A traditional Chinese medicine composition for treating spleen and stomach qi deficiency syndrome in elderly patients with chronic atrophic angina pectoris (CAG) and promoting stomach health.

Abstract

This invention belongs to the field of traditional Chinese medicine compositions, and relates to a stomach-protecting and atrophy-reducing traditional Chinese medicine composition for treating elderly patients with chronic atrophic gastrointestinal tract (CAG) due to spleen and stomach qi deficiency. The composition comprises the following ingredients in parts by weight: 10-15 parts of *Anoectochilus roxburghii*, 6-15 parts of *Ampelopsis japonica*, 15-20 parts of *Acanthopanax senticosus*, 15-20 parts of *Lilium brownii*, 6-15 parts of *Bletilla striata*, 20-35 parts of *Agrimonia pilosa*, 6-9 parts of *Aconitum carmichaelii*, 3-6 parts of *Impatiens balsamina*, and 15-20 parts of roasted barley malt. This formula is based on the pathogenesis theory of "qi deficiency leading to atrophy – prolonged atrophy leading to toxicity – toxicity damaging the stomach meridians," and uses "tonifying deficiency and nourishing the meridians, clearing toxins and resolving atrophy" as the treatment principle. *Anoectochilus roxburghii* is the principal ingredient, tonifying deficiency and nourishing the meridians and detoxifying; *Ampelopsis japonica* and *Acanthopanax senticosus* are the assistant ingredients, assisting the principal ingredient in strengthening the body, clearing the meridians, and resolving atrophy; the remaining ingredients are adjuvant ingredients. This composition has a good therapeutic effect on elderly patients with chronic atrophic gastritis due to spleen and stomach qi deficiency, with a total effective rate of up to 95.56%. It can effectively improve the pathological state of the gastric mucosa and block the pathogenesis of "deficiency-atrophy-toxin-damage-deficiency".

Description

Technical Field

[0001] This invention relates to the field of traditional Chinese medicine compositions, and more specifically, to a traditional Chinese medicine composition for treating elderly patients with chronic atrophy due to spleen and stomach qi deficiency. Background Technology

[0002] Chronic atrophic gastritis (CAG) is a chronic gastric disease characterized by a reduction or disappearance of the intrinsic glands of the gastric mucosa, which may be accompanied by intestinal metaplasia or dysplasia. Modern medicine mainly adopts measures such as Helicobacter pylori eradication, mucosal protection, improvement of motility, and nutritional support, but there is still a lack of universally accepted specific drugs for the stable reversal of existing gastric mucosal atrophy and intestinal metaplasia.

[0003] Compared to young adults or the general adult population with chronic atrophic gastritis, elderly patients, while lacking a single, absolutely exclusive "specific symptom," exhibit a more pronounced age-related clinical phenotype. For example, elderly patients with spleen and stomach qi deficiency often do not present with typical acid reflux, heartburn, or severe stomach pain. Instead, they commonly experience symptoms such as abdominal distension, persistent dull stomach pain, fatigue, lethargy, poor appetite, sallow complexion, loose stools, and weight loss. Some patients may have mild gastric complaints, yet gastroscopy and pathology may reveal moderate to severe glandular atrophy, intestinal metaplasia, or even dysplasia, presenting a pattern of "mild symptoms but severe disease, and a mismatch between symptoms and pathology." These related symptoms are not necessarily present in the general adult population but are more likely to cluster in elderly patients. Because elderly patients with chronic atrophic gastritis often have characteristics such as declining spleen and stomach function, prolonged course of disease, atypical symptoms, comorbidities, and multiple medications, their gastric mucosal repair ability is reduced, and they have relatively poor tolerance to strong tonifying, bitter and cold or aggressive drugs. Therefore, treatment needs to improve symptoms and pathological changes, while also taking into account safety, long-term medication adherence, and overall functional status.

[0004] Currently, the reason why elderly patients are difficult to treat is not only because the pathological changes such as atrophy and intestinal metaplasia have been formed for a long time, but also because the regenerative and repair capacity of the gastric mucosa is reduced due to the decline of qi and blood with age. Dampness, food, blood stasis and toxins are also prone to accumulating in the weak stomach and intestines, forming a contradictory state of "deficiency of the body and excess of pathogens": simple tonification is easy to obstruct the stomach and intestines, simple blood-activating and purging is easy to deplete qi and damage the collaterals, and bitter and cold detoxification may damage the digestive function. At the same time, elderly patients often have chronic diseases such as cardiovascular and cerebrovascular diseases and metabolic diseases and receive multiple drug treatments. The treatment cycle is long and the requirements for drug interaction, gastrointestinal tolerance and compliance are higher.

[0005] Existing publicly available Chinese herbal compositions for treating chronic atrophic gastritis due to spleen and stomach deficiency use herbs such as Astragalus membranaceus to invigorate the spleen, warm and nourish, and promote qi and blood circulation. Clinically commonly used Weifuchun tablets use red ginseng, fragrant tea leaves, and immature bitter orange to invigorate the spleen, replenish qi, promote blood circulation, and detoxify. Moluodan uses Poria cocos, Scrophularia ningpoensis, Lindera strychnifolia, and other herbs to harmonize the stomach, relieve nausea and vomiting, invigorate the spleen, reduce bloating, and relieve pain by clearing the meridians. These are used for chronic atrophic gastritis. The above-mentioned treatment plans have some effect on general CAG or corresponding syndrome types, but still have the following shortcomings: First, they are mostly aimed at general adults or generalized syndrome types, and do not take the "atypical symptoms but more severe pathology, poor appetite, fatigue, and low repair capacity" of elderly patients as an independent basis for prescription; Second, some plans focus on breaking up blood stasis and eliminating accumulations, and attacking toxins and dispersing nodules, without specifically addressing the tolerance problem of "eliminating pathogens without harming the body's vital energy" in the long-term use of medication by elderly patients with weak constitutions; Third, simply strengthening the spleen and replenishing qi is prone to tonification and stagnation, and it is difficult to take into account the stagnation and collateral damage formed by long-term atrophy; simply promoting blood circulation and removing blood stasis or softening and dispersing nodules is too aggressive and not suitable for long-term use by elderly patients with weak constitutions; bitter and cold detoxification may further affect the digestion and transportation of food if it does not take into account the nourishment of stomach qi and stomach collaterals; Fourth, the existing clinically commonly used drugs are not specifically designed for elderly CAG patients with spleen and stomach qi deficiency, and it is difficult to simultaneously cover the complex needs of symptom improvement, mucosal repair and long-term compliance. Therefore, it is necessary to develop a traditional Chinese medicine composition that is relatively mild in nature, nourishing without causing stagnation, clearing without causing harm, and promoting circulation without being drastic, making it suitable for long-term use by elderly patients. Summary of the Invention

