(1) Cold pathogen attacking the stomach
Exogenous cold attacks the stomach, causing cold sobs, qi stagnation in the stomach and severe pain. If the cold pathogen persists, it will turn into heat, and it will also cause stomach heat pain. Such as "Danxi Heart Method"? The pain of the heart and spleen says: "If you know that you are cold, you will get sick. At first, it should be combined with herbs for warming and dispersing or warming and tonifying. If you are ill for a long time, you will be depressed. If you are depressed for a long time, it will be steaming. If it is hot for a long time, it will make a fire. "
(2) Diet hurts the stomach
1. Overeating, overeating stomach, spleen failing to transport, food stagnation for a long time, stomach disharmony leading to decline, and qi stagnation leading to pain. "Su Wen. Bilun said: "Double diet hurts the stomach"; Another example is "miscellaneous diseases? "Chest obstruction and heartache" quoted Sun, as saying: "Too much diet, if not cured, will hurt the stomach, the root cause is always there, and the diet is slightly hurt, that is, stuffy pain. "
2. Overeating leads to catching cold, or catching cold after eating, and cold accumulates in the stomach cavity, causing stomach cold and pain. So, medical prescription testing? Abdominal pain "A guest has a cold attack on the stomach, so be careful with epigastric pain." It is said that eating cold or breathing cold air after a meal is the main cause of stomach qi attack. The pulse is deep in the stomach, and it will be cold if it is late.
3. Overeating is fat, sweet and greasy, or spicy, or drinking strong liquor, so that damp heat is blocked, or the food is not changed, and the stagnation turns into heat, which makes the stomach lose harmony and fall, and the qi stagnates, which shows that the stomach is hot and painful. For example, The True Story of Medicine? "epigastric pain" said: "the cause is mostly due to indulgence of the mouth and stomach, love of bitterness, and the pain of drinking hot wine, which accumulates over time, so epigastric pain."
4. Abnormal hunger, irregular diet and uneven hunger make the stomach lose harmony and health, the spleen lose health, and the spleen and stomach are damaged for a long time. Stomach pain is caused by disharmony between spleen and stomach.
(3) Emotional difficulties
1. Anger injures the liver, and the liver loses the function of promoting qi, resulting in the loss of qi, stagnation of liver qi, and qi stagnation, thus causing stomach pain. Long-term stagnation of the liver will cause fire, while stagnation of the stomach will cause burning pain in the upper abdomen. Qi stagnation for a long time, poor blood circulation, blood vessels coagulation, blood stasis accumulated in it, and then become a stabbing pain in the stomach, and its disease is lingering and difficult to heal. Therefore, there is a saying that "the liver and stomach ache and the qi and blood stagnate for a long time". (Comment on Liu Xuan's four medical records? How to select the medical records of Jizhitang? Abdominal pain ").
2. Sad spleen, weak spleen and strong liver, weak equisetum and depressed stomach, so it hurts and swells. In addition, thinking leads to qi stagnation, and stomach qi cannot communicate, so depression is painful.
Physical weakness and chronic diseases
1. Weakness of the spleen and stomach, or damage to the spleen and stomach due to long-term illness, or overwork can all cause deficiency and cold in the middle energizer, and the cold comes from endogenous sources, and the veins are lost in warm nourishment, so the stomachache is dull. If the spleen and stomach are deficient in cold, it is due to the feeling of external cold and the combination of internal and external evils, which leads to the accumulation of cold and stomachache.
2. Burn yin, or stomach heat and stagnation will hurt stomach yin for a long time, and insufficient stomach yin will also cause stomach pain.
In short, although the causes of stomach pain are divided into the above four aspects, the main reasons are eating stomach injury and bad mood. Like the true story of medicine? Upper abdominal pain. "Abdominal pain is cautious, not a product of phlegm and diet."
Second, the pathogenesis
(1) Stomach qi stagnates, and it hurts if it doesn't work.
It is a high generalization of all the pain syndrome mechanisms in traditional Chinese medicine, and it is also the pathological mechanism of stomach pain. The stomach is full of harmony, and its qi should be clear, not stagnant. Stomach pain can be caused by many reasons, such as loss of stomach qi, qi stagnation and blood stasis, food stagnation, stomach qi stagnation and so on. As for yang deficiency, deficiency of cold in middle energizer, loss of warm nourishment of stomach collaterals, or deficiency of stomach yin and stomach dystrophy, they can all cause rapid pulse, poor circulation of qi and blood, and also form stomachache.
