TCM Acupuncture and Massage

Chapter 48 Digestive System Diseases (1)
Stomachache
An overview of the disease

([-]) Relevant knowledge

Stomach pain, also known as epigastric pain, is a disease caused by exogenous pathogenic factors, internal injury to eating emotions, and dysfunction of viscera, which lead to stagnation of qi, loss of nourishment of the stomach, and pain in the epigastrium near the bisected bone as the main symptom.This disease is the most common in spleen and stomach diseases, and the incidence rate is relatively high in the crowd, so it should be diagnosed and treated as soon as possible.

([-]) Etiology and pathogenesis

Stomach pain is located in the stomach, the liver and spleen play an important role, and the gallbladder and kidney are also related.

Its pathogenesis is mainly caused by disharmony of stomach qi, unfavorable movement of qi, and loss of nourishment in the stomach.It is mainly related to the following factors.

1. Cold pathogens cause stagnation of stomach qi, disharmony of stomach qi, and pain.

2. Diet hurts the stomach, blockage of Qi in the stomach, and pain due to disharmony of stomach Qi.

3. Liver qi invading the stomach, worrying, thinking and anger, emotional disturbance, liver failure to ventilate, qi stagnation, rebellion invading the stomach, loss of harmony and descending of the stomach, resulting in stomach pain.

4. Spleen and stomach weakness and cold pain are due to weakness of the spleen and stomach and coldness in the middle Jiao, resulting in stomach pain due to loss of temperature and nourishment.

([-]) Clinical manifestations

The lesion is in the epigastric cavity below the heart, and sometimes it can be divided into upper, middle, and lower. The nature of the pain is often different due to different etiology and pathogenesis. Pain, dull pain, and swelling pain, tingling pain, dull pain are common, the pain can be persistent or paroxysmal, there can be no tenderness, or the tenderness is not obvious, and there is no rebound tenderness.The pain often occurs or aggravates due to factors such as cold and warm inappropriateness, eating disorders, and emotional discomfort, and is often accompanied by symptoms such as loss of appetite, nausea and vomiting, and acid regurgitation.

([-]) Diagnosis

1. Epigastric pain, often accompanied by loss of appetite, fullness or fullness, nausea and vomiting, acid regurgitation, etc.

2. The onset is often related to factors such as emotional distress, improper diet, fatigue, and exposure to cold.

3. The onset may be acute or slow, often with a history of recurrent attacks.

4. Upper gastrointestinal X-ray barium meal fluoroscopy, fiber optic endoscopy and histopathological examination, etc., gastric and duodenal mucosal inflammation, ulcers and other lesions can be seen.

([-]) Treatment

The treatment of gastric pain includes general treatment and corresponding drug treatment.

1. The general treatment is mainly to pay attention to daily life, including not overeating, not lying down, not eating dinner before going to bed, eliminating life pressure, losing weight, etc.

2. Drug treatment can be selected according to the condition to help digestion and inhibit gastric acid drugs, and can also be combined with traditional Chinese medicine and Chinese patent medicine for regulating qi and stomach pain to enhance the curative effect.In addition, you should also avoid taking some drugs that are more irritating to the gastrointestinal tract.

([-]) Prevention

For patients with epigastric pain, we should pay attention to the adjustment of spirit and diet, maintain a happy spirit, cheerful personality, work and rest, avoid overeating, or hunger and fullness, the principle of eating less and more meals, light and easy to digest, can relieve stomach pain attack, so as to achieve the purpose of preventing stomach pain.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
Main points: Zhongwan, Zusanli, Hegu, Neiguan, Gongsun, Pishu, Weishu.Acupoints: Add Taichong, Yanglingquan, and Qimen for liver qi invading the stomach; add Weishang, Tianshu, and Qihai for spleen and stomach deficiency.

2. Positioning
Zhongwan—Abdomen, on the front midline, 4 cun above the middle of the navel.

Zusanli - 3 inches below the calf's nose, one transverse finger (middle finger) outside the anterior crest of the tibia.

Hegu—radial border of the midpoint of the second metacarpal bone.