[0006] Based on the principle in "The Yellow Emperor's Inner Classic: Basic Questions: Treatise on Regulating the Meridians" that "when blood and qi are not in harmony, all kinds of diseases will arise," and combined with the physiological decline pattern of the elderly and long-term clinical practice, the inventors of this application believe that chronic atrophic gastritis in the elderly is not a simple continuation of general adult chronic gastritis. Its occurrence and development are closely related to the physical foundation of the elderly, which is characterized by "the decline of qi with age, the gradual weakening of the spleen and stomach, and the loss of nourishment to the stomach meridians." As people age, the Qi of the spleen and stomach gradually declines, resulting in insufficient digestion, transformation, ascending and descending functions, and nourishment. The gastric mucosa lacks sufficient Qi and blood nourishment, leading to a decrease in its repair and regeneration capabilities. Consequently, glands easily atrophy due to deficiency, a condition known as "Qi deficiency leading to atrophy." Once atrophy occurs, the stomach's ability to receive, digest, and transport food becomes impaired, making it easier for pathological products such as dampness, food stagnation, and blood stasis to accumulate. Over time, this stagnation and heat can lead to the formation of "original toxins" stemming from the underlying deficiency and atrophy of the stomach, or "atrophy turning into toxins over time." These toxins linger in the stomach's collaterals, obstructing Qi and blood and damaging the collaterals (toxin-damaged stomach collaterals), causing the gastric mucosa to atrophy, intestinal metaplasia, and even dysplasia to continue progressing. Simultaneously, this further depletes the Qi of the spleen and stomach, thus forming a closed loop of "Qi deficiency—atrophy—toxin formation—collateral damage—further deficiency." Therefore, age-related decline in the spleen and stomach is not only the intrinsic basis for the development of this disease but also a significant contributing factor to its prolonged course, pathological aggravation, and difficulty in repair.

[0007] Based on the aforementioned characteristics of geriatric-related pathogenesis, this invention provides a traditional Chinese medicine composition for treating chronic atrophic gastritis in the elderly with spleen and stomach qi deficiency syndrome. It establishes the treatment principle of "tonifying deficiency and nourishing the collaterals, clearing toxins and resolving atrophy," and establishes a continuous intervention pathway from "qi deficiency leading to atrophy" to "prolonged atrophy becoming toxic" and then to "toxin damaging the gastric collaterals." This treatment prioritizes tonifying the gradually weakening spleen and stomach qi in the elderly, enabling the stomach to function properly and nourishing the mucosa, thus cutting off the source of "qi deficiency leading to atrophy." Simultaneously, it clears and resolves the "original toxins" generated by prolonged atrophy, and disperses dampness, food stagnation, and blood stasis to curb the trend of "prolonged atrophy becoming toxic." Subsequently, it nourishes, unblocks, and protects the gastric collaterals, improving the collateral obstruction and damage caused by prolonged toxicity, creating conditions for gastric mucosal repair. Its core lies not in strong tonification, bitter and cold remedies, or aggressive treatments, but in addressing the complex characteristics of elderly patients, such as "deficiency as the root cause, toxin accumulation as the manifestation, damage to the gastric network, and low repair capacity." It forms an intervention system that tonifies without causing stagnation, clears without causing harm, unblocks without being drastic, and protects while treating, thereby blocking the malignant evolution of "deficiency-atrophy-toxin-damage-deficiency" and providing a more targeted intervention approach for elderly patients with chronic atrophic angina (CAG).

[0008] To achieve the above objectives, the present invention adopts the following technical solution: A traditional Chinese medicine composition for treating chronic atrophic angina pectoris (CAG) with spleen and stomach qi deficiency, comprising the following raw materials in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-15 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-15 parts of Bletilla striata, 20-35 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 3-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt.

[0009] As a preferred embodiment of the present invention, the stomach-protecting and atrophic herbal composition is composed of the following raw materials in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-10 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-10 parts of Bletilla striata, 25-30 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 5-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt.

[0010] As a preferred embodiment of the present invention, the stomach-protecting and atrophic traditional Chinese medicine composition is composed of the following raw materials in parts by weight: 15 parts of Anoectochilus roxburghii, 10 parts of Ampelopsis japonica, 20 parts of Acanthopanax senticosus, 20 parts of Lilium brownii, 10 parts of Bletilla striata, 30 parts of Agrimonia pilosa, 9 parts of Acanthopanax senticosus, 6 parts of Impatiens balsamina, and 20 parts of roasted barley malt.

[0011] The above-mentioned traditional Chinese medicine composition for protecting the stomach and healing atrophy provided by this invention specifically targets the characteristics of elderly patients with spleen and stomach qi deficiency syndrome, characterized by "atypical gastric symptoms but severe pathological damage." It is particularly suitable for symptoms such as abdominal distension, poor appetite, dull stomach pain, fatigue, lethargy, and sallow complexion. The treatment design also takes into account the common nutritional deficiencies and slow recovery of elderly patients. The difficulty in treating this type of patient lies in the advanced age and qi deficiency, impaired gastric network nourishment, and low mucosal repair capacity. They often also have multiple coexisting diseases, require multiple medications, and have long-term treatment adherence issues. To address these characteristics, this invention uses "tonifying deficiency and nourishing the network, clearing toxins and resolving atrophy" as its overall approach, which not only improves the symptoms of elderly patients but also creates conditions for the gradual repair of atrophied glands and damaged gastric network. Clinical trials show a total effective rate of 95.56%, thus it can be used in the preparation of drugs for treating elderly patients with spleen and stomach qi deficiency syndrome (CAG).

[0012] The dosage form of the drug for treating elderly patients with chronic atrophic gastrointestinal tract (CAG) due to spleen and stomach qi deficiency according to the present invention is an oral preparation, which is selected from any one of granules, tablets, capsules, powders, decoctions or pills.

[0013] This invention also provides a decoction for treating elderly patients with CAG due to spleen and stomach qi deficiency. The decoction is composed of the following ingredients in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-15 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-15 parts of Bletilla striata, 20-35 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 3-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt. The decoction is prepared as follows: place all the herbs in a container, add cold water to soak, then bring to a boil over high heat, then simmer over low heat for 30-40 minutes, and filter the decoction; add water to the dregs and simmer for another 20-30 minutes, then filter the decoction; mix the two decoctions evenly to obtain the final product.

[0014] In the stomach-protecting and atrophy-healing traditional Chinese medicine composition provided by this invention, *Anoectochilus roxburghii* is the principal ingredient. *Anoectochilus roxburghii* is sweet and neutral in nature, and enters the lung, liver, and stomach meridians. It can replenish qi and blood, clear heat and detoxify, cool the blood and unblock the meridians. *Compendium of Materia Medica Supplement* records that it "cools the blood and calms the liver, clears heat and detoxifies," and *Fujian Materia Medica* states that it "treats stomach pain." It encompasses two major treatment methods: "replenishing deficiency and nourishing the meridians, clearing toxins and resolving atrophy." For "atrophy due to qi deficiency," its mild nature allows it to replenish deficiency and strengthen the body, benefiting the stomach and aiding digestion, thus restoring the qi of the aging spleen and stomach, and nourishing the stomach and its meridians. For "prolonged atrophy leading to toxicity," it clears internal stagnation and resolves stagnant toxins, reducing the "toxins" formed by prolonged dampness, food stagnation, and blood stasis. For "toxins damaging the stomach meridians," it unblocks the meridians and protects the stomach, eliminating pathogens and restoring the meridians and membranes. Therefore, the herb *Anoectochilus roxburghii* takes into account the beginning, middle and end of the pathogenesis chain. It is neither simply a tonic nor a bitter and cold remedy, but rather clears the internal toxins and protects the damaged collaterals on the basis of supporting the body's resistance, which is the core of the whole formula.

