Chronic atrophic gastritis (CAG for short) is classified as a “gastric abscess” in Chinese medicine. Due to the different understanding of the disease by various medical practitioners, there are various clinical types of CAG, and there are more than 20 types in recent years. The Spleen and Stomach Disease Branch of the Chinese Academy of Traditional Chinese Medicine has categorized the disease into six common types of symptoms: liver and stomach qi stagnation, liver and stomach heat, spleen and stomach weakness (deficiency cold), spleen and stomach damp-heat, stomach yin deficiency, and blood stasis in the stomach ligament. However, the disease has a long course, the etiology and pathogenesis are complex and variable, and multiple types of symptoms often coexist during the same period, which makes it difficult to distinguish clearly, thus making the identification and treatment more difficult. The mentor, Zhou Bin, combined with clinical practice and simplified the complexity into simplicity by dividing “gastric pang” into two types of evidence: “deficiency cold evidence of spleen and stomach” and “evidence of deficiency of both qi and yin”, according to which the treatment is highly targeted and effective. The experience is summarized as follows. According to “The Essentials of the Golden Horoscope”, “The abdominal fullness of the patient, when pressed without pain, is deficiency, and the pain is actual”. The “Treatise on Typhoid” has “but fullness without pain, this is a gangrene”. It can be seen that “gastric plumpness” is a long-standing disease leading to deficiency, due to deficiency leading to actuality, “deficiency” is the original and the main, “actuality” is the standard and the secondary. Master Zhou believes that the key to clinical evidence is to distinguish the primary and secondary symptoms, to clarify the nature of the disease, and thus to establish the direction of treatment. In the case of “gastric distention”, “deficiency” is mainly manifested as “deficiency of cold in the spleen and stomach” and “deficiency of both qi and yin”. “Qi stagnation”, “heat stagnation”, “dampness obstruction”, “food accumulation”, “phlegm The symptoms of “qi stagnation”, “heat stagnation”, “dampness obstruction”, “food accumulation”, “phlegm condensation” are all symptoms. 1.Spleen and stomach deficiency cold evidence The different method and formula are different”: “The dirty cold produces fullness disease”. Cheng Jiaoqian said: “above the mouth of the stomach is under the heart …… why from the condensation and see fullness? Know that there is a fill. The cold is angry, the cold is the blood, for phlegm for food, the filling is not one. All should be warm to open it, first make the upper jiao development, Yang Qi to stretch, and then guide to remove its lower.” Spleen deficiency or Yang deficiency of the body, in case of irregularities in living, staying up late and tired, injuring Yang and consuming Qi, coupled with the greed for cold, the middle Jiao is often trapped by cold and damp, resulting in deficiency of cold in the spleen and stomach for a long time, the spleen does not rise clear, the stomach does not descend turbid, the abnormal transport and transformation is “fullness”. Spleen and stomach deficiency cold evidence, clinically common gastric fullness, after the distension, like warmth like to press, fear of cold limbs cold, less food and dull, fatigue, loose stools, tongue light dark fat, side more teeth marks, moss thin white or white greasy, pulse sunken weak. The treatment is to strengthen the spleen, warm the stomach and disperse cold. Herbs used: Perilla frutescens, Poria, Atractylodes macrocephala, Glycyrrhiza glabra, Radix et Rhizoma ginseng, Radix et Rhizoma ginger, Radix et Rhizoma sarcoidum, Wicker, Radix et Rhizoma salviae, Salviae Miltiorrhiza. If the spleen and kidney are deficient, the spleen and kidney are weak, the waist and knees are sore, the limbs are cold, and the diarrhea is worse than the one in the fifth month, we can add black peppermint, simmered nutmeg, bone fructus, cornelian, cinnamon, epimedium, etc. 2, qi and yin two deficiency evidence “Puji formula? Void labor heart and abdominal fullness” in the cloud: “weak people, weak qi and blood deficiency …… so the middle qi blockage, stomach distension, so the heart and abdominal fullness also”. Ye Tianshi believes that “Taiyin wet earth, to get Yang began to transport, Yang Ming dry earth, to get Yin since the peace.” People with a weak stomach or a deficiency of yin and blood, due to fatigue, depression, anger, or excessive consumption of spicy and aromatic dry products, dark depletion of yin and fluids, no production of qi and depression of fire, damage to the middle qi, can not move its yin and fluids for the stomach, thus becoming qi and yin two deficiencies. The clinical symptoms of Qi-Yin deficiency are noisy and vague pain in the