Introduction
Chronic gastritis refers to various chronic inflammation of gastric mucus due to different pathogenic factors. According to the pathological changes, chronic gastritis can be divided into superficial, atrophic and hypertrophic types of gastritis. The clinical manifestations are atypical. The main symptoms are recurrent fullness, oppression and pain in the middle and upper abdomen as well as anorexia, dyspepsia, nausea, vomiting and belching. This disease is similar to epigastralgia and abdominal fullness in TCM. Chronic gastritis is usually caused by emotional upsets, improper diet, overstrain and weakness due to prolonged disease that lead to depression of liver and qi stagnation, asthenia-cold in middle energizer and insufficiency of stomach yin; or by involvement of the collaterals in prolonged disease and stagnation of blood in the collaterals.
Syndrome Differentiation
1. Liver Depression and Qi Stagnation
Epigastralgia involving the rib-sides, migratory pain, frequent belching and sighing, red tongue with thin and yellow fur as well as taut and rapid pulse.
2. Asthenia-Cold in the Spleen and Stomach
Dull stomachache, preference for warmth and pressure, emaciation and spiritual lassitude, lusterless complexion, loose stool, aversion to cold and cold limbs, light-colored and bulgy tongue with thin, white and slippery fur as well as thin and weak pulse.
3. Insufficiency of Stomach Yin
Irregular pain in the stomach, heartburn like hunger, hunger without appetite, dry mouth with desire to drink, red tongue with scanty fur, taut and thin or thin and rapid pulse.
4. Stagnation of Blood in the Collaterals
Stabbing epigastralgia with fixed and unpressable pain, occasional hematemesis or hematochezia, purplish tongue or with ecchymoses and unsmooth pulse.
Treatment
1. Body Acupuncture
Prescription: Zhongwan (CV 12), Neiguan (PC 6), Gongsun (SP 4), Liangmen (ST 21) and Zusanli (ST 36).
Modification: For liver qi invading the stomach, Taichong (LR 3), Qimen (LR 14) and Ganshu (BL 18) are added; for asthenia-cold in the spleen and stomach, Pishu (BL 20) and Weishu (BL 21) are added; for insufficiency of stomach yin, Taixi (KI 3) and Sanyinjiao (SP 6) are added; for stagnation of blood in the collaterals, Xuehai(SP 10) and Geshu (BL 17) are added; for stomach heat, Neiting (ST 44) is added; for fullness and distension in the epigastrium and abdomen, Zhangmen (LR 13), Burong (ST 19) and Pishu (BL 20) are added.
Performance: For liver qi invading the stomach and stagnation of blood in the collaterals, mild reducing and reinforcing needling techniques or reducing needling technique can be used; for asthenia-cold in the spleen and stomach and insufficiency of stomach yin, reinforcing needling technique can be used. For the treatment of asthenia-cold syndrome, moxibustion can be used in addition.
2. Ear Acupuncture
Prescription: Stomach (CO4), Spleen (CO13), Liver (CO12), Triple Energizer (CO17), Sympathetic (AH6a), Ear Shenmen (TF4) and Subcortical (AT4).
Performance: Each time 2 - 3 acupoints is selected. The needles are retained for 30 minutes and manipulated at intervals. Or electropuncture may be used. Or Wangbuliuxingzi (Semen Vaccariae) can be used for ear pressure. Two ears are needled in alternation.