Epigastric Pain Syndrome

Front 1

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 & Tight

Back 1

Cold Invading the Stomach

Scatter Cold, warm Stomach, stop pain

Front 2

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 & warm stomach

Liang Fu Wan: Severe cases

Back 2

Cold Invading Stomach
Treatment

Front 3

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 in center & root (white or yellow)

Pulse: Slippery

Back 3

Retention of Food

Dissolve accumulation, eliminate stagnation, & restore the descending of Stomach Qi

Front 4

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 obstruction
ST-25: LI front mu (promote BM)

Herbal:
Bao He Wan

Back 4

Retention of Food
Treatment

Front 5

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 or slightly red sides
Pulse: Wiry, maybe only on left side

Back 5

Liver Qi Invading the Stomach

Soothe Liver & regulate Qi

Front 6

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, slightly weak-floating in right middle position

Back 6

Damp Heat in Stomach

Clear Heat, resolve Dampness, harmonize the Stomach

Front 7

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

Herbal:
Xiang Sha Ping Wei San:

Back 7

Damp Heat in Stomach
Treatment

Front 8

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 or Firm

Back 8

Stasis of Blood in the Stomach

Move Blood, eliminate stasis, harmonize Stomach, stop pain

Front 9

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 stasis

Herbal:
Shi Xiao San

Dan Shen Yin

Huo Luo Xiao Ling Dan

Tiao Ying Lian Gan Yin

Back 9

Stasis of Blood in Stomach
Treatment

Front 10

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

Back 10

Stomach & Spleen Deficient & Cold

Warm the Middle. strengthen the Spleen & Stomach

Front 11

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

Xiang Sha Liu Jun Zi Pian: stronger to move qi

Back 11

Stomach & Spleen Deficient & Cold
Treatment

Front 12

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 position

Back 12

Stomach Yin Xu

Nourish Yin, benefit Stomach, stop pain

Front 13

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

Back 13

Stomach-Yin Xu
Treatment

Front 14

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 stagnation

Herbal:
Chai Hu Shu Gan Tang

Back 14

Liver Qi Invading the Stomach
Treatment