Basic introduction to the scientific name of Chinese medicine: the site of epigastric pain: epigastric diseases related to western medicine: acute and chronic gastritis, etc. Name: people prone to epigastric pain: classification of all diseases: internal medicine-spleen and stomach infection: no noun explanation, historical evolution, relationship between epigastric pain and western medicine diseases, etiology and pathogenesis, diagnostic points, diagnostic basis, syndrome differentiation and syndrome differentiation. Classification of syndrome and treatment, other therapies, prognosis, prevention and nursing, literature abstracts, and noun explanation Stomach pain, also known as epigastric pain, refers to the symptoms of epigastric pain near the heart pit. Historical evolution 1, the name of epigastric pain was first recorded in Neijing, for example, the table of diseases and syndromes of pathogenic viscera of Lingshu pointed out: "epigastric pain, abdominal distension and epigastric pain." Neijing first proposed that the occurrence of stomachache was related to the liver and spleen, and also put forward the theory of pathogenic cold and food injury. 2. Before the Tang and Song Dynasties, the literature often confused the heartache belonging to epigastric pain with the heartache belonging to the heart meridian itself, until the "epigastric pain" was first established in Shi Lan's Secret Collection by Gao Li in the Jin and Yuan Dynasties, which clearly distinguished epigastric pain from heartache, making stomachache an independent disease. 3. In Ming and Qing Dynasties, the treatment of stomachache was further proposed. "The True Story of Medicine" said: "The nine kinds of heartache in the ancient prescription, ... are all in the stomach, but not in the heart." "The upstream qi surges up, and the downstream qi lifts up, which is cold and warm, hot and warm, artificially cultivated, truly purified, scattered and left." The True Story of Medical Abdominal Pain also points out that we should understand and apply the method of "general principle is painless" from the perspective of syndrome differentiation. Relationship between stomachache and the names of diseases in western medicine. Acute gastritis, chronic gastritis, gastric ulcer, duodenal ulcer, functional dyspepsia, gastric mucosal prolapse and other diseases with abdominal pain as the main symptoms belong to the category of stomachache in traditional Chinese medicine. Etiology: 1. Exogenous pathogens attack the stomach, such as cold, dampness and heat, and exogenous pathogens in the stomach will cause qi stagnation in the gastric cavity, and if it fails, it will cause pain. Among them, cold pathogen is the most common. 2, diet hurts the stomach, the diet is not good, the hunger is too full, the spleen and stomach are damaged, the stomach is stagnant, and it hurts if you don't work. 3, emotional disorder, anxiety and anger, liver injury and spleen injury, liver failure and diarrhea, anti-gastric attack, spleen loss of health, stomach qi block, all lead to stomach loss and stomach pain. 4. The spleen and stomach of vegetarians are warehouse officials, and they are mainly transported to Shui Gu. If vegetarians are weak in spleen and stomach, dereliction of duty in transportation, poor qi movement or insufficient middle yang, deficiency of cold in middle jiao and loss of warm yang, stomach pain will be caused. Pathogenesis Stomach pain is located in the stomach, which is closely related to the liver and spleen. The basic pathogenesis is the obstruction of stomach qi, which leads to the decline of stomach disharmony, and the pain of failure. Pathological factors mainly include qi stagnation, cold coagulation, heat depression, dampness resistance and blood stasis. Pathological: the early stage is mostly empirical; In the later stage, it is often spleen and stomach weakness, but it is often mixed with excess and deficiency. Diagnostic points 1. There is pain in the upper abdominal cavity near the cardiac fossa, and its pain nature is different, such as swelling pain, tingling pain, dull pain and severe pain. 2, often accompanied by loss of appetite, nausea and vomiting, noisy pantothenic acid, belching and vomiting and other upper gastrointestinal symptoms. 3. Characteristics of onset: Most of them are young and middle-aged, with a history of recurrent attacks. There are obvious inducements before the onset, such as weather change, anger, fatigue, overeating, hunger, cold and hard diet, spicy smoking or taking drugs that damage the spleen and stomach. Syndrome differentiation 1, stomach pain and true heartache True heartache is a kind of heartache syndrome caused by heart disease, which is more common in the elderly. It is harmful to the chest, often stinging and aggravating, causing shoulder and back pain. Often accompanied by palpitations, shortness of breath, sweating, cold limbs, and critical illness. It is obviously different from stomachache in the lesion site, pain degree and characteristics, accompanying symptoms and prognosis. 