Chronic atrophic gastritis is a common disease of the digestive system characterized by atrophy of the intrinsic glands of the gastric mucosa, often accompanied by intestinal epithelioid hyperplasia and, in a few cases, heterogeneous hyperplasia, which has been classified by the World Health Organization as a precancerous state of the stomach. Therefore, it is important to prevent and treat chronic atrophic gastritis. Our clinical use of high-dose vine pear root truncated reversal treatment of chronic atrophic gastritis, the treatment experience is described below. 1, the source and efficacy of vine pear root vine pear root, also known as yangtao root, kiwi root, kiwi root, kiwi pear, vine pear, yangtao vine, for kiwi genus Chinese kiwi Actinidia chinensis Planch. or soft date kiwi Actinidiaarguta ( Sieb. et Zucc. ) Planch’s root. There are about 54 species of the genus Kiwifruit worldwide, distributed over a wide area from Malaysia to eastern Siberia, and in China mainly in northeast, north and northwest China and the Yangtze River basin. The Chinese Pharmacopoeia records that the soft date kiwifruit root, light in taste, slightly astringent, cool in nature, enters the spleen, stomach, and liver meridians, and is effective in clearing heat and dampness, dispelling wind and dampness, strengthening the spleen and stomach, and detoxifying and reducing swelling; while the Chinese kiwifruit root, sour in taste, slightly sweet, cool in nature and slightly toxic, enters the heart, kidney, liver, and spleen meridians, and is effective in activating blood stasis, diuretic and laxative, and detoxifying and healing sores [2], and is mainly used clinically to treat Esophageal cancer, gastric cancer, colorectal cancer, liver cancer and other gastrointestinal tumors [3]. In recent years, with the continuous research on vine pear root, many scholars applied vine pear root in the treatment of chronic atrophic gastritis with precancerous lesions such as intestinal chemosis and heterogeneous hyperplasia, and achieved good efficacy [4 – 5]. The vine pear root used in our clinical treatment of chronic atrophic gastritis is Chinese kiwi root from Jiangsu, which is a unique species in China and is particularly prominent in anti-tumor and anti-bacterial infection [6]. 2 , vine pear root and “truncation and reversal” The main pathological histological features of chronic atrophic gastritis are atrophy, intestinal epithelial-like metaplasia, and in a few cases, intraepithelial neoplasia, which can develop into gastric cancer in a few cases after a long-term evolution [7]. Therefore, how to intercept the development and evolution of chronic atrophic gastritis to gastric cancer and reverse the pathological changes such as atrophy and intestinal epithelioid and intraepithelial neoplasia are the key areas of attention and research. To “cut off” means to take decisive measures and prescriptions with special efficacy, to attack the nest of the disease, to quickly eliminate the pathogen or intercept the disease evil to prevent the natural development and extension of the disease; to “reverse” means to reverse the disease and make it develop in a good direction. Clinically, “truncation” and “reversal” are collectively called “truncation therapy”, a concept proposed by Professor Jiang Chunhua in the late 1970s [8]. If we can understand the development pattern of the disease clinically, anticipate its prognosis and regression, and premedicate before the corresponding results appear, we can shorten or influence the course and development trend of the disease, which is in line with the principle of “treating the untreated disease” in Chinese medicine. The cause of chronic atrophic gastritis is mostly related to diet, fatigue, and the seven emotions. The deficiency caused by evil leads to damage and weakness of the spleen and stomach, and the deficiency causes evil, resulting in the loss of qi flow, and the prolonged illness enters the ligament, which leads to stasis and obstruction of the stomach ligament by qi and blood, which turns into heat and becomes poison for a long time, forming a mixed evidence of deficiency and reality. Stasis and toxicity are both pathological products and pathogenic factors. Stasis and toxicity blocking the gastric ligament can cause poor blood flow and lack of nutrition in the gastric mucosa, resulting in thinning of the gastric mucosa and atrophy of the glands, followed by intestinal epithelium-like hyperplasia and heterotypic hyperplasia, which contribute to the development and evolution of the disease. Therefore, stasis and toxicity are the direct pathological factors and key pathogenic mechanisms that contribute to the transformation of gastric mucosa into precancerous lesions of gastric cancer. We believe that for the treatment of chronic atrophic