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[lntroduction]
Gastric and duodenal ulcer is clinically marked by pe-riodic and rhythmic attack and abdominal pain, often ac-companied by belching, acid regurgitation, nausea and vomiting. This disease usually occurs among youth and people prime in life, especially among the male. It per-tains to the conceptions of epigastralgia, acid regurgita-tion, 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 stom-ach.
[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 intes-tines
Burning sensation in the stomach, dryness and bitter taste in the mouth, foul breath, yellow urine and reten-tion 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 pres-sure, regurgitation of clear fluid, spiritual lassitude, lus-terless 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, Tai-chong (LR 3) and Qimen (LR 14) are added; for reten-tion 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 stomach-ache, 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 cos-tal 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 Qi-hai (CV 6) and Zusanli (ST 36) are needled with the addi-tion of moxibustion and cupping.
2. Ear acupuncture
Prescription: Stomach (CO4), Duodenum (CO5), Spleen (C013), Liver (CO12), Triple Energizer (CO17), Sympathetic Nerve (AH
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.