[0015] Bai Lian and Ci Wu Jia serve as assistant herbs, respectively fulfilling the methods of "clearing toxins and protecting the collaterals" and "tonifying deficiency and nourishing the collaterals." Bai Lian is bitter, pungent, and slightly cold, specifically entering the stomach meridian. The "Ben Cao Qiu Zhen" states that it "has the effect of dispersing swellings and sores." Ci Wu Jia, listed as a superior herb in the "Shennong Ben Cao Jing," excels at "benefiting qi." Its nature is warm but not drying, capable of warming and tonifying the spleen and kidneys, and invigorating yang qi. It is particularly effective for the elderly with weakened spleen and stomach qi, impaired digestion, and decreased mucosal repair capacity, assisting the principal herb in nourishing stomach qi, restoring stomach collaterals, and preventing "qi deficiency leading to atrophy." Bai Lian clears and disperses nodules to invigorate blood, remove blood stasis, unblock collaterals, astringe and promote tissue regeneration to repair collaterals, focusing on the toxic nodules and stomach collateral damage formed over time, thus clearing away the evil of "prolonged atrophy leading to toxicity" and protecting the damage to the stomach collaterals caused by "toxicity." The two herbs, one tonifying and one clearing, one nourishing and one astringing, ensure that tonifying the body does not lead to stagnation, and clearing away toxins does not harm the middle jiao (spleen and stomach). This reflects the principle that the treatment of elderly patients with weak constitutions should prioritize tonifying the body, use detoxification as a restraint, and ultimately protect the collaterals.

[0016] Lily bulb, Bletilla striata, Agrimonia pilosa, Acanthopanax senticosus, and Impatiens balsamina are used as adjuvant herbs, while roasted malt is used as the guiding herb. These herbs work synergistically in layers, addressing the overall pathogenesis. Lily bulb nourishes Yin and benefits the stomach, calms the mind and harmonizes the middle Jiao. Combined with Anoectochilus roxburghii and Acanthopanax senticosus, it addresses both deficiency and the need for tonifying the elderly with chronic illness and reduced body fluids, achieving "nourishing the collaterals without causing dryness." Bletilla striata astringes and stops bleeding, invigorates blood circulation, promotes tissue regeneration, and protects the mucous membrane. Paired with Ampelopsis japonica, it repairs damaged gastric collaterals and mucous membranes, fulfilling the principle of "protecting the collaterals and repairing the mucous membranes when toxins damage the gastric collaterals." Agrimonia pilosa combines tonifying, astringent, and harmonizing effects, enhancing the tolerance of a weak constitution. Acanthopanax senticosus regulates Qi and disperses stagnation, while a small amount of Impatiens balsamina softens hardness and promotes circulation. Together, they dispel dampness, food stagnation, and blood stasis, preventing the "original toxin" from attaching to the stomach and allowing the collaterals to flow freely. However, the dosage is moderate to avoid harming the body's vital energy. Roasted malt strengthens the spleen, aids digestion, harmonizes the stomach, and eliminates stagnation. This reduces food stagnation and toxin formation at the source and harmonizes the other herbs, ensuring that tonifying herbs do not hinder the stomach and purgative herbs do not damage the middle Jiao. The combined use of various auxiliary methods ensures that the detoxification process has a way out, the blood circulation has a foundation, and the transformation of atrophy has the conditions.

[0017] The entire formula takes "qi deficiency leading to atrophy—prolonged atrophy leading to toxicity—toxicity damaging the stomach collaterals" as the main pathogenesis and "tonifying deficiency and nourishing the collaterals, clearing toxins and resolving atrophy" as the general principle of treatment, forming a structure in which the pathogenesis and the combination of herbs correspond layer by layer: Anoectochilus roxburghii, Acanthopanax senticosus, and Lilium brownii tonify the spleen and stomach, nourish the stomach collaterals, correct the qi deficiency and malnutrition in the elderly, and directly treat "qi deficiency leading to atrophy"; Anoectochilus roxburghii and Ampelopsis japonica, combined with roasted malt, Ziziphus jujuba, and Aconitum carmichaelii, clear the internal toxins and resolve dampness and food stagnation, and cut off "prolonged atrophy leading to toxicity"; Ampelopsis japonica, Bletilla striata, and Agrimonia pilosa nourish the collaterals, heal damage, promote tissue regeneration and protect the membranes, and, together with Ziziphus jujuba and Aconitum carmichaelii, unblock the collaterals and repair "toxic damage to the stomach collaterals". Therefore, the whole formula is not a simple superposition of tonifying, clearing, unblocking and protecting drugs, but rather a combination of tonifying deficiency to restore the source of biochemistry and repair, clearing toxins to remove the factors of continuous damage, nourishing the collaterals and protecting the membranes to improve the pathological basis, and harmonizing the middle to help reduce the conditions for recurrence. Ultimately, it breaks the closed loop of "deficiency-atrophy-toxin-damage-deficiency", and works together to tonify deficiency and nourish the collaterals, clear toxins and resolve atrophy. It is especially suitable for elderly patients with deficiency, long-term illness, and damage to the collaterals, and who cannot tolerate strong purgatives and bitter and cold medicines.

[0018] Advantages and beneficial effects of the present invention: (1) Academic innovation: This invention is the first to be based on the physiological and pathological characteristics of the elderly, namely “old age and declining qi, gradual weakening of the spleen and stomach, and loss of nourishment of the stomach meridians”. It first connects the age-related decline of the spleen and stomach, the malnutrition of the gastric mucosa and the decline in repair ability with the occurrence, prolongation and progression of chronic atrophic gastritis, forming a new approach to understanding this disease from the overall state of the elderly’s weak body.

[0019] (2) Innovation in pathogenesis theory: This invention proposes for the first time a continuous pathogenesis chain of "qi deficiency leading to atrophy - atrophy leading to toxicity - toxicity damaging the stomach collaterals", and uses "the root toxicity" to summarize the toxicity generated by dampness, food, and blood stasis on the basis of spleen and stomach deficiency and atrophy, revealing the closed-loop evolution of "deficiency - atrophy - toxicity - damage - deficiency". Based on this, a Chinese herbal medicine composition for protecting the stomach and healing atrophy was created with the treatment method of "tonifying deficiency and nourishing collaterals, clearing toxicity and resolving atrophy", in order to provide a better treatment plan for the fundamental pathogenesis of chronic atrophic gastritis with spleen and stomach qi deficiency in the elderly, and to achieve the correspondence and unity of pathogenesis, treatment method and prescription.

[0020] (3) Innovative Clinical Efficacy: This invention differs from the main clinical focus of general chronic atrophic gastritis treatment, constructing a synergistic treatment plan of tonification, clearing, nourishing, unblocking, and protection for elderly patients with chronic atrophic gastritis due to spleen and stomach qi deficiency. Clinical results show that the total effective rate in the treatment group was 95.56%, and the improvement in symptoms, gastric mucosal atrophy, and intestinal metaplasia was better than that in the control group, providing clinical evidence for blocking the pathogenesis chain of "deficiency-atrophy-toxin-damage" in elderly patients.

