The Chinese Medicine Treatment of Epigastric Pain

Digestive

Chief complaint Epigastric pain for a few months. John, 28-year old, male.

Medical History The patient has had for more than one year. Two months ago, the patient had severe epiagstric pain and visited his regular doctor and had his liver checked. The result showed that the functions of the liver were normal, but HBsAg was ++. He has had eaten some Chinese herbs for regulation of the spleen and stomach functions and got better, but he still has epigastric pain when ever he stops taking the herbs.

Presenting Symptoms

Inquiring
Recently he has severe epigastric pain which is more serious from 1 a.m. to 3 a. m. every day. He also has distending pain in the epigastric and hypochondraic regions, acid reflux, sometimes feel nausea and wants to vomit. He has poor appetite, normal urination and bowel movement, general lassitude, and spontaneous sweating.

Pulse and Palpation
Soft but with slight pain of upper abdomen when being palpated, with a desire to warm liquids and an aversion to cold.
Slippery and string-taut pulse.

Tongue and Observation
Red tongue body with thin white greasy tongue coating.

TCM Diagnosis

Epigastric pain (“wood over-acting on earth”, stagnant liver-qi invades the stomach horizontally and impairs the descending of stomach-qi)

Treatment Principle
Soothe the liver and regulate qi, restore the functions of stomach.

Herbal Prescription
Chai Fu Shu Gan San
Chai Fu (Radix Bupleuri) 9g
Ci Ji Li (Fructus Tribuli Terrestris) 12g
Xiang Fu (Rhizoma Cyperi rotundi) 10g
Cao Bai Shao (Radix Paeoniae albae) 10g
Su Zi (Fructus Perillae Frutescentis) 6g
Chen Pi (Pericarpium Citri reticulatae) 9g
Fu Shou (Frectus citri Sarcdactylis) 6g
Sha Ren (Fructus Amomi) 4g (cooked later)
Cao Dou Kou (Semen Alpiniae Katsumadai) 5g (cooked later)
Zi Gan Cai (Radix Glycyrrhizae) 6g
Wu Zei Gu (Os Sepia seu Sepiellae) 12g (cooked first)
Duan Wa Leng Zi (Concha Arcae) 24g (cooked first)

Explanation
Chai Fu, Ci Ji Li, Xiang Fu and Cao Bai Shao: soothe the liver and regulate qi.
Su Zi, Chen Pi and Fu Shou: restore the function of stomach and harmonize the liver and stomach.
Sha Ren, Cao Dou Kou, Wu Zai Gu and Duan Wa Leng: reduce acid
Zi Gan Cao: harmonize the herbs

Acupuncture Prescription
LR14(qimen), PC6(neiguan), ST21(liangmen), RN12(zhongwan), ST36(zusanli), BL21(weishu), GB34(yanglingquan), LR3(taichong)
Reducing or even method

Explanation
LR14: is specific to harmonize liver and stomach.
GB34, LR3: soothe the liver and eliminate stagnation
PC6, ST21: subdues rebellious stomach-qi
RN12, ST36 and BL21: tonify stomach, restore stomach function and prevent the stomach from being invaded by the liver.

Lifestyle Changes
Maintain balanced emotions.
Reduce overworking and/or excessive sexual activity.
Avoid greasy, sweet, sour foods.

Courtesy of:
Xinrong He, TCMD, L.Ac.
TCM Health Center
University-Dinkytown
1313 Fifth Street SE Suite 212
Minneapolis, MN 55414
Tel: (612) 379-3583
Fax: (952) 826-0982
E-mail: TCMHEALTH@aol.com
Website: WWW.AAAOM.ORG

Last modified: September 6, 2009  Tags: , ,  В·  Posted in: Digestive