Introduction: Chronic atrophic gastritis (CAG) is characterized by mucosal atrophy and microbiota dysregulation. This study evaluated the efficacy of an integrative therapy combining conventional treatment with a qi-tonifying, yin-nourishing, and blood-activating formula (Yiqi Yangyin Huoxue), examining its effects on gastric function, inflammation, and gut microbiota. Methods: In a randomized controlled trial, 120 CAG patients were allocated to a treatment group (integrative therapy) or a control group (conventional therapy) for 12 weeks, with an 8-week follow- up. Outcomes were assessed at weeks 0, 4, 8, 12, and 20. Primary outcomes included the Gastric Mucosal Restoration Index (GMRI), Qi-Blood Functional Score (QBFS), and Inflammatory- Immune Regulation Index (IIRI). Secondary outcomes encompassed gastrointestinal motility, nutritional markers, symptom scores, and gut microbiota metrics (16S sequencing, SCFAs, LPS). Results: The treatment group demonstrated significantly greater improvements across all primary indices (GMRI, QBFS, IIRI), showing strong time, group, and interaction effects (all P < 0.001). Superior outcomes were also observed in gastric emptying, pancreatic enzyme activity, prealbumin levels, and symptom relief (65–68% vs. 28–30% "much improved" on PGI-I). Microbiota analysis revealed enhanced α-diversity, a reduced Firmicutes/Bacteroidetes ratio, distinct β-diversity shifts, increased SCFAs, and decreased LPS in the treatment group (all P < 0.001). Efficacy was consistent across subgroups. Conclusion: Integrative therapy provides superior clinical, functional, and microbiotamodulating benefits in CAG, supporting a coordinated “stomach–intestine–immune–microbiota– metabolism” regulatory mechanism.
Cheng et al. (Thu,) studied this question.