[0021] (4) In terms of concept, this invention does not regard elderly CAG as an extension of the age of general adult CAG, but emphasizes "aging constitution - qi deficiency and malnutrition - mucosal inability to recover" as the basis; in terms of treatment, it aims to replenish deficiency to restore the source of repair, nourish the blood vessels and protect the mucosa to improve the damaged foundation, and clear toxins and dissolve nodules to remove the factors of continuous damage; in terms of medication, it avoids strong tonification, strong attack and strong bitterness and coldness, and adopts a mild combination of tonification without stagnation, clearing without harm, and unblocking without stagnation, so as to meet the treatment needs of elderly patients for long-term and gradual repair.

[0022] (5) Compared with solutions that focus on a single treatment method, such as simply strengthening the spleen and replenishing qi, promoting blood circulation and detoxifying, or harmonizing the stomach and unblocking the collaterals, this invention focuses on the pathogenesis of chronic atrophic gastritis in the elderly with spleen and stomach qi deficiency, which is characterized by "deficiency of vital energy, accumulation of toxins, and damage to the collaterals". It organically unifies tonifying deficiency, clearing toxins, nourishing the collaterals, unblocking stagnation, and protecting the mucosa. By tonifying deficiency, the source of stomach qi production and mucosal repair is restored, avoiding the obstruction of the stomach caused by simple tonification; by clearing toxins and resolving stagnation, the continuous damaging factors are removed, and by nourishing the collaterals and protecting the mucosa, and harmonizing the middle jiao to assist transportation, the drawbacks of bitter and cold attack are restrained, avoiding the depletion of qi and damage to the collaterals that may be caused by simply promoting blood circulation and detoxifying; at the same time, by gently unblocking the collaterals and gradually resolving atrophy, the problem of insufficient consideration of qi deficiency and internal toxin accumulation by simply harmonizing the stomach and unblocking the collaterals is overcome. Detailed Implementation

[0023] This invention discloses a traditional Chinese medicine composition and decoction for treating chronic atrophic gastritis (CAG) in the elderly with spleen and stomach qi deficiency syndrome, which protects the stomach and promotes healing. Those skilled in the art can refer to the content of this document and appropriately modify the component parameters or process parameters to achieve the desired effect. It should be particularly noted that all similar substitutions and modifications are obvious to those skilled in the art and are considered to be included within the scope of protection of this invention.

[0024] Example 1:

[0025] This embodiment provides a traditional Chinese medicine composition for treating chronic atrophic gastritis (CAG) in the elderly with spleen and stomach qi deficiency syndrome. The composition is composed of the following raw materials in parts by weight: 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 20g of Lilium brownii, 10g of Bletilla striata, 30g of Agrimonia pilosa, 9g of Citrus aurantium, 6g of Impatiens balsamina, and 20g of roasted barley malt.

[0026] The stomach-protecting and atrophic traditional Chinese medicine composition provided in this embodiment can be formulated into any one of the following dosage forms: granules, tablets, capsules, powders, decoctions, or pills. Among the above dosage forms, decoctions have the advantages of being simple and easy to prepare, fast to be absorbed, and able to quickly exert their medicinal effects. Therefore, decoctions are preferred. The decoctions are prepared by decocting water and then removing the residue to obtain the juice.

[0027] Specifically, the preparation method of the decoction is as follows: Place the above-mentioned herbs in a clay pot, add cold water and soak for 30 minutes, the water level should be 2-3 cm above the herbs. First bring to a boil over high heat, then simmer over low heat for 35 minutes, and filter to obtain about 150 ml of decoction. Add warm water to the dregs and simmer for another 25 minutes, then filter to obtain about 150 ml of decoction. Mix the two decoctions evenly to obtain one dose. Take one dose daily, divided into two doses, taken warm after breakfast and dinner.

[0028] Example 2:

[0029] This embodiment provides a traditional Chinese medicine composition for treating chronic atrophic gastritis (CAG) in the elderly with spleen and stomach qi deficiency syndrome. The composition is composed of the following raw materials in parts by weight: 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 15g of Lilium brownii, 10g of Bletilla striata, 25g of Agrimonia pilosa, 6g of Ziziphus jujuba, 5g of Impatiens balsamina, and 20g of roasted barley malt.

[0030] The stomach-protecting and atrophic traditional Chinese medicine composition provided in this embodiment is preferably taken as a decoction, and the preparation method of the decoction is the same as in Example 1.

[0031] It should be noted that the stomach-protecting and atrophic traditional Chinese medicine composition provided by this invention can be appropriately adjusted in clinical use according to the severity of the patient's symptoms and the duration of the disease. For example, if there is significant abdominal distension and pain extending to both hypochondria, the dosage of *Ziziphus jujuba* can be increased to 9g; if there is fatigue, weakness, shortness of breath, and reluctance to speak, the dosage of *Agrimonia pilosa* can be increased to 35g to enhance its tonifying effect; if gastroscopy reveals severe mucosal congestion and erosion, the dosage of *Bletilla striata* and *Ampelopsis japonica* can be increased to 15g to strengthen their blood-activating and meridian-clearing effects. Of course, regardless of any adjustments to the dosage of the ingredients in the above stomach-protecting and atrophic traditional Chinese medicine composition, the following range must be maintained: Golden Thread Orchid 10-15g, White Peony Root 6-15g, Eleutherococcus senticosus 15-20g, Lily Bulb 15-20g, Bletilla Rhizome 6-15g, Agrimonia pilosa 20-35g, 6-9g, Impatiens 3-6g, Fried Malt 15-20g.

[0032] The stomach-protecting and atrophic traditional Chinese medicine composition provided by this invention is based on the theory of "qi deficiency leading to atrophy - prolonged atrophy leading to toxicity - toxicity damaging the stomach meridians," which aligns with the pathological process of "deficiency-atrophy-toxicity-damage-deficiency" in elderly patients with chronic atrophic gastritis. Clinically, it employs the methods of tonifying deficiency and nourishing the meridians, clearing toxins and resolving atrophy. This formula has been used for many years at the Affiliated Hospital of Changchun University of Traditional Chinese Medicine and has shown good therapeutic effects on elderly patients with chronic atrophic gastritis due to spleen and stomach qi deficiency. The following clinical data illustrates the therapeutic effects of the stomach-protecting and atrophic traditional Chinese medicine composition of this invention: 1. General Information: Ninety-six elderly patients with chronic atrophic gastritis due to spleen and stomach qi deficiency, who were treated at the outpatient and inpatient departments of the Department of Hepatobiliary and Gastroenterology at the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from January 2024 to June 2025, were selected. Among them, 51 were male and 45 were female, aged 60-75 years, with a mean age of (67.8±4.9) years. Patients were randomly divided into a treatment group and a control group, with 48 patients in each group. In the treatment group, 45 patients completed the trial, and 3 dropped out. In the control group, 45 patients completed the trial, and 3 dropped out. Dropout cases were not included in the final efficacy statistics. There were no statistically significant differences in general characteristics (gender, age, disease duration, and gastric mucosal pathological grade) between the two groups. P The values ​​are >0.05, indicating comparability. See Tables 1, 2, 3, 4, and 5 for details.