Neiguan—2 cun above the transverse crease of the wrist, between the two tendons.

Gongsun—1 cun behind this section of the toe, at the junction of red and white flesh.

Pishu—Below the spinous process of No.11 thoracic vertebrae, 1.5 cun laterally.

Weishu—No.12 under the spinous process of the thoracic vertebrae, 1.5 cun laterally.

Ganshu—below the spinous process of the ninth thoracic vertebra, 1.5 cun laterally.

Taichong—in the depression before the junction of the first and second metatarsal bones.

In the depression anterior and inferior to the capitulum of the fibula in Yanglingquan.Period gate - straight down the nipple, the sixth intercostal space.

Point on the stomach - 2 inches above the navel and 4 inches from the side.

Tianshu—abdomen, 2 cun lateral to the middle of the navel.

Sea of ​​Qi—1.5 inches below the navel.

([-]) Self-massage
1. Put the palm of the right hand on the lower right abdomen, and overlap the left palm on the back of the right hand. Starting from the lower right abdomen, rub repeatedly clockwise over the whole abdomen. 100-200 times.

2. Massage the spleen and stomach, put the palms of both hands on the abdomen, rotate from under the left rib to under the right rib, repeat 50-100 times.

3. Knead and press the Zhongwan, Qihai, Zusanli, Neiguan and other acupoints with your thumb repeatedly, each acupoint for 2 minutes.

4. To dredge, use two hands and four fingers to move forward from the back of the abdomen on both sides, and put the thumbs together on the abdomen.Then grab the abs with your right hand.Then push down from the xiphoid process with the whole palm of the left hand, repeat 6 times.

5. Wipe the back of the lower back by another person, along the first thoracic vertebra, push down to the sacrum 9 times on both sides of the spine, and then press the Pishu, Weishu, and Ganshu for 1 minute each.

Vomiting
An overview of the disease

([-]) Relevant knowledge

Vomiting refers to a disease in which the stomach loses its balance, the qi goes against the top, and the contents of the stomach are spit out from the mouth.Generally speaking, when there is something and sound, it is called vomiting, if there is something without sound, it is called vomiting, and if there is no sound, it is called retching.Vomiting and vomiting often occur at the same time, and it is difficult to separate them completely, so they are called vomiting together.

([-]) Etiology and pathogenesis

The vomiting is located in the stomach, and it is also related to the liver and spleen.Its pathogenesis is nothing more than deficiency and excess.Excessive cases are caused by external pathogens, diet, phlegm, stagnant qi and other evil qi invading the stomach, causing the stomach to lose harmony and descend, and the qi is reversed; Run, due to deficiency of the stomach.It is related to the following factors:

1. Exogenous evil invades the stomach, the evil invades the stomach, the qi movement is unfavorable, the stomach loses harmony and descends, water and grains come out with the adverse qi, and vomiting occurs.

2. Improper eating habits can damage the spleen, stagnation of food stagnates internally, loss of harmony in the stomach, upward reversal of stomach qi, and vomiting.

3. Emotional disorders, depression and anger damage the liver, liver loss and stagnation, rebelliousness invades the stomach, stomach loss and descending.

4. Deficiency of the spleen and stomach elements, physical weakness after illness, excessive fatigue, depletion of Qi, deficiency of the stomach cannot absorb water and food, deficiency of the spleen cannot transform and produce essence, stagnation in the stomach, upside down leads to vomiting.According to the specific situation, it can be divided into deficiency of spleen yang and deficiency of stomach yin.

The former is due to the inability to decompose water and grains, resulting in internal cold and turbidity, and vomiting due to inverse Qi; the latter is due to insufficient stomach yin, and the stomach loses nourishment and cannot be moisturized, resulting in vomiting.

([-]) Clinical manifestations

The main symptom is vomiting, the specific symptoms are not the same, or retching, or vomiting silently, or vomiting with a loud voice, or vomiting like a spray; or vomiting immediately after eating, or returning after a long time, or retching without eating; or vomiting new people The food, or vomit saliva; more or less vomit.At the same time, there are often incentives such as smelling and special odor, improper diet, emotional distress, and inappropriateness of cold and heat, and are often accompanied by symptoms such as abdominal fullness and discomfort, anorexia, and acid reflux.

