STOMACHACHE

Lee Chong Leng

1

STOMACHACHE

STOMACHACHE

CONTENTS

1)

Introduction 5

2)

Clinical Manifestations 6 - 10

3)

Essentials for Diagnosis 11

4)

Treatment with Tuina Therapy

12 - 41

5)

Cautions 424

STOMACHACHE

Pain in the epigastric region

Similar to gastrospasm, chronic and acute gastritis, gastric and duodenal ulcer, gastrointestinal neurosis and other functional disorders of the upper digestive tract in modern medicine

5

CLINICAL MANIFESTATIONS

• 1. Stagnation of pathogenic factors

• (1) Due to cold attack

• (2) Retention of food

• 2. Zangfu-organ disorder

• (1) Invasion of liver Qi into stomach

• (2) Deficiency cold of spleen & stomach

6

STAGNATION OF PATHOGENIC FACTORS

(1) Due to cold attack

Sudden onset of vague or colic pain to be alleviated with warmth and worsened with cold

No thirst or preference for warm water, light and white tongue with coating, taut and tense pulse 7

STAGNATION OF PATHOGENIC FACTORS

(2) Retention of food

Distention or even pain in the epigastric region, accompanied by belching, eructation with fetid odor, acid regurgitation or vomiting of indigested food

Alleviation after vomiting and breaking wind, anorexia, unsmooth defecation, yellowish or whitish greasy coating and slippery pulse

8

ZANGFU-ORGAN DISORDER

(1) Invasion of liver Qi into stomach

Fullness in the stomach distending pain involving the hypochondrium

Frequent belching, unsmooth defecation, depression, or pain due to emotional changes, thin whitish tongue coating and taut pulse

9

ZANGFU-ORGAN DISORDER

(2)Deficiency cold of spleen and stomach

Vague stomachache, profuse clear saliva, preference for warmth and pressure, alleviation with warmth and pressure, aggravation on empty stomach, improvement of pain after taking food

Poor appetite, lassitude, or even cold limbs, loose and thin stool, pale tongue, thin and whitish coating, weak soft pulse or slow pulse

10

ESSENTIALS FOR DIAGNOSIS

1. Often accompanied by oppression, distension, eructation and gastric upset

2. Often associated with emotion changes improper diet, overstrain, and cold attack

3. Through barium meal X-ray examination of upper digestive system and gastric endoscope, gastric duodenal mucositis and ulcer can be revealed

4. If stool and vomitus test is positive, it suggests gastrointestinal hemorrhage

5. B ultrasonic examination, liver function and gallbladder tract X-ray examination are helpful for differential diagnosis

11

TREATMENT WITH TUINA THERAPY

Principle:

Regulating Qi and stopping pain

12

TREATMENT WITH TUINA THERAPY

Acupoints and location:

Zhongwan (CV 12), Tianshu (ST 25), Qihai (CV 6),Zusanli (ST 36), Geshu (BL 17), Ganshu (BL 18), Pishu (BL 20), Weishu (BL 21),Sanjiaoshu (BL 22), Jianjing (GB 21), Shousanli (LI 10), Neiguan (PC 6), Hegu (LI 4) and hypochondriac region13

TREATMENT WITH TUINA THERAPY

Operation 1:

(1)Patient - lateral recumbent position

(2)Gently use one-finger pushing and rubbing manipulations to rub the epigastric region to direct warmth into the abdomen

(3)Rub Zhongwan (CV 12), Qihai (CV 6), Tianshu (ST 25) and Zusanli (ST 36) for about 5 minutes

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15

Zhongwan (中脘 ) ， Tianshu (天枢 ) ， Qihai (气海 )

16

Zusanli (足三里 )

TREATMENT WITH TUINA THERAPY

Operation 2:

(1)Patient - prone position

(2)Press both sides of spine along the bladder meridian to Sanjiaoshu (BL 22) for 4-5 times

(3)Alternatively press Geshu (BL 17), Ganshu (BL 18), Pishu (BL 20), Weishu (BL 21) and Sanjiaoshu (BL 22) for about 5 minutes 17

18

Geshu (膈俞 ) ， Ganshu (肝俞 ) ， Pishu (脾俞 ) ， Shenshu (肾俞 )

19

Weishu (胃俞 )

20

Sanjiaoshu (三焦俞 )

TREATMENT WITH TUINA THERAPY

Operation 3:(1)Patient - sitting position

(2)Grasp and hold Jianjing (GB 21) from the arm down to the elbow,

(3)Press harder on Shousanli (LI 10), Neiguan (PC 6) and Hegu (LI 4)

(4)Rub the shoulder and arm to smooth the meridians, wipe the rib-sides upwards and downwards for 5-6 minutes

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22

Jianjing (肩井 )

23

Shousanli (手三里 )

24

Neiguan (内关 )

25

Hegu (合谷 )

MANIPULATIONSACCORDING TO

SYNDROME DIFFERENTIATION

26

(1) COLD ATTACK

Press strongly Pishu (BL 20), Weishu (BL 21) for about 2 minutes

Rub the left part of the back (T7 – T12) until it becomes warm

27

(2) RETENTION OF FOOD

Rub clockwise the abdomen, especially on Zhongwan (CV 12), Tianshu (ST 25), Zusanli (ST36) for 5 minutes

Rub Weishu (BL 21), Dachangshu (BL 25), Baliao for 5 minutes

28

29

Shenshu (肾俞 ) ， Dachangshu (大肠俞 )

30

Baliao (八髎 )

(3) INVASION OF LIVER QI

Press gently Tiantu (CV 22) down to Zhongwan (CV12), specially Danzhong (CV 17)

Rub and press Zhangmen (LR 13), and Qimen (LR 14)

Press strongly Ganshu (BL 18), Danshu (BL 19), Geshu (BL 17)

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32

Tiantu (天突 )

33

Shanzhong (膻中 )

34

Qimen (期门 ) ， Zhangmen (章门 )

35

Danshu (胆俞 )

36

Geshu (膈俞 ) ， Ganshu (肝俞 ) ， Pishu (脾俞 ) ， Shenshu (肾俞 )

(4) DEFICIENCY COLD IN SPLEEN AND

STOMACH

Rub gently Qihai (CV 6), Guanyuan (CV 4) and Zusanli (ST 36) for 2 minutes each

Rub vertically the governor vessel on the back

Rub horizontally the left side of the back (T7 – T12), Shenshu (BL 23) and Mingmen (GV) until it is warm in the local area.

37

38

Guanyuan (关元 )

39

Shenshu (肾俞 ) ， Dachangshu (大肠俞 )

40

Mingmen (命门 )

(5) SEVERE STOMACHACHE

Press strongly Pishu (BL 20) and Weishu (BL 21) for 2 minutes continuously

After the pain is relieved, it can be treated according to syndrome differentiation

41

CAUTIONS1. Tuina therapy is not available for

those with gastrointestinal ulceration and hemorrhage

2. Have a regular daily life and pay more attention to mental state and diet

3. Better to take food that is easy to digest, avoid alcohol and pungent food

4. For chronic stomachache, take liquid or semi-liquid diet for a certain period

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THANK YOU