[0033] Table 1. Comparison of genders before treatment completion in the two groups [n(%)]

[0034] Table 2 Comparison of the ages of the two groups of cases before treatment (actually completed cases) ,age)

[0035] Table 3 Comparison of the disease course before treatment in the two groups of actual completed cases ( ,Year)

[0036] Table 4. Pathological grading of gastric mucosal atrophy [cases (%)]

[0037] Table 5 Comparison of intestinal metaplasia pathological grading before treatment in the two groups of actual completed cases [cases (%)]

[0038] 2. Diagnostic criteria: 2.1 Western Medicine Diagnostic Criteria: Referring to the diagnostic criteria for chronic atrophic gastritis in the "Chinese Consensus Opinion on Chronic Gastritis (2022)," "Expert Consensus on the Diagnosis and Treatment of Chronic Atrophic Gastritis with Integrated Traditional Chinese and Western Medicine (2017)," and "Expert Consensus on Chronic Gastritis in the Elderly in China (2018)," gastroscopy and pathological histological examination confirmed gastric mucosal atrophy, which may be accompanied by intestinal metaplasia or dysplasia.

[0039] 2.2 Traditional Chinese Medicine Diagnosis Criteria: Refer to the diagnosis criteria for spleen and stomach qi deficiency syndrome in the "Expert Consensus on the Diagnosis and Treatment of Chronic Atrophic Gastritis with Integrated Traditional Chinese and Western Medicine (2017)".

[0040] Main symptoms: 1) Abdominal distension, which worsens after meals; 2) Dull pain in the stomach, which is relieved by pressure; 3) Poor appetite and reduced food intake; 4) Fatigue, weakness, and reluctance to speak.

[0041] Secondary symptoms: 1) Loose stools; 2) Sallow complexion; 3) Pale tongue, enlarged tongue body or teeth marks on the edges, thin white coating; 4) Thready and weak pulse. The pale color of the gastric mucosa, the thinning of folds, or the visibility of blood vessels under gastroscopy are recorded as objective manifestations of the disease and are not scored separately as secondary symptoms in Traditional Chinese Medicine.

[0042] A diagnosis can be made based on the presence of two primary symptoms and two secondary symptoms, combined with information from the tongue and pulse.

[0043] 3. Inclusion criteria: 1) Meets the above-mentioned Western and Traditional Chinese Medicine diagnostic criteria, and is ≥60 years old; 2) No medications for treating CAG have been used within the past 3 months; 3) Obtain informed consent from the patient and have them sign the informed consent form.

[0044] 4. Exclusion criteria: 1) Patients with concurrent peptic ulcers, gastric cancer, or pathological diagnosis of severe dysplasia; 2) Individuals with serious primary diseases such as heart, brain, liver, or kidney; 3) Individuals allergic to any of the drug components used in this study; 4) Individuals with mental illness or communication difficulties.

[0045] 5. Treatment methods: 5.1 Basic treatment: Both groups of patients received health education, including regular diet, avoiding raw, cold, spicy and greasy foods, quitting smoking and alcohol, and maintaining emotional stability.

[0046] 5.2 The treatment group received a stomach-protecting and atrophy-healing formula in addition to basic treatment. The formula consists of: 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 20g of Lilium brownii, 10g of Bletilla striata, 30g of Agrimonia pilosa, 9g of Ziziphus jujuba, 6g of Impatiens balsamina, and 20g of roasted barley malt. One dose was taken daily, decocted in water and taken twice a day after breakfast and dinner.

[0047] 5.3 Control group: In addition to basic treatment, patients were given Weifuchun tablets (Hangzhou Huqingyutang Pharmaceutical Co., Ltd., National Drug Approval Number Z20040003) orally, 4 tablets each time, 3 times a day.

[0048] Both groups underwent a 4-week treatment course, and the efficacy was observed after three consecutive treatment courses.

[0049] 6. Observation of therapeutic effects: 6.1 Observation indicators: 1) Traditional Chinese Medicine syndrome scores: Abdominal distension, dull abdominal pain, poor appetite, and fatigue were scored as follows: 0, 2, 4, and 6 points respectively (none, mild, moderate, and severe); loose stools and sallow complexion were scored as follows: 0, 1, 2, and 3 points respectively (none, mild, moderate, and severe). The changes in individual scores and total scores before and after treatment were compared between the two groups.

[0050] 2) Gastroscopy and pathological indicators: Gastroscopy and biopsy were performed before and after treatment to observe the improvement of gastric mucosal atrophy, intestinal metaplasia and dysplasia.

[0051] 3) Safety indicators: Blood routine tests and liver and kidney function tests were conducted before and after treatment, and adverse reactions were recorded.

[0052] 6.2 Efficacy criteria: The guidelines were formulated with reference to the relevant standards in the "Guiding Principles for Clinical Research of New Traditional Chinese Medicine Drugs".

[0053] Clinical cure: Symptoms and signs disappear, TCM syndrome score decreases by ≥95%, and gastroscopy shows disappearance of gastric mucosal atrophy, intestinal metaplasia, or dysplasia.

[0054] Significant effect: Symptoms and signs are significantly improved, the TCM syndrome score is reduced by ≥70%, and gastroscopy re-examination shows an improvement of 2 levels or more in gastric mucosal atrophy or intestinal metaplasia.

[0055] Effective: Symptoms and signs improve, TCM syndrome score decreases by ≥30%, and gastroscopy shows improvement of one level in gastric mucosal atrophy or intestinal metaplasia.

[0056] Ineffective: Symptoms and signs do not improve or worsen, TCM syndrome score decreases by <30%, and gastroscopy and pathological examination show no improvement or worsen.

[0057] 6.3 Rejection and shedding criteria: 1) Those who fail to take medication according to the prescribed regimen and have poor adherence; 2) Individuals who self-medicate with other medications that may affect the evaluation of treatment efficacy; 3) Those who withdraw due to adverse events or serious adverse reactions; 4) Those who are lost to follow-up or voluntarily withdraw.

[0058] 6.4 Statistical Methods: SPSS 30.0 software was used for analysis. Quantitative data are presented as follows: () indicates that within-group comparisons use paired comparisons. t For comparisons between groups, use the independent samples t-test; for count data, use the chi-square test; for ordinal data, use the rank-sum test. P <0.05 indicates a statistically significant difference.

[0059] 7. Treatment results: 7.1 Comparison of the overall efficacy between the treatment group and the control group: The total effective rate of the treatment group was 95.56%, which was significantly higher than that of the control group (77.78%). The difference was statistically significant (P<0.05). See Table 6 for details.

[0060] Table 6. Comparison of overall therapeutic effects between the treatment group and the control group [n(%)]

[0061] Note: Compared with the control group, a P < 0.05.

[0062] 7.2 Comparison of TCM syndrome scores between the treatment group and the control group after treatment: After treatment, the scores of the treatment group for various symptoms such as abdominal distension, epigastric pain, loss of appetite, and fatigue were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). See Table 7 for details.

