Epigastric Pain Syndrome
Terms
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Clinical Manifestations:
Acute severe epigastric pain (sudden onset), chilliness, desire for warmth on stomach, no thirst, desire for warm drinks, pain not alleviated by pressure, nausea, vomiting
Tongue: thick-white coat
Pulse: Full -
Cold Invading the Stomach
Scatter Cold, warm Stomach, stop pain -
Acupuncture:
ST-21: excess St pattern
ST-34: Accumulation point, stop pain
SP-4: obstructions in epigastrium, stop pain
Ren-13: nausea & vomiting
Herbal:
Sheng Jiang Hong Tang Tang: scatter cold & -
Cold Invading Stomach
Treatment -
Clinical Manifestations:
Dull epigastric pain (worse with pressure), distention & fulness, belching, sour regurgitation, foul breath, vomiting (undigested food), better after vomiting, loose stools or constipation
Tongue: thick-sticky -
Retention of Food
Dissolve accumulation, eliminate stagnation, & restore the descending of Stomach Qi -
Acupuncture:
Ren-13: subdue rebellious qi
Ren-10, descend St. Qi
ST-21: excess stomach patterns, stop pain
ST-20: Dissolve food accumulations
ST-44, ST-45: distal for St. excess
SP-4, PC-6: excess St. patterns with obstructi -
Retention of Food
Treatment -
Clinical Manifestations:
Epigastric distress & pain radiating towards the right or left hypochondrium, belching, sighing, irritability, uncomfortable feeling of hunger, pain comes in bouts clearly related to emotional tension
Tongue: normal -
Liver Qi Invading the Stomach
Soothe Liver & regulate Qi -
Clinical Manifestations:
Feeling of oppression in chest, dull epigastric pain, dry mouth, no desire to drink, bitter & sticky taste, nausea, vomiting, ~frontal headache
Tongue: Red with sticky-yellow coat
Pulse: Slippery, rapid, slight -
Damp Heat in Stomach
Clear Heat, resolve Dampness, harmonize the Stomach -
Acupuncture:
Ren-10, Ren-9, ST-21: promotes transformation of fluids & descend St. Qi
SP-9, SP-6, BL-21: clear damp heat from St.
Ren-12, BL-20: tonify Sp to resolve damp
St-8, LI-4: resolve damp from head, frontal headache
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Damp Heat in Stomach
Treatment -
Clinical Manifestations:
stabbing epigastric pain (worse on pressure & post-pandial), palpable masses in epigastrium, ~vomiting of dark blood (coffee grounds), dark complexion
Tongue: Purple, ~only in center
Pulse: Choppy or Wiry -
Stasis of Blood in the Stomach
Move Blood, eliminate stasis, harmonize Stomach, stop pain -
Acupuncture:
Ren-10:descend St. Qi
ST-22: descend St. Qi, dissolve accumulations
ST-34: Accum point, stop pain
SP-10, BL-17: move Blood & eliminate stasis
SP-4, PC-6: open the penetrating vessel
BL-18: for liver blood st -
Stasis of Blood in Stomach
Treatment -
Dull epigastric pain (improves with pressure,after eating,& with heat), vomiting of thin fluids, tiredness, poor appetite, chilliness, loose stools, pale complexion
Tongue: Pale, white coating
Pulse: Depp, Weak -
Stomach & Spleen Deficient & Cold
Warm the Middle. strengthen the Spleen & Stomach -
Acupuncture:
Ren-12, ST-36, BL020, BL-21: tonify Sp & St.
PC-6: stops nausea & pain
Ren-6: moxa, warm Yang (loose stools)
Herbal:
Huang Qi Jian Zhong Tang:
Liu Jun Zi Pian: often stomach qi xu -
Stomach & Spleen Deficient & Cold
Treatment -
Clinical Manifestations:
Dull epigastric pain, dry mouth, sip liquids, dry throat, dry stools, slight nausea
Tongue: normal color, dry, no coat, scattered cracks, or central wide Stomach-type crack
Pulse: Floating-Empty in the right Middle -
Stomach Yin Xu
Nourish Yin, benefit Stomach, stop pain -
Acupuncture:
Ren-12, ST-36, SP-6: Nourish St Yin
Herbal:
Yi Guan Jian & Bai Shao Gan Cao Tang
Yi Wei Tang
Yang Wei Tang -
Stomach-Yin Xu
Treatment -
Acupuncture:
LV-14: harmonize Lv & St
PC-6: regulate Lv Qi, harmonize St, subdue rebellious St qi, calm shen
ST-21: descend St Qi (excess patterns)
Ren-12, ST-36: tonify St qi (front mu)
GB-34: soothes liver & eliminate s -
Liver Qi Invading the Stomach
Treatment