The differentiation of chronic gastritis is mainly to identify different syndromes in light of TCM theory. Is the case caused by qi stagnation or by blood stagnation? Does the case pertain to cold syndrome or to heat syndrome, to deficiency syndrome or to excess syndrome? Generally, the case with a long course and manifested as cold pain, preference for hot food, vomiting of watery fluid belongs to cold syndrome. The case with a short course and manifested as burning pain, preference for cold food,vomiting of acid fluid belongs to heat syndrome. Deficiency syndrome has a long course with preference for pressure at the painful area, pain aggravated by hunger and alleviated by intake of food. Excess syndrome has a short course with pain aggravated by pressure and intake of food, alleviated by hunger. The case with a short course and manifested as paroxysmal painand distention is caused by qi stagnation.
The case with a long course and manifested as continuous, fixed and pricking pain is caused by blood stagnation. The treatment should be based on the principle of regulating the flow of qi, normalizing the function of the stomach and relieving pain. For excess syndrome, cold accumulation, qi stagnation, stomach heat, blood stagnation should be identified and treated respectively by dispersing cold, relieving pain, soothing the liver, clearing liver and stomach heat and removing blood stasis in the channels. For deficiency syndrome, yang deficiency and yin deficiency should be identified and treated by warming the stomach and strengthening middle energizer or nourishing stomach yin.
(1) Pathogenic Cold Attacking the Stomach
Chief Manifestations: Sudden onset of gastric pain which is aggravated by pressure and alleviated by hot compression, preference for warmth and aversion to cold,absence of thirst, preference for hot drinks, white tongue coating, wiry and tense pulse.
(2) Damp Heat in the Spleen and Stomach
Chief Manifestations: Fullness or distending pain in the gastric area, anorexia, bitter taste and stickiness in the mouth, heavy sensation in the head and body, dyschesia, feverish sensation in the anus, red tip and margin of the tongue, with yellow and greasy coating, wiry and smooth pulse. Continue to learn Chinese medicine Treatment for Erosive Gastritis.
(3) Disharmony Between the Liver and Stomach
Chief Manifestations: Distending pain in the gastric area radiating to the hypochondriac area, fullness in the chest, belching, frequent sighing, vomiting, restlessness, irritability, dizziness, insomnia, dyschesia, or diarrhea or constipation, pale tongue with thin and yellow coating or thin and white coating, wiry pulse.
(4) Blood Stasis Blocking the Collaterals
Chief Manifestations: Pricking or cutting epigastric pain, which is fixed and aggravated by pressure, or hematemesis, tarry stools, gloomy complexion, purple tongue or with purple spots, unsmooth pulse.
(5) Qi Deficiency in the Spleen and Stomach
Chief Manifestations: Fullness in the gastric area,which is worse after intake of food, anorexia, lassitude,loose stools, pale and swollen tongue with thin and white coating, deep and weak pulse.
(6) Yang Deficiency in the Spleen and Stomach
Chief Manifestations: Continuous dull pain in the gastric area, which is relieved by warmth, pressure and intake of food, vomiting of clear fluid, anorexia, lassitude, cold limbs, loose stools, pale and swollen tongue with thin and white coating, thready and weak pulse. Continue to learn TCM Treatment Evaluation for Erosive Gastritis.
(7)Yin Deficiency in the Spleen and Stomach
Chief Manifestations: Dull burning pain in the gastric area, restlessness and thirsty, dry mouth and throat,discomfort and feverish sensation in the gastric area, dry stools, dizziness, insomnia, poor appetite, or feverish sensation in the palms and soles, red tongue with little coating or cracks on the tongue, or peeling of the coating,thready and rapid pulse.
