To analyze the distribution of different Traditional Chinese Medicine (TCM) syndromes of chronic atrophic gastritis and summarize its relationship with the changes of gastric mucosa morphology and pathological changes and provide an objective basis for clinical syndrome differentiation.Methods:A total of 230 patients with chronic atrophic gastritis admitted to our department for gastroenterology and ward in the recent 5 years were diagnosed based on syndrome differentiation and classified according to the Consensus of diagnosis and treatment of chronic atrophic gastritis combined with traditional Chinese and western medicine issued by the Chinese Medical Association in 2011.The patients' age, sex, gastroscope changes and pathological features were classified and graded.SPSS 20.0 software was used to conduct statistical analysis of the above data, and the difference was statistically significant at P<0.05.Results: In 230 cases of patients, there were 130 female cases, 100 male cases, aged 18-85 years, with an average (54.25±14.25) years old.145 cases in 41 to 60 years age, accounted for 63.04%, of which 51-60 years old had the largest number of cases.The incidence was higher than other age groups.After testing, there was no significant difference in sex distribution between men and women of all ages (P>0.05). In 230 cases, there were 81 cases with spleen and stomach weakness, accounting for 35.22%; 69 cases with liver and spleen incompatibility, accounting for 30%; 46 cases with spleen and stomach dampness heat, accounting for 20%; 30 cases of stomach yin insufficiency, accounting for 13.04%; 4 cases of blood stasis in stomach, accounting for 1.74%. Comparison of degree of atrophy under gastroscopy：Grade I-There was a significant difference between each syndrome type (P<0.05).There was a statistically significant difference between spleen and stomach weakness and liver and spleen incompatibility (P<0.05), spleen and stomach weakness and stomach yin insufficiency (P<0.05), but there was no significant difference between liver and spleen incompatibility, spleen and stomach dampness heat and stomach yin insufficiency (P>0.05).There was no statistically significant difference between Grade II, Grade II and other syndromes (P>0.05).Gastroscopy showed a simple change of atrophy, but also with hemorrhage, hyperplasia, erosion, bile reflux, without significant difference between the various syndromes (P>0.05). Gastric mucosal pathological features were divided into 3 grades of mild, moderate and severe, there was statistically significant difference between mild and other syndromes (P<0.05), of which the incidence of spleen and stomach weakness and spleen and stomach dampness heat were the highest.There was no significant difference between these two syndromes (P>0.05).There was a significant difference between the spleen and stomach weakness and stomach yin insufficiency (P<0.05), but there was no significant difference between liver and spleen incompatibility and stomach yin insufficiency (P>0.05).There was significant difference between mild and other syndromes (P<0.01).There was a similar incidence for liver and stomach incompatibility, stomach yin insufficiency, and spleen and stomach dampness heat (P>0.05).There was significant difference between spleen and stomach weakness and blood stasis in stomach (P<0.05).There was significant difference between severe and other syndromes (P<0.01).There was significant difference between liver and spleen incompatibility and stomach yin insufficiency (P<0.05), while there was no significant difference between spleen stomach deficiency and stomach yin insufficiency (P>0.05).Conclusion:Chronic atrophic gastritis is characterized by spleen and stomach weakness, liver and spleen incompatibility, spleen stomach dampness heat, stomach yin insufficiency and blood stasis in stomach.There are some differences between the different forms of gastroscopy and pathological changes of mucosa.