To observe the expression changes of HIF-1α and glycolysis enzymes in gastric mucosa of rats with chronic atrophic gastritis (CAG) and explore the mechanism of indirect moxibustion on CAG.Methods:Male Wistar rats were randomly divided into a normal group and an experimental group.The CAG model was induced in the experimental group by administration of MNNG （170 mg/L）.The model rats were then randomly divided into a model group，a herb-partitioned moxibustion (HM) group，a ginger-partitioned moxibustion (GM) group，and a western medicine (WM) group，with six rats in each group.“Zhongwan” (CV 12) and “Qihai” (CV 6) were selected for indirect moxibustion in the HM group and the GM group.The folic acid suspension was administered to the rats in the WM group by gavage.The histopathological changes of gastric antrum were observed by HE staining.The mRNA expression of STAT3，PKM2 and HIF-1α in the gastric mucosa was detected by RT-qPCR，and the protein expression of STAT3 and HIF-1α was detected by immunohistochemistry.The activities of LDH and PKM2 were determined by colorimetry and ELISA.Results:Compared with the normal group，the model group showed the structural disorder of inherent glands，reduced glands，atrophy，intestinal metaplasia，pseudopyloric metaplasia，and/or dysplasia in the gastric mucosa.Furthermore，the mRNA expression of HIF-1α，STAT3，and PKM2 in the gastric mucosa was up-regulated (P<0.05)，the protein expression of STAT3 and HIF-1α was elevated (P<0.05)，and the enzyme activities of LDH and PKM2 were potentiated in the model group (P<0.05).Compared with the model group，the HM group，the GM group，and the WM group showed the regular arrangement of inherent glands，and relieved inherent gland atrophy，intestinal metaplasia，and dysplasia.Compared with the model group，the HM group and the GM group displayed down-regulated mRNA and protein expression levels of HIF-1α and STAT3 in the gastric mucosa (P<0.05)，and weakened enzyme activities of LDH and PKM2 (P<0.05).Conclusion:Indirect moxibustion at “Zhongwan” (CV 12) and “Qihai” (CV 6) can improve the histological changes of the gastric antrum and repair gastric mucosa damage in rats with CAG，and the mechanism of indirect moxibustion in the treatment of CAG may be related to the inhibition of abnormal glycolysis mediated by HIF-1α.