Chronic atrophicgastritis (CAG), a type of chronic gastritis, is a chronic gastric disease in which the epithelium of the gastric mucosa is repeatedly and repeatedly damaged, resulting in a reduction of intrinsic glands with or without fibrous replacement, intestinal glandularization and/or pseudopyloric glandular hyperplasia [1]. In the 1980s, it was generally accepted that CAG is a psychosomatic diseases (i.e., a type of disease between somatic diseases and neurosis). In the 1980s, it was generally accepted that CAG is a psychosomatic disease (a type of disease between physical and neurological disorders), and research on psychosomatic treatment of CAG has been increasing year by year. In this paper, we review the influence of psychiatric/psychological factors on CAG and its treatment from multiple perspectives, hoping to provide some new ideas and methods for the clinical treatment of CAG from the psychosomatic perspective. 1. Modern medical understanding and treatment of the relationship between CAG and psychology 1.1 Research on the psychological characteristics of CAG patients From various clinical studies, it was found that the affective influence of CAG exists objectively, and in patients with this disease, their abnormal psychological characteristics are mainly manifested by depression and anxiety. Lianghui et al [2] used Zung depression self-rating scale (SDS) and anxiety self-rating scale (SAS) to study the psychological status of patients with CAG with liver and stomach disharmony and spleen and stomach weakness, and found that the SDS scores of the liver and stomach disharmony group were compared with those of the spleen and stomach weakness group and control group, p<0.05, the SAS scores of the liver and stomach disharmony group were compared with those of the control group, p<0.05, and the SAS scores of the spleen and stomach weakness group were compared with those of the control group, In a study by Wang Jiehong et al [3] on the psychological status of depression and anxiety in patients with CAG with heterogeneous hyperplasia using the Self-Rating Scale for Depression (SDS), the Self-Rating Scale for Anxiety (SAS) and the 90-item Symptom Self-Rating Scale (SGL-90), it was found that patients with CAG with heterogeneous hyperplasia had significant depressive and anxiety states, with a mean SGL-90 total score of 60. 75 and a mean SDS The mean total score of SGL-90 was 60.75, the mean total score of SDS was 41.05, and the mean crude total score of SAS was 39.67, all three of which were higher than the national norm, and the depression and anxiety states of the hepatogastric group were more obvious than those of the non-hepatogastric group, and the difference between them was statistically significant. However, in clinical practice, doctors tend to focus only on the endoscopic and pathological manifestations of CAG and the symptomatic features of patients, but neglect the psychological state of patients, so the lack of diagnosis and treatment of CAG accompanied by anxiety and depression abnormal psychology, which often affects the overall treatment effect of patients, and may even cause misdiagnosis and improper treatment in serious cases. 1.2 Research on the mechanism of CAG caused by psychological factors Most scholars believe that the influence of psychological factors on the occurrence and development of CAG is related to the neurological, endocrine, immune system, enzyme system and so on. The motor and secretory functions of the gastrointestinal system are mainly regulated by the vegetative nervous system and the endocrine system, and the centers of these two systems are located in the same anatomical site as the subcortical integration center of the emotional center, which are vulnerable to the influence of internal and external environmental stimuli and emotional factors [2]. Among the above mentioned mechanisms, the production of symptoms such as: stomach pain, bloating, warmth, acidity, and poor appetite due to changes in psychological state has been demonstrated [4]. Haug et al [5] suggested that low vagal activity may act as a regulatory mechanism through which psychological factors can influence gastrointestinal physiological activity and cause dyspeptic symptoms.HeSS et al [6] further demonstrated experimentally that poor clearing and unhealthy behaviors make the non-specific response system (Ergotrop1csystem) trophic system ( Trophotropicsystem), which affects the function of vegetative nerves and gastrointestinal glands, and the dysfunction of gastric motility, gastric juice secretion, gastric acid content and gastric mucosal vasodilatation, which weakens the gastric mucosal barrier mechanism and resistance to disease, resulting in the occurrence and recurrence of CAG. Psychological factors such as anxiety and depression contribute to the development of