Clinical Observation of 52 Cases of <i>Helicobacter pylori</i> -Positive Chronic Atrophic Gastritis (Spleen–Stomach Damp-Heat Syndrome) Treated with Acupuncture Combined with Qinghua Tongjiang Decoction

Objective To evaluate the clinical efficacy of acupuncture combined with Qinghua Tongjiang decoction on Helicobacter pylori (Hp)-positive chronic atrophic gastritis (CAG). Methods Fifty-two patients with Hp-positive CAG, admitted between October 2023 and October 2025, were retrospectively assigned to two groups. The control group received Qinghua Tongjiang decoction alone, while the observation group received acupuncture combined with Qinghua Tongjiang decoction. Both groups underwent continuous treatment for 3 months. The total effective rate and Hp-negative conversion rate were calculated. Differences in pepsinogen I (PGI), gastrin-17 (G-17), pepsinogen II (PGII), mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) signaling pathway indicators, gastric mucosal pathological scores, etc. were compared between the two groups. Results There was no statistically significant difference in the total effective rate and Hp-negative conversion rate between the two groups ( P &gt; 0.05). For PGI, PGII, and G-17, significant main effects of time and group, as well as a significant time-by-group interaction, were observed ( P &lt; 0.05). Intra-group comparisons showed that PGI levels increased at 4 weeks and 12 weeks of treatment compared with pre-treatment levels in both groups, while PGII and G-17 levels decreased ( P &lt; 0.05). Intergroup comparisons revealed that the observation group had higher PGI levels and lower PGII and G-17 levels at both 4 and 12 weeks compared with the control group ( P &lt; 0.05). The time-by-group interaction indicated different change trends in PGI, PGII, and G-17 ( P &lt; 0.05). Before treatment, there was no significant difference in MAPK/ERK signaling pathway indicators or gastric mucosal pathological scores between the two groups ( P &gt; 0.05). After 12 weeks of treatment, both groups showed a decrease in MAPK mRNA, ERK mRNA, and glandular atrophy scores compared with baseline, with the observation group demonstrating lower levels than the control group ( P &lt; 0.05). Conclusion The combination of acupuncture and Qinghua Tongjiang decoction in treating Hp-positive CAG (spleen–stomach damp-heat syndrome) can regulate the MAPK/ERK signaling pathway, modulate PGI and G-17 levels, and improve gastric mucosal pathological scores, but no significant improvement was observed in intestinal metaplasia or dysplasia scores.