Objective To understand the distribution features of traditional Chinese medicine（ TCM） syndromes and syndrome elements in the precancerosis of chronic atrophic gastritis（ CAG）. Methods By searching literatures on CAG and gastric precancerous lesions related syndromes and syndrome elements published in domestic database. The included literature was from the begining of the database built to October 31

2018. The literatures were screened according to including and exclusion criteria. The canceration process of CAG was divided into 3 phrases of CAG

CAG with intestinal metaplasia（ IM） and CAG with intraepithelial neoplasi（ IN）. Syndromes and syndrome elements of these phrases were collected and recorded into the database and then this paper maperformed a statistical analysis. Results A total of 33 papers with syndromes and syndrome elements and 9261 reported cases were enrolled. It was found that the basic syndromes of the process of precancerosis of CAG were qi deficiency of the spleen and stomach

heat and dampness of the spleen and stomach

yin deficiency of the stomach

disharmony of the liver and the stomach

stasis obstructing the stomach and yang deficiency of the spleen and stomach

and the syndrome mentioned above had statistical significance in the 3 phrases of the precancerosis of CAG（ P < 0. 05）. Among them

qi deficiency of the spleen and stomach

yin deficiency of the stomach and disharmony of the liver and the stomach were common in the phrase of CAG. Heat and dampness of the spleen and stomach was common in the phrase of CAG with IM. Stasis obstructing the stomach and yang deficiency of the spleen and stomach were common in CAG with IN.The major syndrome elements of disease location were stomach

spleen and liver. The major nature of the disease of the syndrome elements were qi deficiency

qi stagnation

heat

yin deficiency

dampness

static blood and yang deficiency. Among them

syndrome elements of qi deficiency and qi stagnation could be seen in the 3 phrases while syndrome elements of heat

yin deficiency

dampness

static blood and yang deficiency all had statistical significance in the 3 phrases of the precancerosis of CAG（ P < 0. 05）. Among them

syndrome element of yin deficiency was common in the phrase of CAG. Syndrome elements of heat and dampness were common in the phrases of CAG and CAG with IM. Syndrome elements of static blood and yang deficiency were common in the phrases of CAG with IN. Conclusion In the process of the precancerosis of CAG

the syndrome and syndrome elements evolution rule of "intermingled deficiency and excess

from deficiency to excess

from excess to deficiency"was present. Qi deficiency of the spleen and stomach is the basic pathogenesis characteristic. Syndrome elements of qi deficiency and qi stagnation can be seen in the whole phrases of the disease. The disease location is in the stomach

related to the liver and spleen.