To investigate the effect of Modified Xiangsha Liujunzi Decoction（香砂六君子汤加减）on the precancerous lesions of chronic atrophic gastritis and the levels of gastric mucosal related factors.

A hundred patients with chronic atrophic gastritis with deficiency of spleen and stomach treated in Jinhua Hospital of Traditional Chinese Medicine from May 2021 to April 2024 were randomly divided into control group and combination group, with 50 cases in each group. After admission, the patients of two groups were instructed to have a light diet, avoid spicy and stimulating foods, and pay attention to rest. The control group was treated with folic acid combined with Weifuchun Tablets（胃复春片）, and on the basis of the above, Xiangsha Liujunzi Decoction was treated with a course of 4 weeks for 3 consecutive courses. After treatment, TCM syndrome scores, clinical total effective rates, gastroscopy pathological scores and adverse reactions during treatment as well as the changes of gastric mucosal related factors nitric oxide（NO）, recombinant P-selectin（SELP）, leukocyte endothelial cell adhesion molecule-1（LECAM-1）and endothelin-1（ET-1）were compared between the two groups.

（1）TCM symptom score：After treatment, all symptom scores of the two groups were lower than those before treatment（P < 0.05）, and the combination group was better than the control group in improving TCM symptom scores of stomachache, belching, lethargy, loose stool, shortness of breath, fatigue and fatigue（P < 0.05）. There was no significant difference in improvement of epigastric fullness between the two groups（P > 0.05）.（2）Clinical efficacy：The total clinical effective rate of the combination group was 94.00%, which was significantly higher than that of the control group（72.00%）, and the difference was statistically significant（P < 0.05）.（3）Gastroscopy pathological score：After treatment, the gastroscopy pathological scores of the two groups were decreased compared with those before treatment（P < 0.05）, and all the gastroscopy pathological scores of the combination group were decreased compared with those of the control group（P < 0.05）.（4）After treatment, the levels of NO, SELP, LECAM-1 and ET-1 in two groups were lower than those before treatment（P < 0.05）. The reduction in the combination group was more significant than that in the control group, and the difference was statistically significant（P < 0.05）.（5）Adverse reactions：The incidence of adverse reactions during treatment in the combination group was 8.00%, which was lower than that in the control group（14.00%）, but the difference was not statistically significant（P > 0.05）.

Xiangshan Liujunzi Decoction has a certain therapeutic effect on patients with chronic atrophic gastritis with deficiency of spleen and stomach, which can improve the total effective rate and the pathological status of patients, inhibit the secretion of NO, SELP, LECAM-1 and ET-1, regulate the inflammatory microenvironment of gastric mucosa, and plays a role in protecting gastric mucosa.