TCM and Chronic Gastritis
By Dr. Hong-Yen Hsu
Chronic gastritis refers to a dull epigastric pain which persists for several weeks, especially when accompanied by substernal ache, flatulence, nausea, poor appetite, sensations of obstruction in the stomach and compression. Clinical findings will be negative regarding topic changes based on barium meal examinations of the upper digestive tract (esophagus, stomach and duodenum), and gastroscopic examination will reveal atrophic or erosive gastritis. Japanese literature refers to this disease as a kind of water and phlegm stagnancy. Chinese medicine believes that it may be caused by a disharmony between the liver and stomach, heat' stagnancy in the liver and stomach, splenogastric asthenia, blood stagnation or injured gastric yin. The commonly used formulas are as follows:
Pinellia Combination: This is used for stagnant sensations in the subcardiac epigastric area, dull pains at the substernum and poor appetite. It is also used for gastroptosis with splashing sounds in the area of the substernum. If the patient has belching with a fetid odor, Pinellia and Ginger Combination should be used instead.
Hoelen Combination: This formula is indicated for the above symptoms together with heartburn and regurgitation of stomach acid. It is also indicated for the postgastrectomic symptoms of epigastric obstructive sensations and poor appetite.
Six Major Herb Combination: This is a formula commonly used for patients with an average constitution and an asthenic deficiency conformation, epigastric dull pains and poor appetite. It can also be used for acidic regurgitation. Chinese medicine treats splenogastric asthenia with Saussurea and Cardamon Combination.
Ginseng and Ginger Combination: This formula is indicated for those who have an asthenic GI tract, adynamic constitution, lack of vitality, limbic chilling, occasional nausea and somnolence, slight anemia, poor appetite and eructation of acid. It can eliminate sensations of stagnation at the substernum, although, if the patient's general metabolism is markedly decreased, Aconite, Ginseng and Ginger Combination should be used.
Cardamon and Fennel Formula: This formula treats slight deficiency conformations in patients who have prolonged gastralgia and in whom a sloshing sound is detectable in the epigastric area. The formula removes substernal aching.
Magnolia and Ginger Formula: This formula treats excess conformations with flatulent sensations in the abdomen, especially when the intestines contain gas producing a full sensation from the epigastrium to the abdomen, heartburn, nausea and belching. The formula is usually used together with Hoelen Combination.
Formulas for Specific Symptoms
1. Abdominal pain: Acute attacks of chronic gastritis - some patients may appear to have excess yang conformations use Bupleurum and Cinnamon Combination or Major Bupleurum Combination. For chronic cases, which are often yang deficiency conformations, use Cinnamon and Peony Combination, Minor Cinnamon and Peony Combination, or Ginseng and Ginger Combination. Chinese herbal medicine usually uses a Melia and Corydalis Formula, composed of Melia and corydalis, which is effective for disharmonies of the liver and stomach in superficial gastritis.
2. Dry mouth: Usually indicates a deficiency conformation. The commonly used formula is Six Major Herb Combination.
3. Hyperhidrosis: A condition marked by an excess of saliva in the mouth or an excessive secretion of saliva caused by a disorder in gastrointestinal function, for which Ginseng and Ginger Combination is commonly used. If the patient has a ruddy face with flushing-up, use Coptis and Scute Combination.
4. Vomiting: If accompanied by nausea, use Pinellia and Hoelen Combination; if accompanied by thirst and oliguria, use Hoelen Five Herb Formula; if accompanied by nausea and epigastric discomfort, use Ginseng and Ginger Combination.
5. Lassitude and somnolence following a meal: This is due to degeneration of digestive functions, for which Six Major Herb Combination or· Ginseng and Astragalus Combination should be used.
6. Anorexia: For reduced appetite and stickiness in the mouth use Cinnamon and Ginseng Combination, or Ginseng and Ginger Combination. For a total loss of appetite and the presence of flatulence immediately after a meal, use Saussurea and Cardamon Combination.
7. Abnormal bowel movement: For hard feces and constipation which accompany a yang sufficiency conformation, use Coptis and Rhubarb Combination, or Rhubarb and Licorice Combination. For diarrhea due to yang deficiency, use Ginseng and Ginger Combination, Ginseng and Astragalus Combination, or Hoelen Five Herb Formula.
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