Chronic Atrophic Gastritis

Depressive symptoms are highly prevalent in patients with chronic atrophic gastritis (CAG) but are frequently under-detected due to stigma and reliance on subjective questionnaires. This multicenter, cross-sectional observational study aims to validate a novel clinical triage workflow. It repurposes routine vascular assessments (specifically dorsalis pedis artery ultrasound and arterial stiffness metrics) as objective "biological entry points" to facilitate mental health referrals. The study will enroll approximately 450-520 adults with histologically confirmed CAG across four clinical centers in China. The primary objective is to determine the diagnostic accuracy of these vascular biomarkers for identifying patients with moderate-to-severe depressive symptoms (PHQ-9 score \>= 10). Secondary objectives include evaluating the implementation feasibility (e.g., referral uptake, screening completion rate) of this integrated care model in routine gastroenterology practice.

Brief Summary Template for the Study: This clinical trial aims to evaluate whether electroacupuncture can treat chronic atrophic gastritis (CAG) in adult subjects aged 18 to 75 years (including both males and females), all of whom have been diagnosed with CAG based on endoscopic and histopathological criteria. The primary objectives of this study are to answer the following questions: * Can 5 Hz electroacupuncture therapy reverse the pathological state of the gastric mucosa in patients with chronic atrophic gastritis? * Can 5 Hz electroacupuncture therapy improve gastrointestinal symptoms in patients with chronic atrophic gastritis? * Is there a difference in efficacy between the combination of 5 Hz electroacupuncture therapy and gastric mucosa protectants versus the use of gastric mucosa protectants alone in the treatment of chronic atrophic gastritis? Researchers will compare the effects of 5 Hz electroacupuncture combined with gastric mucosal protectants versus gastric mucosal protectants alone to determine which method can reverse the pathological state of gastric mucosa and provide more significant symptom relief. Participants will: * Receive acupuncture treatment at specific acupoints (such as Shangwan(CV13), Zhongwan (CV12) ,Xiawan(CV10), Liangmen (ST21), Tianshu (ST25), Zusanli (ST36), and Xiajuxu (ST39).) Electroacupuncture is administered at the abdominal points 'CV13-CV12' and 'ST21-ST21', alongside bilateral lower limb points 'ST36-ST39', using an SDZ-IIB handheld electroacupuncture device (Huatuo brand, Suzhou Medical Supplies Factory Co., Ltd.). Receive electroacupuncture treatment at 5Hz.for 30-minute sessions, three times weekly for 1-8 weeks; twice weekly from weeks 9 to 16, once weekly from weeks 17 to 24, for a total of 24 weeks, comprising 48 treatment sessions. * Be randomly assigned to one of the following groups: 5 Hz electroacupuncture combined with gastric mucosal protective agent group or gastric mucosal protective agent group (control group). * Have their dyspepsia symptoms, quality of life, and any adverse reactions continuously monitored and assessed throughout the study period.

Chronic atrophic gastritis with intestinal metaplasia or dysplasia is called precancerous lesions of gastric cancer ( PLGC ). It is an important stage in the transformation of normal mucosa to gastric cancer and is significantly associated with the risk of gastric cancer. Early identification of PLGC high-risk groups is the focus of prevention and treatment of gastric cancer. Gastroscopy and pathological examination are the key means to diagnose PLGC. However, due to the invasiveness, high cost, strong professional operability and traumatic pathological sampling, the application of gastroscopy is greatly limited, and the predictive significance of serum markers for the occurrence and prognosis of PLGC is limited. The current PLGC monitoring methods are not targeted enough, and there is still a lack of effective risk prediction models for PLGC. New screening methods are needed to improve the early diagnosis rate of PLGC. Tongue diagnosis is simple, convenient, easy and inexpensive. It can dynamically monitor the risk of PLGC in patients with chronic atrophic gastritis in early real time, and timely formulate individualized intervention measures, which is of great significance for improving the prognosis of patients, controlling medical expenses and truncating disease progression. Based on the objectification of tongue diagnosis, it may become an important method for screening PLGC from the perspective of macroscopic tongue image characteristics and microscopic tongue coating flora.