chronic gastritis, and in turn, the disease adds to the psychological burden of patients, such as increased negative emotions such as moodiness, emotional depression, anxiety, and tension [7]. In addition, studies on psychogenic gastrointestinal disease have found that the susceptibility is related to somatic and psychological qualities as well as blood factors, suggesting that the deeper root of the disease may be in the genes [8], and all these studies suggest that psychological abnormalities are one of the factors in the pathogenesis of CAG. 1.3 Psychological treatment of CAG patients Modern society is rich in information sources, advertisements and the Internet exaggerate the chance of CAG cancer to varying degrees, leading to increased fear and worry in the minds of CAG patients, and even sleepless nights, but nervous and anxious emotions are more harmful than CAG itself, and more likely to lead to tumors. Therefore, doctors should pay attention to the psychological treatment of patients while treating CAG with medication. Psychotherapy, also known as psychiatric treatment, refers to the application of psychological methods to influence or change patients' feelings, perceptions, emotions and behaviors, and adjust the balance between individuals and the environment, using a good doctor-patient relationship as a bridge, so as to achieve the purpose of treatment [9]. In other words, we can actively carry out health education and provide targeted psychological counseling according to patients' specific conditions, so as to help patients understand their diseases correctly, eliminate cancer-phobia, and establish confidence in overcoming diseases, so that they can better cooperate with doctors' treatment and strive to better improve clinical efficacy. For patients with relatively heavy anxiety and depression, psychotropic medication can be used appropriately. For patients with more complicated psychiatric symptoms and more serious conditions, they should be given high priority and advised to go to relevant hospitals for comprehensive and targeted treatment as soon as possible on the basis of basic treatment. 2, traditional medicine on the relationship between CAG and psychological understanding and treatment 2.1 Chinese medicine on the understanding of GAG CAG clinical pain, fullness, stuffiness, belching, dullness, etc. as the main manifestations of the stomach, is a Chinese medicine "fullness", "false gangrene", "gastric pain", "gastric pain", "gastric distress", "gastric distress", "gastric distress", "gastric distress" and "gastric distress". It belongs to the categories of "fullness", "deficient fullness", "stomach pain", "noisy", etc. in Chinese medicine. It is generally believed that CAG is located in the stomach and is closely related to the liver and spleen. The clinical manifestation is often a combination of deficiency of the spleen, deficiency of the stomach and deficiency of gastric yin, and deficiency of the blood stagnation, damp heat and blood stasis. 2.2.1 Meaning of emotion and will 2.2.1 The meaning of emotion and will is that when people come into contact with and know objective things, they show certain attitudes toward things and have rich inner experiences such as love, fear, anger, sadness, dissatisfaction and disappointment. Chinese medicine refers to these inner experiences collectively as emotions. Traditional Chinese medicine has always attached importance to the influence of psychological factors on disease during the physiological and pathological activities of human beings, emphasizing the "unity of form and spirit", and that changes in the emotions can lead to pathological changes in the internal organs and qi and blood. The Seven Emotions of the Book of Rites says: "What are the human emotions? Joy, anger, sorrow, fear, love, evil, desire seven, not learn and can ......"; "Nei Jing" five will say: "people have five organs into five qi, to produce joy, anger, sadness and fear". The "seven emotions" defined in modern Chinese medicine textbooks, that is, the new "seven emotions" proposed by the Song Dynasty doctor Chen Wuzhe, "the seven emotions, joy, anger, worry, thought, grief, fear, and fear is also", (see (See "The Three Causes of the Disease? (See "The Three Causes of Disease"). 2.2.2 Emotions cause disease The earliest record of emotions causing disease is found in the Nei Jing. Su Wen? Yin and Yang impression of the Great Theory: "anger hurts the liver, thought hurts the spleen, joy hurts the heart, sadness lung, fear hurts the kidneys"; "liver sadness and weakness in the move will hurt the soul, soul injury is wild and not fine, not fine is not correct, when people shrink and contracted tendons, the two ribs do not lift, hair emaciated color die in autumn". Ling Shu? Mouth question" said: "the great fright and fear, then the qi and blood separation, yin and yang broken, meridians and collaterals syncope, the pulse path does not work". Guanzi? Inner work" has said: "depression into disease, disease is death". Ji Sheng Fang" cloud: "worry, thought, joy, anger, people can not be without the gas, too much will hurt the five organs." The Classics? Huitong class: "the liver collects blood, the blood of the soul, liver Qi deficiency is fear, the real is anger ......" and so on, these discusses the impact of the human organs and blood disease on the emotional activity. 