lntroduction
Gastric and duodenal ulcer is clinically marked by periodic and rhythmic attack and abdominal pain, often accompanied by belching, acid regurgitation, nausea and vomiting. This disease usually occurs among youth and people prime in life, especially among the male. It pertains to the conceptions of epigastralgia, acid regurgitation, heartburn, hematemesis and hematochezia in TCM. It is usually caused by improper diet, emotional changes and overstrain due to dysfunction of the liver in dispersion and conveyance and impairment of the spleen and stomach.
Syndrome Differentiation
1. Disharmony Between the Liver and Stomach
Epigastralgia involving the rib-sides, belching and acid regurgitation, even nausea and vomiting, aggravation after emotional changes, yellow and thin tongue fur and taut pulse.
2. Retention of Heat in the Stomach and Intestines
Burning sensation in the stomach, dryness and bitter taste in the mouth, foul breath, yellow urine and retention of dry feces, red tongue with yellow fur and rapid pulse.
3. Qi Stagnation and Blood Stasis
Stabbing and unpressable epigastralgia, aggravation after meal, or hematemesis, hematochezia, purplish tongue with ecchymoses and unsmooth pulse.
4. Asthenia-cold in the Spleen and Stomach
Dull epigastralgia, preference for warmth and pressure, regurgitation of clear fluid, spiritual lassitude, lusterless complexion, loose stool, light-colored tongue with white fur and thin and weak pulse.
Treatment
1. Body Acupuncture
Prescription: Pishu (BL 20), Weishu (BL 21), Zhongwan (CV 12), Neiguan (PC 6) and Zusanli (ST 36).
Modification: For liver qi invading the stomach, Taichong (LR 3) and Qimen (LR 14) are added; for retention of heat in the stomach and intestines, Neiting (ST 44) and Qiangu (SI 2) are added; for qi stagnation and blood stasis, Hegu (LI 4) and Geshu (BL 17) are added; for asthenia-cold in the spleen and stomach, Zhangmen (LR 13) and Qihai (CV 6) are added; for severe stomachache, Liangqiu (ST 34) is added; for constipation and loose stool, Tianshu (ST 25) and Xiajuxu (ST 39) are added; for hematemesis or hematochezia, Zhongwan (CV 12) is deleted while Xuehai (SP 10) and Geshu (BL 17) are added.
Performance: The acupoints on the abdomen should not be vertically needled too deeply. Qimen (LR 14) should be needled obliquely medial or lateral along the costal space with moderate stimulation. Liangqiu (ST 34) is needled with strong stimulation and reducing needling technique. For asthenia-cold in the spleen and stomach, Back-Shu acupoints and Front-Mu acupoints as well as Qihai (CV 6) and Zusanli (ST 36) are needled with the addition of moxibustion and cupping.
2. Ear Acupuncture
Prescription: Stomach (CO4), Duodenum (CO5), Spleen (CO13), Liver (CO12), Triple Energizer (CO17), Sympathetic Nerve (AH6a), Ear Shenmen ( TF4 ) and Subcortex (AT4).
Performance: Each time 3 - 5 acupoints are selected and needled with routine techniques or embedded with needles. Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure. The two ears are treated in alternation.