Atrophic gastritis, also known as chronic atrophic gastritis, is a type of chronic gastritis. It is a chronic digestive disease characterized by atrophy of the epithelium and glands of the gastric mucosa, reduction in number, thinning of the gastric mucosal layer, thickening of the mucosal muscle layer, or with pyloric glandular hyperplasia and intestinal glandular hyperplasia, or with atypical hyperplasia. It often manifests as vague pain in the upper abdomen, fullness, belching, loss of appetite, or wasting and anemia, etc. It is not specific. Treatment includes the following modalities: 1. Targeting the cause: the foci of infection in the nose and mouth and pharynx should be removed, and smoking and alcohol should be avoided. Diet should be soft, easy to digest, avoid too rough, avoid food containing strong and spicy seasonings or taking drugs that are stimulating to the stomach. 2, drug treatment: ① improve gastric mucosal inflammation and slow down the progress: for Hp positive patients, eradication therapy is still the most basic treatment for CAG and intestinal eradication of Hp can reverse or slow down the progress of atrophy. A quadruple therapy consisting of bismuth + PPI + 2 antibacterial drugs is recommended. Supplementation of folic acid and vitamin C can be used as CAG to prevent gastric cancer. ②Symptomatic treatment: prokinetic drugs and digestive enzyme preparations can be used according to patients’ symptoms. For those with epigastric fullness, nausea or vomiting as the main symptoms, prokinetic drugs can be used, while those with bile reflux can apply prokinetic drugs and/or gastric mucosal protective agents with bile acid binding effect; those with obvious indigestion symptoms such as feeding-related bloating and poor appetite can be considered to apply digestive enzyme preparations; for epigastric pain and acid reflux, PPI, H2 receptor blockers or gastric acid neutralizing drugs can be used moderately; those with mental psychological factors, sleep disorders or those with obvious psychiatric factors, those with ineffective conventional treatment and poor efficacy, psycho-psychotherapy can be considered to eliminate or relieve patients’ psychological stress as well as symptomatic treatment of clinical symptoms, which has certain significance in improving prognosis. (3) Specific identification according to the basic theory of Chinese medicine: at the same time, identification according to medical history and symptoms, endoscopic pathology and laboratory test results, clarification of each patient’s gastric mucosal lesions and pathophysiological changes, and individualized combined Chinese and Western medicine treatment by combining disease and evidence. 3, atrophic gastritis and intestinalization are not absolute indications for surgery. For those with polyps, anisotropic hyperplasia or focal depressions or bulges, follow-up should be strengthened. When chronic atrophic gastritis with severe anisotropic hyperplasia or severe intestinal chemosis, especially large intestinal chemosis, endoscopic mucosal stripping ESD treatment can be considered.