2.3 The relationship between emotion and the development of GAG According to Chinese medicine, among the five viscera and six internal organs, the development of emotional factors is very closely related to the spleen and liver. In literature and clinical studies, it is found that the spleen and stomach are sensitive to changes in the seven emotions, and excessive changes in emotions such as worry, thought, grief, fear, anger and joy can affect spleen function. Li Dongyuan in his treatise on the spleen and stomach The spleen and the stomach are the most sensitive to changes in the seven emotions. "Ling Shu? The book of the gods says: "because of the will and the existence of change, is called thinking", so the seven emotions are easy to hurt the spleen, especially excessive thinking is even more. The spleen and stomach are located in the middle jiao and are the hub of qi lift and lower, so abnormal mental and physical conditions will easily affect the function of the spleen and stomach, and when the qi lift and lower is not normal and the qi is not smooth, it will affect the flow of qi and blood in the meridians and the normal activities of the internal organs, and all kinds of diseases will arise. Raise pain theory" said: "all diseases born in the gas". Zhu Danxi has a cloud: "all diseases in life, are born in depression." Therefore, any excessive worry, depression, etc., can injure the spleen and stomach, resulting in the lack of power to transport, lifting and lowering, the lack of blood and Qi, depression, heat, damage to the stomach Yin, or blood stagnation, paralysis of the stomach ligament, stomach loss of moistening, long lead to CAG lesions. The liver is a rigid organ, with a strong tendency to be unrestricted, and is the master of drainage. Its drainage function is manifested in the drainage of qi, helping the spleen and stomach to transport and transform, and in the drainage of emotions. Su Wen? The secret of Linglan says: "The liver is the official of the general, and it is the source of ideas and thoughts." Su Wen? The Six Sections of the Tibetan Elephant says: "The liver is the residence of the ...... soul." The liver is the residence of the soul. These can be noted that the human spirit and emotional activities and the liver have a close relationship. If the liver is not drained, the qi is not smooth, liver qi is depressed, the mood is not smooth, mostly manifested as depression, sentimental; if the liver qi is too much, the qi fire on the rebellion, it is mostly manifested as anxious and irritable; on the other hand, worry and depression, anger and irritation and other adverse emotional stimulation will make the liver is not in order, all the symptoms within. CAG disease is located in the spleen and stomach for the bribe of Yang Ming, like moist and dry, more gas and blood, the main intake, liver and stomach are closely related to the physiopathology of both, liver is wood, spleen is earth, earth to wood and up to, wood on earth and glory. If the patient's emotions are not smooth, the liver loses drainage, cross-rebellion offends the stomach, which will damage the spleen and stomach, the spleen and stomach are weak, the transport and transformation is weak, so that the stomach can not receive, ripen water and grain, the spleen can not transport, transfer the essence, biochemical lack of sources, the qi and blood are deficient, the body loses nourishment, and gradually lead to atrophy of the gastric mucosa glands, as the "clinical evidence guide medical case? Wood by earth" said: "The liver is the source of disease, the stomach is the transmission of disease." If liver qi stagnates, qi does not flow smoothly, qi disease and blood, then blood stasis can also stagnate the stomach body, making CAG disease aggravated, stagnant and difficult to cure, and over time may also form a tangible product, developing into gastric cancer. If liver stagnation turns into heat and fire, there may be symptoms of liver and stomach heat, such as dry mouth, bitterness, noisy stomach, red tongue, yellow tongue coating, etc. If the heat is strong, it can be poisonous, and in severe cases, it can form the evidence of heat and poison. Liver and stomach heat, the stomach's yin and fluids are damaged, resulting in the evidence of gastric yin deficiency, yin deficiency is