2. Stomach pain and hypochondriac pain are symptoms of hypochondriac pain, which may be accompanied by fever and aversion to cold, or yellow eyes and skin, or chest tightness and shortness of breath, and rarely accompanied by noisy pantothenic acid, belching and vomiting. Stomach pain caused by liver-qi invading the stomach can sometimes occur and even threaten the stomach, but it is still characterized by upper abdominal pain. There is a clear difference between the two. 3, stomach pain and abdominal pain refers to the pain below the upper abdomen and above the pubic hair. Stomach pain is a symptom of upper abdominal pain near the heart socket. The difference between the two is only in the pain area. However, the stomach is located in the abdomen and connected with the intestine, so in some special diseases, stomach pain can affect the abdomen, and abdominal pain can also be implicated in the stomach, which should be distinguished from the main parts of pain and how to get sick. The key point of syndrome differentiation and treatment is to distinguish deficiency from excess, cold and heat, and qi and blood. Real people are more painful, fixed, refuse to press, and have a strong pulse; Deficiency leads to slow pain, uncertain pain, preference for pressing and weak pulse. It hurts when it's cold, and it hurts when it's warm, which is cold syndrome; Stomach burning, acute pain, very painful when hot, and shrinking when cold, which is a heat syndrome. Generally, the initial illness is in qi, and the chronic illness is in blood. The principle of treatment is to regulate qi and relieve pain, and then treat deficiency and excess. Those who belong to stomach cold, dispelling cold is the so-called pass; Belonging to eaters, digestion is the so-called communication; Belonging to qi stagnation, regulating qi is the so-called communication; It belongs to heat depression, and releasing heat is called communication; Belonging to blood stasis, removing blood stasis is called dredging; Belonging to yin deficiency, benefiting stomach and nourishing yin is called tong; Yang deficiency, warming spleen and yang, is called tong. Only by adopting corresponding treatment methods according to different pathogenesis can we make good use of the "dredging" method. Classification of Syndrome and Treatment (1) Symptoms of cold pathogen invading the stomach: severe stomachache, aversion to cold and warmth, less pain in case of cold, pale mouth and thirst, or preference for hot drinks, pale tongue, thin and white fur and tight pulse. Treatment: Warming stomach and dispelling cold, activating qi and relieving pain. Prescription: Su Xiang Powder and Fu Liang Pill. Commonly used drugs: Alpinia officinarum, Evodia rutaecarpa, Cyperus rotundus, Linderae, Pericarpium Citri Reticulatae and Radix Aucklandiae. (2) Symptoms of stomach injury caused by diet: epigastric pain, fullness, refusal to press, acid regurgitation, or vomiting when food is undigested, with rancid smell, pain relieved after vomiting, loss of appetite, unpleasant stool, depressed feeling after defecation, thick and greasy tongue coating and slippery pulse. Treatment: digestion and stagnation, stomach and pain relief. Prescription: Baohe Pill. Commonly used drugs: Massa Medicata Fermentata, Crataegus pinnatifida, Radish, Poria, Pinellia ternata, Pericarpium Citri Tangerinae, Forsythia suspensa. (3) Symptoms of liver-qi invading the stomach: abdominal distension and pain, bilateral pain, pain or acute pain, belching, suffocation, pain relief, chest tightness and belching, prolonged sighing, poor stool, thin and white tongue coating and thready pulse. Treatment: soothing the liver and relieving depression, regulating qi and relieving pain. Prescription: Chaihu Shugan Powder. Commonly used drugs: Radix Bupleuri, Radix Paeoniae Alba, Rhizoma Chuanxiong, Curcuma Rhizome, Rhizoma Cyperi, Pericarpium Citri Tangerinae, Fructus Aurantii, Fructus Citri Sarcodactylis, and Glycyrrhrizae Radix. (4) Symptoms of damp-heat stagnation: epigastric pain, acute pain, dull and burning pain in the epigastric cavity, dry mouth and bitter taste, thirst without drinking, heavy weight and fatigue, anorexia and nausea, yellow urine, poor stool, yellow and greasy tongue coating and slippery pulse. Treatment: clearing damp-heat, regulating qi and regulating stomach. Prescription: Zhong Qing soup. Commonly used drugs: Coptidis Rhizoma, Fructus Gardeniae, Rhizoma Pinelliae Preparata, Poria, Fructus Amomi Rotundus, Pericarpium Citri Tangerinae and Glycyrrhrizae Radix. (5) Symptoms of blood stasis blocking the stomach: epigastric pain, such as acupuncture and knife cutting, is localized, and the pain is very intense when pressing. The pain lasts for a long time and gets worse after eating, especially at night, or hematemesis, black stool, purple tongue or ecchymosis and unsmooth pulse. Treatment: removing blood stasis and dredging collaterals, regulating qi and regulating stomach. Prescription: Shixiao Powder combined with Danshen Drink. Commonly used drugs: Pollen Typhae, Oletum Trogopterori, Radix Salviae Miltiorrhizae, Lignum Santali Albi and Fructus Amomi. (6) Symptoms of stomach yin deficiency: burning and dull pain in the epigastrium, hunger without food, dry mouth and throat, vexation and fever, emaciation and fatigue, thirst and constipation, red tongue and scanty body fluid, and rapid pulse. Treatment: nourishing yin and benefiting stomach, harmonizing middle energizer and relieving pain. Prescription: Yiguanjian combined with Shaoyao Gancao decoction. Commonly