[0063] Table 7 Comparison of TCM syndrome scores before and after treatment in the treatment group and the control group (scores)

[0064] Note: Compared with the same group, a P<0.05; comparison between groups with the control group b P<0.05.

[0065] 7.3 Comparison of gastric mucosal pathological improvement between the treatment group and the control group after treatment: After treatment, the improvement rate of gastric mucosal atrophy and intestinal metaplasia in the treatment group was higher than that in the control group, and the difference was statistically significant (P<0.05), as detailed in Table 8.

[0066] Table 8 Comparison of improvement rates of gastric mucosal pathological indicators between the two groups [n(% of the total group)]

[0067] Note: The number of cases with improvement refers to the number of patients whose corresponding pathological grade decreased by at least one grade or whose lesions disappeared after treatment; the percentage in parentheses is calculated based on the actual number of cases completed in this group. The chi-square test was used for comparisons between groups.

[0068] Typical case: Case 1: Zhao, male, 72 years old, retired worker. First visit on March 8, 2024.

[0069] Chief complaint: Recurrent epigastric fullness and dull pain for more than 10 years, which has worsened and been accompanied by loss of appetite and fatigue for 3 months.

[0070] Present Illness: The patient developed epigastric discomfort over 10 years ago due to dietary indiscretion, intermittently taking omeprazole and Weisu granules, with symptoms fluctuating in severity. For the past 3 years, epigastric fullness has become more frequent, especially after meals, and weight has decreased annually (approximately 6 kg in the past 3 years). In December 2023, a gastroscopy at another hospital revealed chronic atrophic gastritis (type C-2), with pathology showing antral mucosal atrophy (++), moderate intestinal metaplasia, and mild dysplasia. In the past 3 months, due to household chores and stress, the symptoms have significantly worsened. Current Symptoms: Epigastric fullness and discomfort, worsening after meals, intermittent dull pain, fatigue, lethargy, poor appetite, loose stools (2-3 times daily), and sallow complexion. The tongue is pale and swollen with teeth marks on the edges, a thin white coating, and a weak pulse.

[0071] Physical examination: Abdomen soft and flat, mild tenderness below the xiphoid process, no rebound tenderness or muscle guarding. Thin build, BMI: 19.2 kg / m². 2 .

[0072] Western medicine diagnosis: Chronic atrophic gastritis (Type C-2, with moderate intestinal metaplasia and mild dysplasia).

[0073] Traditional Chinese Medicine diagnosis: Stomach fullness (spleen and stomach qi deficiency syndrome).

[0074] Treatment: Nourish the blood vessels and replenish deficiencies, clear toxins and resolve atrophy.

[0075] Prescription (initial consultation): 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 20g of Lilium brownii, 10g of Bletilla striata, 30g of Agrimonia pilosa, 9g of Citrus aurantium, 6g of Impatiens balsamina, and 20g of roasted barley malt. 14 doses, one dose per day, decocted in water to obtain 400ml of juice, taken warm twice a day after breakfast and dinner.

[0076] Second visit (March 22, 2024): The patient's epigastric distension was significantly reduced, and the frequency of dull pain attacks decreased from 3-4 times per day to 1-2 times per day. Appetite increased, and bowel movements were more formed, occurring 1-2 times per day. Fatigue persisted, but had improved compared to before. The tongue was pale and swollen, with reduced teeth marks on the edges, a thin white coating, and a thready pulse. Considering that the original prescription was appropriate for the pathogenesis, the patient was advised to continue taking the initial prescription for 14 doses.

[0077] Third visit (April 5, 2024): The patient's mental state improved significantly, complexion became more radiant, occasional episodes of epigastric fullness and dull pain disappeared, appetite was normal, and bowel movements were regular. The tongue was pale red, slightly swollen, with a thin white coating, and the pulse was thready and forceful. A follow-up gastroscopy showed improvement in gastric mucosal atrophy (from ++ to +); pathology showed mild chronic atrophy of the gastric antrum mucosa, and intestinal metaplasia improved from moderate to mild, with no obvious dysplasia. The patient continued to take the initial prescription for 14 doses, then changed to one dose every other day for another month to consolidate the treatment. During a 6-month follow-up, no symptom recurrence was observed, and the patient gained 2 kg.

[0078] Commentary: The patient in this case is over seventy years old and has suffered from stomach problems for more than ten years. This is a time when the spleen and stomach are gradually weakening and the production of qi and blood is insufficient due to old age. In recent years, the patient has experienced weight loss, epigastric fullness and dull pain, poor appetite, fatigue, and loose stools. The tongue is pale and swollen with teeth marks, and the pulse is weak and thready, all indicating that spleen and stomach qi deficiency has become the root cause of the disease's continued development. Qi deficiency leads to malnourishment of the stomach and its collaterals, resulting in gastric mucosal atrophy reaching (++), which is "qi deficiency leading to atrophy". With prolonged atrophy, the body's ability to receive and transform food is further weakened. Dampness, food stagnation, and blood stasis combine and stagnate, eventually leading to toxicity. Pathologically, moderate intestinal metaplasia and mild dysplasia are observed, reflecting "prolonged atrophy leading to toxicity". The toxins accumulated in the stomach collaterals for a long time also hinder the repair of glands and make it difficult to reverse the atrophy, forming "toxic damage to the stomach collaterals", which in turn aggravates the qi deficiency. Therefore, the treatment should not simply focus on attacking the toxins or promoting blood circulation, but rather on "tonifying deficiency and nourishing the collaterals, clearing toxins and resolving atrophy": *Anoectochilus roxburghii* tonifies deficiency, clears toxins, and unblocks the collaterals; *Acanthopanax senticosus* and *Lilium brownii* support the body's vital energy and nourish it; *Ampelopsis japonica* and *Bletilla striata* clear toxins, disperse nodules, and protect the mucosa and promote tissue regeneration; *Agrimonia pilosa* tonifies and astringes; *Ziziphus jujuba* and *Ziziphus jujuba* gradually open up long-standing nodules; and roasted malt harmonizes the stomach and aids digestion. The entire treatment followed the prescribed formula without adding any additional medication. Symptoms decreased at the second visit, and at the third visit, atrophy improved from (++) to (+), and intestinal metaplasia improved from moderate to mild with no obvious dysplasia observed. Follow-up showed weight gain and stable symptoms, indicating that by tonifying deficiency to restore the source of repair, clearing toxins to relieve continuous damage, and nourishing the collaterals to promote mucosal recovery on the basis of the elderly's weakened constitution, the pathogenesis loop of "deficiency—atrophy—toxin—damage—deficiency" can be effectively interrupted.

[0079] Case 2: Ms. Sun, 66 years old, retired cadre. First visit on June 15, 2024.

[0080] Chief complaint: recurrent episodes of dull pain and fullness in the epigastric region for 8 years, which have worsened in the past six months.