stomach and epigastrium, hunger and lack of desire to eat, fullness and distension, dry mouth and cold, hot flashes and night sweats, tiredness and fatigue, dry or non-dry stools, red and thin tongue with cracks, thin moss or no moss, and thin pulse strings. The “only yin does not grow, the only yang does not grow”, reflecting the mutual root and use of yin and yang. Long-term mismanagement of the spleen and stomach deficiency cold evidence leads to the loss of spleen and stomach yang, and over time, yang loss and yin, into qi-yin two deficiency evidence or yin-yang two deficiency evidence. This patient has both yin deficiency and yang deficiency, but yin deficiency is the main manifestation, such as dry mouth, happy to drink but not to be cool, red tongue, less fluid and less moss but dark tongue, etc. The treatment is to strengthen the spleen, benefit the stomach and nourish yin. Medicines used: Perilla stems, Poria, raw Atractylodes, honey licorice, Qing Hanxia, Sharen, Danshen, Prince’s ginseng, Wu Mei, Smallpox powder, Bei Sha Shen, Tian Dong, Mai Dong, Bai Shao, Papaya, etc. Master Zhou emphasized that this evidence should be used to sweeten and nourish Yin or sour and sweeten Yin, do not use nourishing and greasy products that hinder the stomach, bitter and cold products that hurt Yang, so as not to hurt the spleen and stomach. In recent years, many doctors believe that “blood stasis” is the most important pathological factor in CAG, and is the key link in the development of the disease or even malignant changes. It may be caused by deficiency of cold in the spleen and stomach, which leads to the failure of warming and transformation, and the deep entrapment of cold and dampness in the gastric ligament, or by deficiency of both qi and yin, which leads to the drying up of the gastric ligament due to deficiency of fire and burning of yin and decoction of fluid and blood, resulting in stasis of the ligament and obstruction of blood stasis. The clinical symptoms are pain in the stomach and epigastrium like needles, frequent attacks at night, dark tongue with petechiae, or angry veins under the tongue and astringent veins. Inheriting the viewpoint of Ye Tiansh that “the initial illness of qi knots in the meridian, while the prolonged illness of blood injury enters the luo”, Master Zhou classified “gastric abdominal pain” as a “luo disease” and believed that the disease does not lie in the qi part but in the blood part, and proposed that “The weakness of the spleen and stomach and the deep entrapment of cold and dampness in the stomach ligament are the important etiological factors and fundamental pathological mechanisms leading to the occurrence of this disease. Because the disease is in the Blood component, although the use of Qi component medicine alone can improve the symptoms, in order to reverse the pathological changes and achieve the purpose of curing the disease, we must add Blood component products at our discretion to invigorate blood circulation, remove blood stasis and open up the ligaments, and add and subtract from the formula of Strengthening the Spleen and Eliminating Gangrene. The medicine includes Salvia miltiorrhiza, Radix Angelicae Sinensis, Lutong, Paeonia lactiflora, Phellodendron, Wu Ling Li, Hedgehog Bark, Jiu Xiang Worm, Trigonella, Curcuma longa, etc. 4.Example of the case A male patient, 41 years old, was first seen on April 13, 2012 for “stomach distension for more than 1 year”. His symptoms included gastric distension, obvious after nausea, cold fear and warmth, frequent belching, reduced nausea, easy fatigue, unformed stool, 1-2 times a day, fat and dark tongue with tooth marks on the side, white and greasy tongue coating, and sunken and weak pulse. Gastroscopic pathological biopsy showed chronic atrophic inflammation of the small curvature of the gastric sinus, with mild intestinal epithelial hyperplasia of some glands; moderate local atrophy of the gastric horn, with mild intestinal epithelial hyperplasia of some glands. The TCM diagnosis was gastric gangrene with evidence of deficiency cold in the spleen and stomach. The prescription was Strengthening the Spleen and Eliminating Gangrene Soup with addition and subtraction of 20g of Perilla stems, 30g of Poria, 20g of bran fried Atractylodes, 15g of Fructus Sempervis, 30g of Gangsong, 6g of sand (posterior), 20g of Salvia, 6g of honey licorice, 15g of bran fried hedgehog shell, 15g of fried lycopodium, 15g of ginger, 30g of simmered nutmeg (posterior), 20g of salt bone marrow, 3g of made dogwood, 7 Dose of water decoction. After one week, the stomach distension was significantly reduced, and the remaining symptoms were relieved, and a total of 84 doses of soup were taken with addition and reduction above. After three months, gastroscopic pathological biopsy of the gastric sinus and gastric horn did not see atrophy and intestinalization.