([-]) Diagnosis

1. Vomiting is mainly characterized by vomiting food, saliva, water and other objects, or retching without object, ranging from several times a day, persistent or recurrent.Often accompanied by epigastric discomfort, nausea and loss of appetite, pantothenic acid noisy embolism.

2. The onset may be acute or slow, often preceded by a feeling of nausea and vomiting, which is mostly induced by factors such as smell, diet, emotion, cold and heat, or due to taking chemical drugs or accidentally ingesting poison.

3. Upper gastrointestinal X-ray examination and endoscopy are often helpful for diagnosis and differential diagnosis.

([-]) Treatment

Mild vomiting has little effect on health and does not require treatment.Severe vomiting not only spits out a lot of water, but also spits out electrolytes, causing symptoms of dehydration and acid-base imbalance, which must be treated urgently.

1. Fasting for 6 to 8 hours. Mild or moderate dehydration can take "oral rehydration salts". Take small amounts several times. Most patients can correct dehydration and acidosis.

If it cannot be corrected, the best way is to carry out intravenous infusion correction according to blood biochemical tests.

2. To treat the primary surgical obstructive disease, surgery should be performed to relieve the obstructive segment.If it is medical vomiting, the primary disease should be treated.

3. The safest and most effective drug for taking antiemetics is morphine, 0.3 mg per kilogram of body weight each time, 3 times a day, 15 to 30 minutes before meals.

4. For recurrent vomiting, you can drink a small amount of cold boiled water or ice water several times during the fasting period.Drinking warm water can easily cause vomiting.

([-]) Prevention

Avoid the evil of wind, cold and dampness or the invasion of filthy air, avoid mental stimulation, avoid eating fishy and dirty things, do not overeat, and avoid raw, cold, spicy, and fragrant products.Severe vomiting should stay in bed.

[-]. Point massage

([-]) Acupuncture therapy

1. Select acupoints Neiguan, Gongsun, Zusanli, Zhongwan, Tianshu, Geshu, Tanzhong, and Taichong.

2. Positioning
Neiguan—2 cun above the transverse crease of the wrist, between the two tendons.

Gongsun—toe 1 cun behind this section, at the junction of red and white flesh.

Zusanli - 3 cun below the calf's nose, one transverse finger (middle finger) outside the front edge of the tibia.

Zhongwan—Abdomen, on the front midline, 4 cun above the middle of the navel.

Tianshu—abdomen, 2 cun lateral to the middle of the navel.

Geshu—back, below the spinous process of the seventh thoracic vertebra, 7 cun lateral to the posterior midline.

Tanzhong—chest, on the front midline, level with the fourth intercostal space, and the midpoint of the line connecting the two nipples.

Taichong—in the depression before the junction of the first and second metatarsal bones.

([-]) Self-massage
1. Pinching and kneading acupoints Use your thumb to pinch Neiguan, Gongsun, Zusanli, Zhongwan, and Tianshu points for 1 minute each.

2. Rub the rectus abdominis Put your palms on the rectus abdominis on both sides, rub from top to bottom for about 1 minute, until the abdomen is slightly hot and reddish.

3. Knock on the back with half-clenched fists, lightly tap the bladder meridian on both sides of the chest 3 to 12 spine for about 1 minute.

4. Lift the back. The patient lies prone. Others start from the Mingmen point, lift the sacral spinal muscles on both sides of the spine, and stop at the Dazhui point. Repeat 20 times.

Diarrhea
An overview of the disease

([-]) Relevant knowledge

Diarrhea is a disease characterized by increased frequency of defecation, thin or incomplete feces, and even watery discharge.Diarrhea is mainly caused by excessive dampness and dysfunction of the spleen and stomach, and is a common spleen and stomach disease.It can occur all year round, but it is more common in summer and autumn.Diarrhea is prone to recurring attacks, and some have different concurrent syndromes depending on individual physique, seasons, and regions.In ancient times, loose stools that were thin and slow were called Xie, and those with clear and watery stools were called Xie, and now they are collectively referred to as diarrhea in clinical practice.In addition, according to the urgency of the onset, it is now divided into two categories: acute and chronic.

