Association of Warm Acupuncture at Zusanli (ST36) and Zhongwan (CV12) Combined with Xiaozhang Hewei Decoction With Clinical Outcomes in Chronic Gastritis: A Retrospective Cohort Study

Objective To evaluate the association between warm acupuncture at Zusanli (ST36) and Zhongwan (CV12) combined with Xiaozhang Hewei decoction (XHD) and clinical outcomes in patients with chronic gastritis (CG) using a retrospective cohort design. Methods This retrospective cohort study included 165 patients with CG (January 2024–December 2025), categorized into observation ( n = 83, warm acupuncture + XHD) or control ( n = 82, XHD alone) groups. The primary inferential outcomes were the baseline-adjusted between-group differences in symptom score and serum gastrin-17 at week 4. Secondary outcomes included ≥50% symptom reduction. Data were extracted from records at baseline, week 2, week 4, and week 8. Linear mixed-effects models adjusted for baseline values, age, sex, Helicobacter pylori history, and disease duration. Results Baseline characteristics were comparable despite nonrandomized allocation. At week 4, the observation group showed greater reductions in symptom scores (adjusted mean difference: −5.2; 95% confidence interval [CI]: −6.8 to −3.6; p < 0.001) and gastrin-17 (adjusted mean difference: −5.4 pg/ml; 95% CI: −7.5 to −3.3; p < 0.001). The proportion achieving ≥50% symptom reduction was 62.7% (52/83) in the observation group compared with 37.8% (31/82) in the control group (risk difference: 24.8%; 95% CI: 10.1%–39.6%; p = 0.001). Among the included treatment completers, no serious adverse events were documented in the available records. Conclusion In this retrospective cohort, the addition of warm acupuncture to XHD correlated with favorable changes in symptom scores and gastrin-17 levels. However, due to the nonrandomized design, these results are preliminary and strictly hypothesis-generating. Confirmation via prospective randomized trials is warranted before any clinical application.