used drugs: Radix Adenophorae, Radix Ophiopogonis, Radix Rehmanniae, Fructus Lycii, Radix Angelicae Sinensis, Fructus Toosendan, Radix Paeoniae and Radix Glycyrrhizae. (7) Symptoms of deficiency and cold of the spleen and stomach: persistent dull pain in the epigastric cavity, warm tenderness, severe abdominal pain, slow eating, illness or aggravation after fatigue or cold, vomiting of clear water, listlessness of limbs, tepid hands and feet, thin stool, pale tongue with white fur, weak or slow pulse. Treatment: warming the middle energizer and strengthening the spleen, harmonizing the stomach and relieving pain. Prescription: Huangqi Jianzhong Decoction. Commonly used drugs: Radix Astragali, Ramulus Cinnamomi, Rhizoma Zingiberis Recens, Radix Paeoniae, Radix Glycyrrhizae Preparata, maltose and Fructus Jujubae. Other therapies acupuncture therapy 1, acupuncture: Neiguan, Zhongwan and Zusanli. Suitable for all kinds of stomachache. The empirical study uses purging method, while the deficiency and pain use reinforcing method. 2, moxibustion: Zhongyu, Zusanli, Shenque. Suitable for deficiency-cold stomachache. The prognosis of stomachache can come from the changes of syndromes, such as excessive stomach heat and forced blood to rush to the ren; Or blood stasis block, blood does not follow menstruation; Or weak temper, unable to control blood, can cause hematochezia and hematemesis. Massive bleeding can lead to qi escaping with blood, which is life-threatening. If the spleen and stomach are not well transported, the damp pathogen is endogenous, and the stagnation turns into heat and fire, which leads to the obstruction of fu-organs and qi, which can be seen as severe abdominal pain, refusal to press, sweating like a note, and limb syncope; Or long-term stagnation, qi stagnation, stomach failure, stomach qi rushing up, resulting in vomiting and nausea. If the stomachache lasts for a long time, the components of qi will penetrate into the components of blood, and the long-term pain will enter the collaterals and cause blood stasis, which will lead to the formation of choking diaphragm. The prevention and nursing of this disease should pay attention to the adjustment of spirit and diet. Patients should pay attention to regular life and eating habits to avoid overeating and being hungry; Those with persistent stomachache should take a liquid or semi-liquid diet for a certain period of time, eat less and eat more meals, and light and digestible food is appropriate; Avoid coarse grains and fiber-rich diets, try to avoid strong tea, coffee, tobacco, alcohol and spicy food, chew slowly when eating, and use western medicine such as salicylic acid and adrenocortical hormone with caution. At the same time, keeping optimistic mood and avoiding overwork and tension are also the key to prevent the recurrence of this disease. Literature summary 1, Syndrome Table of Zang-fu Organs Caused by Lingshu Pathogen: "Stomach disease, abdominal distension, epigastric pain with caution, upper limbs, obstruction of diaphragm and pharynx, inability to eat and drink, take Sanli." 2, "Three Causes and One Disease Syndrome on Nine Pains": "If a husband is heartbroken, ... his pain is in the middle, so in a word, he is heartbroken, but not heartbroken ... If the twelve meridians is exogenous, qi is blocked, qi and evil are struggling, it is caused by pain and is an external cause; If the five internal organs move with the seven emotions, the qi accumulates in the stomach and the qi and blood beat, which is the internal cause; Eating and resting, touching the non-category, making the dirty qi uneven, separating, eating and drinking, messing up the stomach and causing pain, is not an internal cause or an external cause. " 3, "Jing Yue Quan Shu Xin Abdominal Pain": "Stomach pain syndrome, mostly due to food, because of cold, because of gas, but because of food because of cold, all related to gas. When food is covered and stopped, qi stagnates, and when it remains cold, qi condenses. Therefore, the key to treating pain, but if the fruit is true or false, it should be based on regulating qi. " 4, "Clinical Guide to Stomach Pain in Medical Records": "The initial illness is in the meridians, but it will hurt the body for a long time. Meridians govern qi and collaterals govern blood, so we can know that it is natural to treat blood. Where the qi is blocked for a long time, the blood is also sick, and the context of the action is self-arthralgia, and the method of soothing qi and blood by Xinyi is an inevitable principle. " 5, "Gu Medical Mirror Stomach Pain": "It should be noted that those who refuse to press it are true, and those who press it are virtual; Those with pain and distension are more solid, while those without distension and closure are more virtual; Those who like cold are more solid, and those who love heat are more virtual; Full will be more practical, hungry will be more empty. Qi deficiency leads to strong pulse, while qi deficiency leads to less pulse. There are many strong people in new diseases, and many old people in long-term diseases; Those who don't work in makeup are more realistic, and those who attack more are more virtual. It is necessary to distinguish between looking, smelling, asking and cutting, and then the reality is self-evident. "