| Objective: This paper analyzes the etiology and pathogenesis of epigastric pain,probes into Professor Zhang Qingxiang ’ s experience in diagnosis and treatment of epigastric pain,and sums up the rule of medication.Methods: In this paper,theoretical research and case studies are employed as research methods.(1)Theoretical research: the paper probes into the physiology and pathology of stomach,its relations with zangfu organs and qi movement,the etiology,pathogenesis and treatment rule of epigastric pain.(2)Case study: 225 cases,treated by Professor Zhang Qingxiang from January 2016 to October 2018 in Zhonglu Hospital of Shandong University of Traditional Chinese Medicine,were selected for study.Symptoms and signs,syndromes and medication were selected from those case and recorded in Shennong Chinese medicine management system,and on this basis,we established a database for Professor Zhang Qingxiang clinical treatment of epigastric pain.By using the functions of data analysis of Shennong system,we discussed the statistic results with Chinese medicine theories.Research results:(1)Theoretical research: Classic theories of Chinese medicine show that the stomach is responsible for reception and decomposition,and it likes moisture while hates dryness.The occurrence of epigastric pain is mainly due to improper diet,emotional stimulation,or exogenous pathogens.Deficiency of stomach qi,stomach failing to receive and descend can lead to epigastric pain,nausea,vomiting,hiccup and belching.(2)Experimental study: According to the statistics of 225 cases recorded by Professor Zhang Qingxiang in the treatment of epigastric pain,we find that the minimum age of the patients was 16 years old while the maximum age was 83 years old,and the average age was about 44.78 years.Epigastric pain mostly happens in the middle and old aged.Of the225 cases,there are a total of 450 syndrome types: 125 cases for syndrome of liver and stomach stagnation(accounting for 55.56%),90 cases for syndromes of heat-dampness(accounting for 40.00%);39 cases for syndrome of liver and stomach depression(accounting for 17.33%),37 cases for syndrome of spleen deficiency and liver stagnation(accounting for 16.44%),25 cases for syndrome of spleen deficiency and liver hyperactivity(accounting for 11.11%),24 cases for syndrome of disorder of cold and heat(accounting for 10.67%),23 cases for syndrome of spleen deficiency due to obstruction of dampness(accounting for 10.22%),17 cases for syndromes of deficiency of qi and yin(accounting for 7.56%),12 cases for qi stagnation caused by obstruction of qi(accounting for 5.33%),and there are still 59 cases(accounting for 26.22%)for other syndromes such as obstruction of phlegm and qi,qi weakness and blood stasis,cold coagulation in channel,spleen deficiency leading to accumulation of food.Statistics show that epigastric pain is mainly due to disorder of spleen,stomach and liver.Professor Zhang Qingxiang tends to use Chaiping Decoction,Erchen Decoction,Banxia Xiexin Decoction and Xiaoyao Power,and the most common medicinals include Chinese Thorowax Root,Baical Skullcap Root,Pinellia Tuber,Dried Tangerine Peel,Green Tangerine Peel,Chicken’s Gizzard-Skin and so on.Conclusion : The stomach is in the abdomen,and it has the effect of receiving and decomposing food,which is closely related to liver governing free flow of qi and spleen governing transformation and transportation.Due to the pressure of life,irregular diet and emotional disorder,qi movement becomes disorder and leads to liver and stomach qi stagnation,and thus dampness and heat accumulated inside are the main pathogenesis of patients with epigastric pain.So,in treatment,methods of soothing the liver and regulatingqi,clearing dampness and heat,and balancing stomach and spleen are most commonly used.In clinical practice,five zang organs should be taken into consideration,especially regulating the liver,spleen and stomach to regulate qi movement. |
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