Peptic ulcer disease (gastric ulcer and duodenal ulcer) is a common clinical problem. The lifetime prevalence of peptic ul-cer disease is 5 % to 10 %. The most important risk factors are infection with H. pylori, NSAID ingestion, and the unopposed hypergastrinemia of Zollinger Ellison syndrome. A number of "myth"factors are clearly not associated with the development of ulcers: stress, personality, occupation, alcohol consump-tion, and diet.
Diagnosis in Traditional Chinese Medicine
Peptic Ulcer is categorized as "weiwan tong", "outu ", etc. in traditional Chinese medicine.
1. Symptoms: Cardinal symptom of the disease is chronic epigastralgia which is marked by dull pain or pinching pain. Sometimes it is manifested as distending pain or burning pain which often radiates to the lumbar region or the back. The pains are closely related to meals. The rule of attack in gastric ulcer is food intake pain remission, while in duodenal ul-cer the rule is pain food intake remission. The pain oc-curs periodically and is often induced by coldness, fatigue and improper food intake. The attack is frequently in winter and spring.
Other symptoms include acid regurgitation, belching, nausea and vomiting. In a few cases, perforation or bleeding may be the first clinical findings.
2. Signs: In active ulcer, there is often tenderness in the middle and upper abdominal regions. Tenderness on the left side of upper gastric region is found in gastric ulcer, while in duodenal ulcer it is found on the right side, often localized in 3-4 cm. Ulcer in the posterior wall may have pain hypersensi- tive area on the back at T11--12 level.
Differentiation and Treatment of Common Syndromes in Traditional Chinese Medicine
1. Insufficiency-cold Type :
Clinical manifestations: Latent pain in the upper abdomen with predilection for heat, and intolerance of cold which ag-gravates the pain, sallow complexion, lassitude and weakness, or loose stool, pale tongue with thin whitish fur, deep, slow and weak pulse.
Therapeutic method: Warming and invigorating middle-jiao .
Recipe: Modified Decoction of Astragalus for Tonifying middle-iiao.
Ingredients:
Radix Astragali seu Hedysari 9g
Ramulus Cinnamomi 18g
Radix Paeoniae Alba 30g
Os Sepiella seu Sepiae 30g
Radix Angelicae Dahuricae 15g
Radix Glycyrrhizae Praeparata 30g
Administration: All the above drugs are to be decocted in water for oral administration.
