Objective To investgate the effect of “Tiaohezhizhong”acupuncture combined with Chinese medcine on chronic atrophic gastritis(CAG) with intestinal metaplasia(IM).Methods 80 patients dignosised as CAG with IM were selected as the reserch objects and divided into observe group and control group by random table mathod. Acupuncture combined with heber were used in observe group, and Weifuchun pills was given to patients in control group. After 6 months of treatment and 1 year after follow-up, the changes in TCM symptoms integrals, clinical efficacy, gastric mucosal microscopic signs, pathological changes and follow-up recurrences before and after treatment were compared between the two groups.Results After six months of treatment,compared with the TCM symptoms integral, mucosal sign integral and gastric mucosal pathology integral within the group, the difference was statistically significant (P<0.05), and the difference was statistically significant compared with the observe group, and the reduction of TCM syndrome integral, mucosal sign integral and gastric mucosal pathology integral was better than that of the control group, and the difference was statistically significant(P<0.05).After one year,compared with the TCM syndrome integral, mucosal sign integral and gastric mucosal pathology integral within the group, the difference was statistically significant (P<0.05),In the control group, compared with gastric distension and/or pain and belching pantothenic acid, granular (nodule) and erosion integral, inflammation and enteration integral compared to before treatment(P>0.05).The difference between gastric noise and diet reduction, mucosal folds, vascular translucency and bleeding was statistically significant (P<0.05) compared with the observe group, and the reduction of TCM syndrome scores, mucosal signs, inflammation and enteratination scores was better than that in the control group compared with the observe group (P<0.05).Conclusion For patients with CAG and IM, “Tiaohezhizhong”acupuncture and atrophy biochemical decoction can significantly improve their clinical symptoms, and even delay or reverse the endoscopic mucosal and pathological manifestations to a certain extent, and can effectively reduce the recurrence rate.