Objective To examine the evolution of TCM patterns from Non-atrophic gastritis（ CSG） to atrophic gastritis（ CAG）. Methods We analyzed TCM patterns in 400 cases of chronic gastritis. χ2test was used to compare the evolution of TCM patterns from CSG to CAG. Results There were nine essential pattern elements for chronic gastritis

namely

Qi deficiency

Qi stagnation

dampness

heat

Yin deficiency

Yang deficiency

blood stasis

food accumulation

and cold. Eight basic pattern categories for chronic gastritis were liver-stomach disharmony

liver-stomach constraint heat

spleen cold and stomach heat

retention of heat in the interior

spleen-stomach weakness（ including Qi deficiency and yang deficiency）

phlegm obstructing the stomach collaterals

food accumulation

and stomach-Yin deficiency

respectively. Chi-square test showed that CSG was closely related to Qi deficiency

Qistagnation

heat

Yang deficiency

blood stasis

food accumulation and coldness while CAG was related to dampness

particularly to Yin deficiency. The correlation between nine essential pattern elements and Hp-positive CSG were: food accumulation > Heat > Yin deficiency; food accumulation > Qi stagnation> Yin deficiency; indigestion > coldness > Yin deficiency; food accumulation > dampness; blood stasis > dampness; Qi deficiency > Yin deficiency; Yang deficiency > Yin deficiency; blood stasis >Yin deficiency. Hp-positive CAG was just the opposite. Chi-square test also showed that stomach-Yin deficiency pattern was related to CAG and that CSG was related to other six basic pattern types except the pattern of heat retention in the interior. The correlation between the eight basic pattern categories and Hppositive CSG were: food accumulation > liver-stomach constraint heat > stomach-Yin deficiency; food accumulation > pattern of spleen-stomach weakness > stomach-Yin deficiency; food accumulation >accumulation of damp-heat; stasis obstructing stomach collateral > pattern of heat retention in the interior; liver-stomach disharmony > stomach-Yin deficiency; stasis obstructing stomach collaterals >stomach-Yin deficiency. Hp-positive CAG was just the opposite. Conclusion Food accumulation is the earliest TCM pattern in chronic gastritis

thereafter dampness

heat

and blood stasis. Pattern of heat retention in the interior and deficiency of Healthy Qi is present throughout the development of chronic gastritis. In CSG stage

excess of pathogenic factors is often dominant. Sometimes

deficiency and excess patterns may coexist. In CAG stage

deficiency of Healthy Qi is dominant.