoms in the identification and treatment model. According to the different types of physical evidence, it is a better treatment method to detoxify the toxins. According to the theory of turbid toxin, turbid toxin is a pathogenic factor that causes serious damage to human body, and also refers to the pathological products that are produced in the body because of the disorder of the internal organs and the abnormal operation of qi and blood caused by various pathological factors, resulting in the metabolites produced in the body cannot be discharged out of the body in time, but are accumulated in the body. In Chinese medicine, it is considered to be a mixture of stagnation, stagnation, accumulation, toxicity, dampness, carbuncle and other factors. Treatment should be based on the fundamental method of resolving turbidity and detoxification, focusing on building a six-pronged integrated treatment network of dispersing stasis, clearing stagnation, resolving stagnation, detoxification, dispelling dampness, and eliminating carbuncles. The medicine used should focus on resolving turbidity. For example, the combination of canker sores and turbidity, eliminating dampness and turbidity, eliminating stagnation and turbidity, clearing heat and eliminating canker sores and detoxifying toxins. For canker sores and detoxification, Coix lacrymae, Fructus septicae, Dong Gua Zi; for removing dampness and detoxification, Qian Cao Jin, Yu Jin, Tu Fu Ling; for removing stasis and detoxification, Red Vine, Angelica dahuricae, Yuan Hu; for removing stagnation and detoxification, Hou Pu, Citrus aurantium, Lycopodium, Aromatic Herb, Sempervivum, Citrus aurantium, Chicken Nei Jin; for clearing heat and detoxifying canker sores, Snake Tongue Herb, Half Branch Lotus, Half Side Lotus, Snake Sixth Valley, Cat’s Claw Herb, etc. Those with deficiency of righteousness should be added to support the righteousness, such as princely ginseng, astragalus, poria, atractylodes for spleen qi deficiency; salvia, maitake, dendrobium, yu zhu for stomach yin deficiency; epilobium, dried ginger for yang deficiency.