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STOMACH PAIN

NESA Int Med STOMACH PAIN

QuestionAnswer
Define stomach pain. Painful sensation between the lower margin of the sternum and the infracostal margins.
What are the most common etiologies and pathologies of stomach pain? Cold evil qi attacking the Stomach and obstructing the circulation of qi and blood; improper diet impairing the Stomach; Liver qi overacting on Stomach; overexertion; constitutional weakness; improper medical treatment damaging the Stomach (TCM or pharma)
What is the site of disease in cases of stomach pain? Stomach, but intimately related to Spleen and Liver
What are the crucial points in diagnosing stomach pain? Distinguish cold from heat, xu from shi and qi stagnation from blood stasis and determine the sit of disease (organ involvement)
What are the common treatment strategies for stomach pain? Regulate the qi (Liver or Stomach); Harmonize the Stomach, improve digestion; Descend rebellious Stomach qi; Expel evil qi; Tonify deficiency
What are the eight patterns associated with stomach pain? Cold invading the Stomach; retention of food; Liver qi attacking the Stomach; accumulation of heat in the Liver and Stomach; blood stasis in the Stomach; heat-dampness obstructing the middle burner; Stomach yin xu; and Spleen and Stomach yang xu
What are the s/s, treatment principle and formula for cold invading the Stomach? Sudden onset of severe epigastric pain, better w/warmth, worse w/cold and pressure, cold extremities, T:thin w/twc, P:wiry,tight; Warm the Stomach, dispel cold, promote the movement of qi and alleviate pain w/ Liang Fu Wan
What are the s/s, treatment principle and formula for retention of food? Dull pain, fullness, distension, belching, acid reflux, foul breath, nausea, vomiting undigested food, alt loose stools and constipation, T:thick greasy tc, P:slippery; Reduce food stagnation, regulate qi, harmonize the Stomach and stop pain w/ Bao He Wan
What are the s/s, treatment principle and formula for Liver qi attacking the Stomach? Distending pain radiating toward hypochondria worse w/emotional strain, freq hiccups, jaw tension, h/a, irreg BMs, T:twc, P:deep,wiry; Soothe the Liver, regulate qi, harmonize the Stomach and relieve pain w/ Chai Hu Shu Gan San
What are the s/s, treatment principle and formula for accumulation of heat in the Liver and Stomach? Acute, sudden burning pain w/acid reflux, irritability, dry mouth, bitter taste, strong hunger, T:red w/dry ytc, P:wiry,slippery,rapid; Soothe the LV, clear heat, harmonize the ST and relieve pain w/ Jia Wei Xiao Yao San or Hua Gan Jian plus Zuo Jin Wan
What are the s/s, treatment principle and formula for blood stasis in the Stomach? Fixed, stabbing pain, worse at night, worse w/pressure and after meals, poss. hematemesis or melena, T:dark purple w/petechiae, P:choppy; Invigorate the blood, dispel blood stasis, harmonize the Stomach and relieve pain w/ Shi Xiao San plus Dan Shen Yin
What are the s/s, treatment principle and formula for heat-dampness obstructing the middle burner? Burning sensation, gnawing hunger, thirst, bitter taste, dark urine, sluggish body, low appetite, foggy headed, irreg BM, T:red w/thick greasy ytc, P:slippery, rapid; Clear heat, transform dampness, regulate qi and harmonize the Stomach w/ Qing Zhong Tang
What are the s/s, treatment principle and formula for Stomach yin xu? Vague burning epigastric pain, hunger sans desire to eat, dry mouth and throat, dry stools, T:dry, red, P:thin, rapid; Nourish yin, strengthen the Stomach, harmonize the middle burner and alleviate pain w/ Yi Guan Jian plus Shao Yao Gan Cao Tang
What are the s/s, treatment principle and formula for Spleen and Stomach yang xu? Vague, dull epigastric pain, better w/warmth, pressure and after meals, worse w/hunger, vomiting water, low appetite, fatigue, cold limbs, loose stools, T:pale w/wtc, P:weak,slow; Warm and supplement SP and ST and relieve pain w/ Huang Qi Jian Zhong Tang
Created by: rswain