([-]) Etiology and pathogenesis

Spleen deficiency and dampness are the important factors leading to the occurrence of this disease.The incidence of acute and chronic diarrhea is different, as follows:
1. Acute diarrhea caused by raw, cold, unclean diet or exposure to cold, damp and summer heat will cause evil guests in the stomach, stagnation of evils, disharmony of qi, and abnormal conduction of the stomach and intestines, resulting in mixing of water and grain, and indistinguishable clearness and turbidity , sent out as diarrhea.

2. Chronic diarrhea with weak spleen and stomach elements, chronic illness and qi deficiency, which makes the health of the middle burner decline, food is difficult to consume, and the food stops in the past, "water turns wet, valleys turn stagnant"; It cannot help the spleen to cook the rotten water and grains, and the grains will not be melted, and the water and dampness will accumulate and overflow in the intestines, and diarrhea will occur.

([-]) Clinical manifestations

The lesion site of diarrhea is in the intestine, and the clinical features are clear and loose stools (increased stool frequency and change in stool quality).The manifestations of acute and chronic diarrhea are different, as follows:
1. The onset of acute diarrhea is more rapid, and the number and frequency of stools increase.If it tends to be cold and damp, the stool will be clear and thin, mixed with water and grains, borborygmus and abdominal pain, no thirst, cold body and warm temperature, slow pulse, pale tongue with white slippery coating.If it is more humid and hot, the yellow glutinous rice will be hot and smelly, abdominal pain and burning in the anus, short red urine, wet and rapid pulse, yellow and greasy tongue, or hot and thirsty all over the body.

2. The onset of chronic diarrhea is slow, or it changes from acute diarrhea, and the number of stools per day is less.Can have the difference of spleen deficiency and kidney deficiency.The former has a pale complexion, or mental fatigue and limb weakness, likes temperature and chills, does not think about eating, loose stools, weak pulse, tender tongue with white fur.The latter often has slight pain in the abdomen before dawn, and the pain leads to diarrhea, or borborygmus without pain, once or several times every morning, the pulse is deep and thready, the tongue is pale and the coating is white, and it is also called Wugeng diarrhea.

([-]) Diagnosis

1. The main basis for diagnosis is clear and thin stool.Or the frequency of defecation increases, and the feces are thin; or the frequency is not many, and the feces are thin, or even watery;

2. Often accompanied by abdominal distension and abdominal pain, the onset may be acute or slow, often with abdominal pain first, followed by diarrhea, often with a history of recurrent attacks, mostly induced by factors such as cold and heat, diet, and emotions.

3. Stool routine, stool bacterial culture, colon X-ray and endoscopy are helpful for diagnosis and differential diagnosis.

4. It is necessary to rule out certain physiological habits of increased frequency of defecation, as well as diarrhea symptoms in other diseases.

([-]) Treatment

The treatment of diarrhea can generally be divided into two aspects: general treatment and drug treatment, as follows:
1. The general treatment is mainly to pay attention to daily life, and some foods with laxative effect should be avoided.In case of acute diarrhea and severe dehydration of the whole body, attention should be paid to the supplement of water and fluid, and intravenous fluid rehydration can be given if necessary.

2. For drug treatment, appropriate antibiotics can be selected according to the condition, and Chinese patent medicines such as berberine can be taken that have the effect of transporting the spleen and removing dampness.

([-]) Prevention

Diarrhea should be based on prevention.Usually, you should develop good food hygiene habits, do not drink unboiled water, do not eat raw and cold melons and fruits; the temperature of the living place is suitable; and it can be combined with diet therapy to strengthen the spleen and stomach.For acute diarrhea, the patient should gently wipe the anus with soft paper and wash it with warm water after each bowel movement, so as to avoid infection of the anus and ulceration of the mucous membrane.For those with severe diarrhea, care should be taken to prevent body fluid loss and replenish body fluids in time.After the diarrhea is cured, attention should be paid to diet, mental health and physical exercise to prevent recurrence.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
(1) For acute diarrhea, take Zhongwan, Tianshu, Shangjuxu, and Yinlingquan.

