OBJECTIVE： To provide reference for clinical treatment of precancerous lesions of gastric cancer. METHODS： A total of 685 patients with precancerous lesions of gastric cancer were selected from our hospital during Jan.-Dec. 2018. Totally 455 patients in treatment group received individualized TCM therapy according to syndrome differentiation， 7 days as a course， 4 courses in total； another 230 patients in control group received Folic acid tablets， 5 mg， tid， for 2 months. The changes of pepsinogen ratio （PGⅠ/PGⅡ）， gastrin-17 （G-17） and Helicobacter pylori （Hp）before and after treatment， and the occurrence of ADR were compared between 2 groups. RESULTS： After treatment， total response rate of treatment group was 90.3％， which was significantly higher than 68.6％ of control group. PGⅠ/PGⅡ of treatment group were increased significantly， which was significantly higher than control group； G-17 levels of 2 groups were decreased significantly （P＜0.05）； there was no statistical significance in Hp level between 2 groups before and after treatment （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： Chinese medicine syndrome differentiation individual therapy can significantly delay the development of precancerous lesions of gastric cancer， and has good safety.