Objective To observe the clinical effect and possible mechanism of Xiaoguishao Huazhuo Jiedu Decoction（ 小归芍化浊解毒方） on pepsinogen of the patients with gastric precancerous lesions and syndrome of interior retention of turbidity and toxin. Methods A total of 102 patients were randomly divided into a treatment group and a control group

with 51 patients in each group. The treatment group was given Xiaoguishao Huazhuo Jiedu Decoction

and the control group was given Weifuchun tablets both for 3 months. The changes of clinical symptoms

scores of mucosal lesion under gastroscopy

scores of pathology

were observed before and after the treatment. The levels of serum pepsinogen Ⅰ

pepsinogen Ⅱ and pepsinogen ratio（ PGR） were examined. Results The scores of symptoms in the treatment group were reduced after treatment（ P < 0. 05）

and the reduciton of scores of gastric pain

stomach distention

belching

gastric discomfort

insomnia

and cool stomach was more significant than that of the control group（ P < 0. 05）. The score of mucosal lesions in the treatment group decreased（ P < 0. 05）. The changes of score of leukoplakia or versicolor mucosa

and the blood vessel penetration and the bulge nodules in the treatment group was superior to that in the control（ P < 0. 05）. The improvement of scores of atrophy and intestinal metaplasia in the treatment group was better than that of the control group（ P < 0. 05）. The levels of pepsinogenⅠ and PGR in both groups were higher than those before treatment

and the treatment group was superior to the control group（ P < 0. 05）.Conclusion Xiaoguishao Huazhuo Jiedu Decoction in the treatment of gastric precancerous lesions and syndrome of interior retention of turbidity and toxin

can not only improve clinical symptoms

but also improve pathological conditions

whose mechanism might be regulating pepsinogen levels.