(2) Take Pishu, Zhangmen, Zhongwan, Tianshu, Zusanli, Mingmen and Guanyuan for chronic diarrhea.

2. Positioning
Zhongwan—Abdomen, on the front midline, 4 cun above the middle of the navel.

Tianshu—abdomen, 2 cun lateral to the middle of the navel.

Upper Juxu—6 cun below Dubi Point, one transverse finger (middle finger) outside the anterior crest of the tibia.

Yinling Spring—the inner side of the calf, in the depression below the medial condyle of the tibia.

Pishu—Below the spinous process of No.11 thoracic vertebrae, 1.5 cun laterally.

Zhangmen—side abdomen, below the free end of No.11 rib.

Zusanli—3 cun below Dubi Point, one transverse finger (middle finger) outside the anterior crest of the tibia.

Mingmen—waist, on the posterior midline, in the depression under the spinous process of the second lumbar vertebra.

Guanyuan—lower abdomen, on the front midline, 3 cun below the middle of the navel.

([-]) Self-massage
1. Knead the lower abdomen Take a sitting or supine position, and use the palm kneading method on the lower abdomen in a clockwise direction for about 2 minutes, depending on the temperature.

2. Massage Qihai Take the sitting or supine position, and massage Qihai with the palm of your hand for about 2 minutes.

3. Chiropractic patients lie prone, others start from the gate of life, pinch the skin of the spine, loosen and tighten up to Dazhui, repeat the operation 9 times.

4. Push the sacral coccygeal part of the patient to lie prone, another person uses the heel of the palm to support the coccyx, push it from bottom to top to Mingmen point, operate for 2 minutes, until the local area is reddish and slightly hot.

Liver Disease
An overview of the disease

([-]) Basic knowledge

1. Where is the liver in our human body? The liver is located in the upper right part of the abdominal cavity (partly in the upper left part of the abdominal cavity), divided into two lobes, the left (small) and the right (large), weighing 1200-1500 grams.The upper boundary of the liver is between the 5th and 6th ribs of the right thorax; the lower boundary does not exceed the lower border of the ribs, sometimes it can be felt under the xiphoid process, but it does not exceed 3cm.The liver can move up and down with breathing.Below it is the portal of the liver, which is the entrance and exit of the hepatic arteriovenous, portal vein, hepatic bile ducts, lymphatic vessels, and nerves, and the gallbladder is located on the left below.

2. What is the function of the liver? The liver is the largest digestive gland in the human body. It has important functions such as secreting bile, storing glycogen and detoxifying. It is the main place of human metabolism and is called the chemical factory of the human body.The metabolism of the three major nutrients (sugar, protein, fat) requires the participation of the liver.The storage and metabolism of other substances also require the liver to participate, such as: vitamins, hormones, bilirubin, etc.In addition, the liver also has the functions of detoxification and phagocytosis, which can protect the human body.

([-]) Hepatitis

1. What is viral hepatitis? It is a group of infectious diseases caused by hepatitis virus, with liver inflammation and degeneration and necrosis of liver parenchymal cells as the main lesions.The main clinical manifestations are: reluctance to eat, easy fatigue, nausea, vomiting, hepatosplenomegaly, abnormal liver function test, or jaundice, fever.

2. How many types of viral hepatitis? There are at least 5 types of common hepatitis: A (HA), B (HB), C (HC), D (HD), and E (HE).Types A and E are transmitted through the fecal-oral route.Among them, type A mostly occurs in summer and autumn, and if the prevention and control is not effective, it can become an outbreak; type E mostly occurs in the rainy season and after floods, and rarely becomes chronic.Types B, C, and D are mainly transmitted through blood, without seasonality, and are mainly sporadic. They are easy to become chronic, and some of them can be transformed into liver cirrhosis, and finally lead to primary liver cancer.

(End of this chapter)