Tong YL, Bian QY, Zheng HX, Xiao JD. Clinical efficacy and mechanisms of Astragalus membranaceus, active components, and herbal formulas for chronic atrophic gastritis. World J Gastroenterol 2026; 32(47): 124712 [DOI: 10.3748/wjg.124712]
Corresponding Author of This Article
Hong-Xin Zheng, PhD, Professor, School of Basic Medical Sciences, Liaoning University of Traditional Chinese Medicine, No. 79 Chongshan East Road, Shenyang 110032, Liaoning Province, China. zhenghx2002@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yu-Lian Tong, Qi-Yan Bian, The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Hong-Xin Zheng, School of Basic Medical Sciences, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Jing-Dong Xiao, Party Committee Office, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Co-corresponding authors: Hong-Xin Zheng and Jing-Dong Xiao.
Author contributions: Tong YL and Bian QY wrote the entire manuscript; Xiao JD and Zheng HX revised and reviewed the final manuscript, and both authors contribute equally to this study as co-corresponding authors. All authors approved the final version to publish.
AI contribution statement: AI tools, specifically DeepSeek-V4-Flash, were used solely for language polishing and formatting assistance. No AI tool was used to generate research data, interpret results, or formulate conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Supported by National Science and Technology Major Project, No. 2024ZD0521002; General Program of the National Natural Science Foundation of China, No. 82074296; Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China, No. [2022]75; and Innovation Team Project of Traditional Chinese Medicine of Liaoning Province, No. LNZYYCXTD-CCCX-003.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Hong-Xin Zheng, PhD, Professor, School of Basic Medical Sciences, Liaoning University of Traditional Chinese Medicine, No. 79 Chongshan East Road, Shenyang 110032, Liaoning Province, China. zhenghx2002@126.com
Received: June 23, 2026 Revised: July 25, 2026 Accepted: August 18, 2026 Published online: December 21, 2026 Processing time: 127 Days and 3.7 Hours
Abstract
Chronic atrophic gastritis (CAG) is a gastric disease characterized by atrophy of the gastric mucosal glands and fibrosis of the lamina propria. Regarded as a recognized precancerous lesion preceding gastric cancer, CAG requires early intervention to prevent malignant progression. As a widely used herbal remedy in traditional Chinese medicine, Astragalus membranaceus (Huangqi) is abundant in a variety of bioactive compounds, such as polysaccharides, saponins, and flavonoids. Astragalus membranaceus-based herbal formulas have demonstrated remarkable clinical efficacy for CAG treatment. The underlying mechanisms primarily include eradicating Helicobacter pylori, modulating immunity, protecting the gastric mucosa, alleviating inflammatory responses, regulating gastrointestinal microbiota, and mitigating oxidative stress, thereby effectively delaying disease progression. This review systematically examined the classical records on Astragalus membranaceus and overviewed the recent therapeutic effects and pharmacological mechanisms of its formulas and active constituents in treating CAG. Based on this comprehensive analysis, it aims to establish a scientific basis and theoretical framework to support the clinical application of traditional Chinese medicine and the development of novel therapeutics strategies for CAG.
Core Tip: Chronic atrophic gastritis carries the risk of malignant transformation into gastric cancer, posing a severe threat to patient health. Astragalus membranaceus and its herbal formulas have demonstrated remarkable efficacy in the treatment of chronic atrophic gastritis. The underlying mechanisms primarily involve eradication of Helicobacter pylori, modulation of immunity, alleviation of inflammatory responses, mitigation of oxidative stress, and protection of the gastric mucosa.
