Disease and Condition Overview
Gastroneurosis is a group of symptoms characterized by irregularity of motility and secretion from the stomach and intestines but without any structural abnormalities of the digestive system. The disease course is often long with chronic recurrence. Its clinical symptoms are mainly around the stomach: regurgitation, nausea, heartburn, burping, poor appetite, vomiting, upper abdominal distension or cramps, and are often accompanied by other neurological symptoms such as exhaustion, forgetfulness, headache, heart palpitations, tightness in the chest, hyperhidrosis, nocturnal emissions and anxiety. In Chinese medicine, this is caused by all types of external and internal factors which lead to irregular functions of stomach, or disharmony of liver and stomach. After a prolonged period, the symptoms lead to spleen and kidney yang deficiency or yang deficiency, yin deficiency or both yin and yang deficiency.

This is a common disease most often seen in young adults, predominantly females. The clinical symptoms include vomiting, burping and loss of appetite. Because the disease does not involve any structural changes, diagnosis and differentiation are important. Because the physiological changes in some diseases may not be apparent in the beginning and gastroneurosis can occur as a result of some other illness, both scenarios may exist and influence each other. In addition, gastrointestinal functional and motility disorder may occur after structural changes in the gastrointestinal system have been rectified. Use endoscopy, x-ray and other methods to help obtain an accurate diagnosis.

Pair-point Treatment Combinations

(1) Liangmen (ST 21), Yangfu (GB 38) (Fig 101)
Liangmen (ST 21): on the upper abdomen, 4 cun superior to the umbilicus, 2 cun lateral to the anterior midline.
Yangfu (GB 38): on the lateral side of the lower leg, 4 cun superior to the tip of the lateral malleolus, slightly anterior to the anterior border of the fibula.
Liangmen (ST 21) regulates qi in the middle jiao and facilitates the functions of both intestine and stomach. Yangfu (GB38) disperses the liver to resolve blockages and opens the luo-connecting channels to stop cramps. This pair point combination, one stomach and one gallbladder, work in synergy to disperse liver, harmonize stomach and resolve shaoyang. This treatment is appropriate for gastroneurosis caused by liver qi invading stomach.

Needling techniques:
1. Liangmen (ST 21) perpendicular insertion to a depth of 1 cun.
2. Yangfu (GB 38) perpendicular insertion to a depth of 1.5 cun.

(2) Shousanli (LI 10), Zusanli (ST 36) (Fig 102)
Shousanli (LI 10): On the radial side of the dorsal surface of the forearm, 2 cun distal to the cubital crease, on the line connecting Yangxi (LI 5) and Quchi (LI 11).
Zusanli (ST36): on the anteriolateral side of the lower leg, 3 cun inferior to Dubi (ST35), one finger breadth (middle finger) lateral to the anterior crest of the tibia.
Shousanli (LI10) opens the luo-connecting channels, stops cramps and harmonizes stomach and intestine. Zusanli (ST36) strengthens spleen, harmonizes stomach, facilitates qi and stops pain. This pair point combination, one superior and one inferior, one intestine and one stomach, regulates qi of the yangming and unobstructs intestine and stomach. This treatment is appropriate for gastroneurosis caused by dysfunction of qi.

Needling techniques:
1. Shousanli (LI10) perpendicular insertion to a depth of 1 cun.
2. Zusanli (ST36) perpendicular insertion to a depth of 2 cun.

(3) Liangmen (ST 21), Zusanli (ST 36) (Fig 103)
Liangmen (ST 21): on the upper abdomen, 4 cun superior to the umbilicus, 2 cun lateral to the anterior midline.
Zusanli (ST 36): on the anteriolateral side of the lower leg, 3 cun inferior to Dubi (ST35). One finger breadth (middle finger) lateral to the anterior crest of the tibia.
Liangmen (ST21) harmonizes and regulates qi and stomach to reduce distension. Zusanli (ST36) strengthens spleen, harmonizes stomach, facilitates qi and stops pain. This pair point combination, one superior and one inferior, disperses and opens channels, harmonizes the stomach by reversing the nsing, invigorates blood and stops pain. This treatment is appropriate for all types of gastroneurosis.

Needling techniques:
1. Liangmen (ST21) perpendicular insertion to a depth of 1 cun.
2. Zusanli (ST36) perpendicular insertion to a depth of 2 cun.

Commentaries
Acupuncture is effective in the treatment of gastroneurosis. During the treatment it is important to observe the patient's psychological state as well.
For gastroneurosis caused mainly by liver qi invading the stomach, use Liangmen (ST 21), Yangfu (GB 38).
For patients with qi dysfunction, select Shousanli (LI 10), Zusanli (ST 36). Also, Liangmen (ST 21), Zusanli (ST36) can be used to treat all types of functional disorder of the digestive system.