[0081] Present Illness: Eight years ago, the patient experienced epigastric discomfort due to high work stress and irregular eating habits, intermittently taking both Chinese and Western medicine (specific details unknown), with recurring symptoms. In the past six months, after retirement, significant mood swings led to increased epigastric pain, fullness, and discomfort, which worsened after meals and during periods of emotional distress. In May 2024, a gastroscopy at a tertiary hospital revealed chronic atrophic gastritis (type C-1), with pathology showing antral mucosal atrophy (++) and mild intestinal metaplasia. Current Symptoms: Dull epigastric pain, persistent and intermittent, epigastric fullness, frequent belching, poor appetite, fatigue, dry mouth without thirst, poor sleep, and constipation with bowel movements every 2-3 days. The tongue is pale red, thin, and lacks moisture, with a thin, white, and dry coating; the pulse is thready and wiry.

[0082] Physical examination: The abdomen was soft and flat, with no obvious tenderness or rebound tenderness. The patient appeared unwell and anxious.

[0083] Western medicine diagnosis: Chronic atrophic gastritis (C-1 type, with mild intestinal metaplasia).

[0084] Traditional Chinese Medicine diagnosis: Stomach pain (spleen and stomach qi deficiency syndrome).

[0085] Treatment: Nourish the blood vessels and replenish deficiencies, clear toxins and resolve atrophy.

[0086] Prescription (initial consultation): 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 20g of Lilium brownii, 10g of Bletilla striata, 30g of Agrimonia pilosa, 9g of Citrus aurantium, 6g of Impatiens balsamina, and 20g of roasted barley malt. 14 doses, one dose per day, decocted in water to obtain 400ml of juice, taken warm twice a day after breakfast and dinner.

[0087] Second visit (June 29, 2024): The patient's epigastric pain lessened, fullness improved, belching decreased, appetite increased, but fatigue and poor sleep persisted, and dry mouth improved compared to before. The tongue was pale red, with less saliva than before, and the coating was thin and white; the pulse was thready. Considering that lily bulb in the original prescription can nourish yin and calm the mind, and that *Anoectochilus roxburghii* and *Eleutherococcus senticosus* can replenish deficiencies and nourish the blood vessels, and that *Aconitum carmichaelii* can regulate qi and harmonize the stomach, the patient continued to take the same prescription for 14 doses without adding any additional medication.

[0088] Third visit (July 13, 2024): The patient's mental state improved significantly, stomach pain basically disappeared, occasional mild episodes of epigastric fullness, normal appetite, improved sleep (5-6 hours continuously), and regular bowel movements. The tongue was pale red with a thin white coating, and the pulse was thready. A follow-up gastroscopy showed that gastric mucosal atrophy had improved from ++ to +; pathology showed mild chronic inflammation of the gastric antral mucosa and disappearance of intestinal metaplasia. The patient continued to take the initial prescription for 14 doses, followed by one dose every other day for consolidation. At the 3-month follow-up, the symptoms remained stable, and a follow-up gastroscopy showed no recurrence of atrophy.

[0089] Note: This patient is 66 years old and has been ill for 8 years. The condition is characterized by gradual decline of spleen and stomach qi in the elderly, compounded by yin deficiency due to prolonged illness and emotional distress. Symptoms include dull stomach pain, fullness, poor appetite, and fatigue, indicating spleen and stomach qi deficiency and insufficient nourishment of the stomach. The atrophy (++) suggests that "qi deficiency leading to atrophy" has already occurred. Mild intestinal metaplasia indicates that dampness, food stagnation, and blood stasis have accumulated over time and are beginning to transform into toxins, but have not yet developed into severe damage to the collaterals. The patient's belching, worsening symptoms during periods of emotional distress, and thready, wiry pulse suggest stagnation of liver and stomach qi. Dry mouth with little saliva, poor sleep, and a thin, dry tongue indicate both yin deficiency in the elderly and depletion from prolonged illness. Therefore, the treatment principle remains "tonifying deficiency and nourishing the collaterals, clearing toxins and resolving atrophy." The original prescription is further enhanced by the synergistic effects of lily bulb for nourishing yin and calming the mind, *Anoectochilus roxburghii* and *Eleutherococcus senticosus* for tonifying deficiency and nourishing the collaterals, and *Aconitum carmichaelii* for regulating qi and dispersing stagnation. No additional herbs are added to avoid a complex formula and an imbalance between tonifying and purging. After treatment, the patient's stomach pain, abdominal distension, belching, poor appetite, and sleep gradually improved. Follow-up examination showed that the atrophy changed from (++) to (+) and intestinal metaplasia disappeared. This suggests that for elderly patients in the transitional stage from "qi deficiency leading to atrophy" to "atrophy leading to toxicity", restoring stomach qi, nourishing stomach yin, regulating qi, and clearing the initial toxins can prevent the pathogenesis from continuing to develop into "toxic damage to the stomach meridians" without harming the body's vital energy.

[0090] Case 3: Liu, male, 69 years old, farmer. First visit on August 20, 2024.

[0091] Chief complaint: Abdominal fullness and bloating after meals for 12 years, which has worsened and been accompanied by weight loss for 4 months.

[0092] Present Illness: The patient has been a farmer for many years, with irregular eating habits and inconsistent mealtimes, suffering from chronic stomach problems for 12 years. He has taken omeprazole and magnesium aluminum carbonate multiple times, but his symptoms were not well controlled. In April 2024, due to worsening epigastric distension and bloating after eating, he underwent a gastroscopy at a local hospital, which revealed chronic atrophic gastritis (type C-2). The pathology report showed atrophy of the gastric antrum and body mucosa (+++), accompanied by moderate intestinal metaplasia and focal low-grade intraepithelial neoplasia. Current Symptoms: A feeling of fullness and obstruction in the epigastric region, worsening after meals, sometimes accompanied by nausea, intermittent dull pain, fatigue, shortness of breath, reluctance to speak, poor appetite, pale complexion, loose stools 2-3 times a day, and cold extremities. His tongue is pale and dark, enlarged with teeth marks on the edges, and has a white, greasy coating. His pulse is deep, thready, and weak.

[0093] Physical examination: The abdomen was flat and soft, with tympanic sound on percussion of the epigastric region and no obvious tenderness. The patient was thin, pale, and had cold extremities.

[0094] Western medicine diagnosis: Chronic atrophic gastritis (Type C-2, with moderate intestinal metaplasia and low-grade intraepithelial neoplasia).

[0095] Traditional Chinese Medicine diagnosis: Stomach fullness (spleen and stomach qi deficiency syndrome).

[0096] Treatment: Nourish the blood vessels and replenish deficiencies, clear toxins and resolve atrophy.

[0097] Prescription (initial consultation): 15g of Anoectochilus roxburghii, 10g of Ampelopsis japonica, 20g of Acanthopanax senticosus, 20g of Lilium brownii, 10g of Bletilla striata, 30g of Agrimonia pilosa, 9g of Citrus aurantium, 6g of Impatiens balsamina, and 20g of roasted barley malt. 14 doses, one dose per day, decocted in water to obtain 400ml of juice, taken warm twice a day after breakfast and dinner.

