To investigate the impact of cell senescence(CS) on gastric mucosal intestinal metaplasia(IM) and its regulatory mechanisms，providing new insights for the prevention and treatment of IM using traditional Chinese medicine(TCM).Methods:Core gene sets for the co-expression of CS and IM were downloaded and constructed from public databases.The correlation between CS and IM was analyzed using immune infiltration analysis，functional enrichment analysis，gene correlation analysis，and protein-protein interaction networks.The Coremine Medical platform was used to map effective Chinese medicines for treating IM and to statistically analyze their therapeutic properties，flavor，nature，and meridian tropism.Results:Immune infiltration analysis showed that the level of plasma cell infiltration in the IM group was significantly higher than that in the normal group(P=0.025 4).Functional enrichment analysis indicated that the 80 core differential genes co-expressed between IM and CS were mainly enriched in CS-related pathways，including NAD biosynthesis，cell fate，and transcriptional dysregulation in cancer.Ten hub genes(CEBPA，LGALS3，ANPEP，etc.) co-expressed between IM and CS were identified，and the expression of these hub genes showed a certain degree of correlation with IM-related marker genes(P<0.05).Chinese medicine prediction analysis identified 56 potential Chinese medicines for treating IM，involving 11 meridians，with Arnebiae Radix appearing most frequently(2 times).The Chinese medicines were categorized into 33 efficacy groups，with the highest frequency of usage in “wind-extinguishing and convulsions-stopping” drugs(6 times)，followed by “qi-tonifying”“blood-activating and stasis-removing”，and “heat-clearing and blood-cooling” drugs(all 4 times).Conclusion:Chronic persistent inflammation mediated by CS promotes the occurrence and development of IM.The hub genes co-expressed between IM and CS may interact with IM-specific molecular markers by activating inflammation-related CS，thus facilitating the progression of IM.The “tonifying the spleen，resolving stasis，and removing toxin” method is an effective approach in TCM for treating IM.