gastritis, regardless of whether there are pathological changes of intestinal epithelioid hyperplasia and heterotypic hyperplasia, the method of purging stasis and toxicity should be used throughout the treatment. The purpose of this is to interrupt the pathological changes that are about to occur or to reverse the pathological changes that have already occurred. In short, the treatment of chronic atrophic gastritis should follow the principle of “early expulsion of evil”, “to get rid of evil”, “evil to go to the right peace”. The choice of vine root as a drug to interrupt and reverse the natural development and extension of chronic atrophic gastritis is because vine root not only has the effect of activating blood circulation and removing blood stasis, clearing heat and detoxifying, which can meet the direct pathological factors and key pathological mechanism of chronic atrophic gastritis, but also has the pharmacological activities of inhibiting gastric cancer cells, inducing their apoptosis, enhancing cellular immunity, suppressing humoral immunity, lowering glucose and lipid, protecting liver and lowering enzymes [9]. Since the 1990s, we have been applying the formula of “Nourishing the stomach and invigorating the blood” [10], which has the effect of fostering the blood circulation and detoxifying the toxin (vine root, white flowering snake’s tongue, dandelion, iron tree leaves, Dan Shen, angelica, prunus ginseng, white peony, maitake, roasted licorice, sandalwood, raw malt, hedgehog’s bark), plus reduction for the treatment of chronic atrophic gastritis. With the continuous development of modern medicine, the correlation of chronic atrophic gastritis with Helicobacter pylori and gastric cancer has gradually attracted the attention of scholars. Combined with clinical experience, we proposed the hypothesis that stasis and toxicity are the key pathogenesis of precancerous lesions in chronic atrophic gastritis, and analyzed the ingredients of the formula of Nourishing Stomach and Invigorating Blood, and found that one of the ingredients of the formula, Vine Root, has the effects of clearing heat and detoxifying and invigorating the stomach and blood, which can better target the pathogenesis of “stasis and toxicity” and play a role in preventing and treating chronic atrophic gastritis, especially precancerous lesions. Especially the role of precancerous lesions. Therefore, we conducted an experimental study on the inhibitory effect of vine root on gastric cancer cells and its mechanism [11 – 12], and found that vine root has a dose-dependent effect on gastric cancer cell growth inhibition; the mechanism is not only related to the down-regulation of Cyclin E, a regulator of cell cycle regulation, and the up-regulation of p53, but also related to the promotion of apoptosis and the up-regulation of tumor necrosis factor and TRAILR2 gene. The mechanism is not only related to the down-regulation of Cyclin E and up-regulation of p53, but also related to the pro-apoptotic effect with the up-regulation of tumor necrosis factor, TRAILR2 and down-regulation of Cer B2. Based on the clinical experience and experimental research on the use of Vine root, in recent years, we have improved the composition of the formula of Nourishing Stomach and Invigorating Blood by using Vine root as the monarch and increasing the dose (90~180 g) to form the formula of Vine and Curcuma Clear Stasis (Vine root, Curcuma longa, Tianji Huang, Baihua Serpentine, Yanhuosuo, Su stems, Coix seeds), and added and subtracted with the symptoms to treat chronic atrophic gastritis, and the total efficiency was found to be 91. 19% [ 13]. 13]. Clinically, we have experienced that increasing the dose of vine root can improve the symptoms of patients with chronic atrophic gastritis with acid reflux and gastric discomfort, especially those with bile reflux; for patients with different constitution and different types of symptoms, adding high dose of vine root on the basis of evidence can also improve the efficacy. Therefore, we believe that the high dose of vine root plays a major role in the compound preparation and helps to improve the efficacy. 4, the safety of high-dose use of vine root We have conducted a clinical study of high-dose ( 90 ~ 180 g) vine root for the treatment of chronic atrophic gastritis, and the results showed that the safety indexes of blood routine, liver function, kidney function, electrocardiogram, etc. of patients before and after treatment were not found to be abnormal, and no special abnormal symptoms were produced [14]. In conclusion, we believe that the treatment of chronic atrophic gastritis with 90 to 180 g of vine pear root is safe and effective, and can be used as a specific medicine to interrupt and reverse the natural development and prolongation of chronic atrophic gastritis.