[0098] Second visit (September 3, 2024): The patient's epigastric fullness was relieved, and the severe bloating after meals was better than before. The patient could eat semi-liquid foods, and the frequency of dull pain decreased. However, the patient remained fatigued, had cold hands and feet, and loose stools, 1-2 times daily. The tongue was pale and dark, swollen, with a thinner, white, greasy coating than before. The pulse was deep and thready. Considering that spleen and stomach qi deficiency remained the primary pathogenesis, the patient continued to take the initial prescription for 14 doses without adding any additional medication.

[0099] Third visit (September 17, 2024): The patient's mental state has significantly improved, the epigastric fullness has basically disappeared, and the patient can eat soft foods normally. Occasional dull pain and fatigue have significantly improved, the hands and feet are warm, and bowel movements are formed once a day. The tongue is pale red, and the swelling has significantly improved; the coating is thin and white, and the pulse is thready and forceful. A follow-up gastroscopy showed that the gastric mucosal atrophy has improved from +++ to ++; pathology showed mild to moderate atrophy of the gastric antrum mucosa, intestinal metaplasia has improved from moderate to mild, and focal low-grade intraepithelial neoplasia has disappeared. Continue taking the initial prescription for 14 doses.

[0100] Fourth consultation (October 1, 2024): The patient's symptoms had basically disappeared, appetite was normal, bowel movements were regular, and weight had increased by 1.5 kg. The tongue was pale red with a thin white coating, and the pulse was thready. Follow-up pathology showed mild atrophy of the gastric antrum mucosa, with no obvious intestinal metaplasia or neoplasia. Considering the stagnation had subsided, the dosage of Acute Herbal Extract was adjusted to 3g, while the remaining medications remained as prescribed at the initial consultation. The patient continued this regimen for 14 doses, followed by one dose every other day for one month to consolidate the treatment. At the 6-month follow-up, gastroscopy showed that the atrophy remained mildly stable, and no recurrence of neoplasia was observed.

[0101] Commentary: This case involves a 69-year-old patient with a 12-year history of chronic gastritis, exhibiting atrophy (+++), moderate intestinal metaplasia, and focal low-grade intraepithelial neoplasia. This represents a severe stage of chronic atrophic gastritis in the elderly, characterized by "prolonged atrophy leading to toxicity and damage to the gastric collaterals." Symptoms included epigastric fullness, nausea after eating, fatigue, shortness of breath, poor appetite, loose stools, cold hands and feet, a pale, dark, swollen tongue with a white, greasy coating, and a weak, thready pulse. These symptoms indicate that the underlying cause is a deficiency of spleen and stomach qi and yang, leading to impaired digestion and the accumulation of dampness and food stagnation. Prolonged illness further obstructs the collaterals, causing dampness, food stagnation, and blood stasis to combine and eventually form "the root toxicity." This toxicity accumulates in the gastric collaterals, causing glandular malnutrition and collateral damage, resulting in severe atrophy, intestinal metaplasia, and neoplasia. This constitutes a typical closed loop of "extreme deficiency leading to atrophy—prolonged atrophy leading to toxicity—toxicity damaging the gastric collaterals—collateral damage further weakening." The treatment adhered to the principle of "tonifying deficiency and nourishing the collaterals, clearing toxins and resolving atrophy," using *Anoectochilus roxburghii* to comprehensively tonify deficiency, clear toxins, and unblock the collaterals; *Acanthopanax senticosus* and *Agrimonia pilosa* to strengthen the body's resistance and boost qi; *Ampelopsis japonica* and *Bletilla striata* to clear toxins and protect the membranes; *Impatiens balsamina* and *Impatiens balsamina* to open blockages and relieve stagnation; and roasted barley malt to strengthen the spleen and aid digestion. Considering the patient's advanced age and weak constitution, although the pathology was severe, a strong attack was not used, but rather a mild combination of herbs was used to gradually resolve the blockages. At the second visit, dampness and turbidity decreased, and digestion returned to normal. At the third visit, the tumor had disappeared and shrunk, and intestinal metaplasia had decreased. At the fourth visit, after most symptoms had disappeared, the dose of *Impatiens balsamina* was reduced to 3g, reflecting the principle of "reducing the attacking medicine as the pathogenic factors decrease, and consolidating the foundation to prevent recurrence as the body's resistance recovers." This case demonstrates that even severely ill elderly patients should be treated with tonifying the body's resistance as a prerequisite for clearing toxins and unblocking the collaterals, and the ratio of attacking to tonifying should be adjusted promptly as the pathogenesis changes from excess to deficiency, so as to both resolve atrophy and restore the membranes, and avoid depleting the stomach's qi.

[0102] The above description is a preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

Claims

1. A traditional Chinese medicine composition for treating spleen and stomach qi deficiency syndrome in elderly patients with chronic atrophy (CAG), characterized in that, The stomach-protecting and atrophic traditional Chinese medicine composition consists of the following raw materials in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-15 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-15 parts of Bletilla striata, 20-35 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 3-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt.

2. The traditional Chinese medicine composition for treating spleen and stomach qi deficiency syndrome in elderly patients with chronic atrophic angina pectoris (CAG) according to claim 1, characterized in that, The stomach-protecting and atrophic traditional Chinese medicine composition consists of the following raw materials in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-10 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-10 parts of Bletilla striata, 25-30 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 5-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt.

3. The traditional Chinese medicine composition for treating spleen and stomach qi deficiency syndrome in elderly patients with chronic atrophy (CAG) according to claim 1, characterized in that, The stomach-protecting and atrophic traditional Chinese medicine composition consists of the following raw materials in parts by weight: 15 parts of Anoectochilus roxburghii, 10 parts of Ampelopsis japonica, 20 parts of Acanthopanax senticosus, 20 parts of Lilium brownii, 10 parts of Bletilla striata, 30 parts of Agrimonia pilosa, 9 parts of Aconitum carmichaelii, 6 parts of Impatiens balsamina, and 20 parts of roasted barley malt.

4. The use of the traditional Chinese medicine composition for treating spleen and stomach qi deficiency syndrome in elderly patients with chronic atrophic angina pectoris (CAG) as described in any one of claims 1 to 3 in the preparation of a medicament for treating spleen and stomach qi deficiency syndrome in elderly patients with CAG.

5. The application according to claim 4, characterized in that, The dosage form of the drug for treating elderly patients with chronic atrophic gastroenteritis (CAG) due to spleen and stomach qi deficiency is an oral preparation, which is selected from any one of granules, tablets, capsules, powders, decoctions, or pills.

6. A decoction for treating elderly patients with CAG due to spleen and stomach qi deficiency, characterized in that, The decoction is composed of the following ingredients in parts by weight: 10-15 parts of Anoectochilus roxburghii, 6-15 parts of Ampelopsis japonica, 15-20 parts of Acanthopanax senticosus, 15-20 parts of Lilium brownii, 6-15 parts of Bletilla striata, 20-35 parts of Agrimonia pilosa, 6-9 parts of Citrus aurantium, 3-6 parts of Impatiens balsamina, and 15-20 parts of roasted barley malt. The decoction is prepared as follows: place all the herbs in a container, add cold water to soak, then bring to a boil over high heat, then simmer over low heat for 30-40 minutes, and filter the decoction; add water to the dregs and simmer for another 20-30 minutes, then filter the decoction; mix the two decoctions evenly to obtain the final product.

Images