(2) The lesion is in the stomach, which is closely related to the liver and spleen.
The basic lesion of gastropathy is in the stomach, but it is closely related to the liver and spleen.
1. Stomach and liver
The liver belongs to wood, because it is just dirty, it likes to drain water, and the stomach belongs to earth, because it is a fu-organ full of qi and blood, and it likes to be absorbed. Between the liver and the stomach, wood and soil coexist, so the liver qi stagnates, and it is easy to attack the stomach, causing qi obstruction and stomach pain. Therefore, there is a "wood gas depression, more hair, then the disease of the people has the disease of civil thieves" ("The true story of medicine? Stomach pain ").
2. Stomach and spleen
Spleen and stomach are the exterior and interior of each other, and meridians are the collaterals of each other, which are all formed the day after tomorrow. Spleen is wet soil, ascending to smooth, stomach is dry soil, descending to harmony, spleen is wet and stomach is dry, spleen ascending to stomach descending, dryness and dampness are combined, and ascending and descending are in harmony, so Shui Gu can be absorbed and decomposed, and subtle changes become transport. Therefore, the two are complementary in physiology, but often affect each other in pathology. Such as "spleen and stomach theory"? Roll it up? "Theory of Spleen and Stomach Ascension" said: "Improper diet leads to stomach diseases, and stomach diseases lead to spleen diseases, so the disease is also." . Physical labor leads to spleen disease. When the spleen is sick, its stomach can't enjoy body fluids alone, so it is also sick. "It shows that spleen diseases can reach the stomach, and stomach diseases can also reach the spleen. Clinically, stomach diseases and stomachaches caused by stomach are mostly deficiency syndrome.
(3) The pathological attribute is based on excess and deficiency, but its evolution is varied.
Stomach pain can be divided into cold and heat deficiency and qi and blood deficiency, but both can be summarized from two aspects. Among them, stagnation of stomach cold, stagnation of liver qi, stagnation of diet, stagnation of heat in liver and stomach, stagnation of damp-heat and internal resistance of blood stasis belong to the empirical category. Deficiency of cold in middle energizer and deficiency of stomach yin are deficiency syndromes of epigastric pain.
Syndrome of excess and deficiency: Stomach pain is mostly empirical at first. If you persist for a long time, or have repeated attacks, the spleen and stomach will be damaged, which can turn from excess to deficiency. If pain is caused by cold, cold pathogen hurts yang and spleen yang is insufficient, it can become a syndrome of spleen and stomach deficiency and cold. If the pain is caused by heat, the pathogenic heat hurts the yin, and the stomach yin is insufficient, it will lead to stomach diseases due to yin deficiency. Stomach pain due to deficiency syndrome is easily affected by pathogenic factors, such as spleen and stomach deficiency and cold, or has no right to exercise, and diet can be stagnant, so the clinical manifestations are both deficiency and excess.
Cold syndrome and heat syndrome: exogenous wind-cold or cold diet leads to cold accumulation in the stomach cavity, and the pain lasts for a long time. Cold pathogens can be turned into heat, which can cause stomach heat syndrome. If the pain is caused by heat, it is due to excessive cold, which makes the cold and heat uncoordinated, and the two are mixed, which can also form a mixed syndrome of cold and heat.
Qi stagnation and blood stasis: qi is handsome for blood, qi is good for blood circulation, and qi stagnation is bad for blood circulation. Therefore, qi stagnation causes disease for a long time. On the contrary, blood stasis will inevitably hinder qi activity, so qi depression is even worse. Therefore, qi stagnation and blood stasis can be mutually causal.
Generally speaking, the prognosis of stomachache is good. If the stomach heat is too strong, the heat forces blood circulation, or blood stasis blocks, and the blood does not follow the menstruation, but hematemesis, or spleen and stomach deficiency and spleen deficiency can not control the blood, but hematochezia is a serious stage of the development of the disease. If the amount of hematemesis is large or repeated, it is a dangerous syndrome. If you can't stop bleeding in time, it will often endanger your life. Secondly, if phlegm and blood stasis combine with epigastric cavity to form syndrome accumulation, touch the lump, lose weight quickly, have unbearable upper abdominal pain, and it is difficult for conventional drugs to relieve pain, even vomit red bean juice, and the prognosis is extremely poor, which is also a critical illness.