{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:27:21Z","timestamp":1790771241297,"version":"4.1.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n \n Chronic atrophic gastritis (CAG) associated with\n Helicobacter pylori<\/jats:italic>\n (HP) infection is a common precancerous condition characterized by mucosal atrophy and gastrointestinal symptoms. Existing treatments show limited efficacy in symptom relief and are challenged by rising antibiotic resistance. Qingyoufang decoction (QYFD), a traditional Chinese herbal formula, is recommended for patients with spleen\u2013stomach damp\u2013heat syndrome (SSDHS), a common subtype of HP-positive CAG.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This real-world retrospective study enrolled 113 patients with HP-positive CAG and SSDHS from a single hospital between September 2021 and September 2024. Patients received either standard bismuth-containing quadruple therapy (\n n<\/jats:italic>\n \u202f=\u202f44) or the same regimen plus QYFD (\n n<\/jats:italic>\n \u202f=\u202f69) for 2\u202fweeks. Clinical efficacy was evaluated through HP eradication rates, SSDHS symptom scores, serum inflammatory markers (interleukin-6 [IL-6], interleukin-6 [IL-8], and tumor necrosis factor-alpha [TNF-\n \u03b1<\/jats:italic>\n ]), and 6-month symptom recurrence. Kaplan\u2013Meier analysis and Cox regression analysis were used to assess prognostic factors.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The HP eradication rate was significantly higher in the QYFD group than in the control group (92.75% vs. 79.55%,\n p<\/jats:italic>\n \u202f=\u202f0.038). The overall symptom improvement rate (cure + marked improvement + improvement) was also higher in the QYFD group (92.75%) than in the control group (79.55%,\n p<\/jats:italic>\n \u202f=\u202f0.033). In an exploratory subgroup analysis (\n n<\/jats:italic>\n =\u202f8 control,\n n<\/jats:italic>\n =\u202f13 QYFD), inflammatory cytokines (IL-6, IL-8, TNF-\n \u03b1<\/jats:italic>\n ) decreased in both groups, with a greater trend toward reduction in the QYFD group (\n p<\/jats:italic>\n &lt;\u202f0.05 for all). The 6-month symptom recurrence rate was lower in the QYFD group (15.87% vs. 37.14%,\n p<\/jats:italic>\n \u202f=\u202f0.017). The Cox regression analysis identified alcohol consumption (HR\u202f=\u202f8.681, 95% CI: 1.070\u201370.413,\n p<\/jats:italic>\n \u202f=\u202f0.043) and severe atrophy (HR\u202f=\u202f26.536, 95% CI: 3.390\u2013207.735,\n p<\/jats:italic>\n \u202f=\u202f0.002) as independent risk factors for recurrence, while QYFD treatment was a protective factor (HR\u202f=\u202f0.318, 95% CI: 0.107\u20130.840,\n p<\/jats:italic>\n \u202f=\u202f0.038).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n QYFD, as an adjunct to standard therapy, was associated with higher HP eradication rates, better symptom improvement, and lower symptom recurrence in patients with HP-positive CAG. A small exploratory subgroup suggested a potential reduction in inflammatory cytokines, which should be interpreted with caution. Further prospective studies are warranted to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1701915","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:19:57Z","timestamp":1768205997000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of adjunctive Chinese herbal decoction in treating Helicobacter pylori\u2013positive chronic atrophic gastritis: a real-world retrospective 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