difficult to restore, and treatment is difficult. Emotional factors play an important role in the pathogenesis of CAG. In this disease, the specific manifestations of the influence of emotion are mainly depression and anxiety. The anxiety disorder belongs to the category of Chinese medicine r Zhi disease, its content is scattered in "sleeplessness", "irritability", "good fear", "palpitation The content of anxiety disorders is found in "sleeplessness", "irritability", "good fear", "panic and palpitation", etc. The key to anxiety disorders is that liver stagnation turns into fire. Treatment is based on the basic rule of draining the liver and clearing the fire. Depression belongs to the category of depression disease in Chinese medicine. Depression disease is caused by emotional discomfort and qi stagnation, mainly with liver qi stagnation as the core, depression for a long time can hurt the five organs, involving the liver, heart, spleen and kidney, making them dysfunctional. Treatment is based on de-stressing the liver and relieving depression, regulating qi and clearing the ligaments. 2. 4 CAG emotional therapy When patients see the gastroscopic pathology report, know that suffering from CAG, especially severe CAG and / or with intestinal epithelial hyperplasia, atypical hyperplasia, more anxiety, depression, fear of performance, the slightest adverse stimulus, that will trigger or aggravate the symptoms, and over time the CAG disease lingering, difficult to cure, patients often lose confidence to continue treatment, so in the diagnosis and treatment of CAG In the process of diagnosis and treatment of CAG, we should pay attention to both the physical pathological changes of the disease itself and the state of mind of the patient, and adopt the method of treating both the mind and the body to regulate the spleen and stomach. In the beginning, we can give psychological guidance and use the method of sparing words, as stated in "Ling Shu? This method can reduce the psychological pressure of the faithful, so that the messenger can adjust his own state of mind, be cheerful, face the disease with confidence and actively cooperate with the doctor's This method can reduce the psychological pressure of the faithful, so that the messenger can adjust his or her state of mind, be cheerful, face the disease with confidence, and actively cooperate with the doctor's diagnosis and treatment. In addition, the "Nei Jing" has put forward the emotional treatment method of emotional and moral victory, that is, "sadness is better than thought ...... fear is better than joy: ...... joy is better than worry ...... thought is better than fear ...... anger is better than thought", this treatment method uses the principle of the five elements winning over each other, using one kind of emotion to regulate the corresponding emotion, so as to achieve better results. In the Qing Dynasty, Wei Zhilu collected a lot of psychological treatment cases in the "Continued Famous Medical Cases", from which it was found that the main methods of psychological treatment are: transferring the essence to change the qi, treating fraud with fraud, behavior satisfaction, stimulation treatment, emotion and will swell, words to enlighten, behavior induction, opposite emotion treatment, etc. If the patient shows bright depression and anxiety, western medicine can be treated with antidepressant and anti-anxiety drugs on top of CAG drugs as appropriate. In the case of Chinese medicine, the treatment is widely applicable and has a lot of room for development. Volume 4" cloud: "where the internal organs of the twelve channels of gas gasification, all must have the liver and gallbladder gasification to encourage the, to be able to regulate and not pain." It can be seen that the emotions and wills of the scourge of precious regulation. And Zhu Danxi has a cloud: "qi and blood rushing and, all diseases do not arise; there are fries and depression, all diseases are born." It can be seen that the common feature of most of the diseases of prevention and control is the stagnation of qi and the malfunction of elevation [10]. Therefore, CAG can be treated from liver theory; clinically, while paying attention to psychological guidance, we also pay attention to the use of liver regulating method, and in the case of accurate clinical evidence, we combine liver dredging, liver pacifying, liver clearing, liver draining, liver nourishing and liver softening methods to improve the efficacy of Chinese medicine treatment of CAG. 3.Conclusion Psychiatric/psychological abnormalities have a high incidence and diverse manifestations in CAG, thus reducing the quality of life of patients with chronic gastritis. The combination of Chinese and Western medicine and psychotherapy is increasingly useful in the treatment of CAG and is worthy of reference by clinicians.