According to TCM theory, pain in the epigastrium is the main symptom of epigastralgia and is caused by one of three syndromes: hyperactive liver Qi attacking the stomach, insufficiency of the spleen Yang, stagnation of Qi, and stasis of blood. Improper diet, climate change, and mental factors may also give rise to epigastralgia.
Symptoms. When this condition is caused by hyperactive liver Qi attacking the stomach, there will be pain and fullness in the gastric region, vomiting and sour regurgitation which gets worse when excited, a taut pulse, and white, thin tongue fur. When epigastralgia is caused by insufficiency of the spleen Yang, pain will be relieved by pressing and warming the affected area, the patient will have a poor appetite, flatulence, watery vomitus and stools, clear urine, aversion to cold, a white, thin tongue fur, and a slow pulse. When epigastralgia is caused by Qi stagnation or blood stasis, there will be localized pain and tenderness in the epigastrium, masses in the abdomen, black stool, reddened tongue, and a taut, hesitant pulse.
1. Self-Treatment with Qigong Exercise. Practice Psychosomatic Relaxation Exercise and Inner Health Cultivation Exercise. The method Rubbing Zhongwan (Ren 12) Area, saying "Hu" and the manipulation procedures of Dredging the Spleen and Stomach described in Spleen Regulation Exercise may be practiced by patients with hyperactive liver Qi which is attacking the stomach and causing Qi stagnation and blood stasis. Patients with insufficiency of spleen Yang should use the technique Taking Yellow Qi to regulate the spleen and Dredging the Spleen and Stomach. As described in Spleen Regulation Exercise, Chest-Hypochondrium Exercise and Abdominal Exercise should also be performed.
2. Treatment with Outgoing Qi. The patient should lie supine, breathe evenly, relax, and expel any distractions. When exhaling, guide Qi to flow towards the gastric area where pain exists. Knead the location of Lanmen (ileocecal) junction with the right hand and press the point Jiuwei (Ren 15) with the middle finger of the left hand. Using the Flat Palm gesture and vibrating manipulation, emit Qi towards the gastric area for a period of 14 normal respirations. The Middle Finger Propping gesture with vibrating manipulation should then be used to emit Qi towards the points Zhongwan (Ren 12) and Qthai (Ren 6). Qi emission should last for 14 normal respirations. Then, push, rub, and knead the abdomen in accordance with Pushing the Abdomen to separate Yin and Yang. Use the Flat Palm gesture and pushing-vibrating manipulation to emit Qi towards the point Zhongwan (Ren 12). The emitting hand should be above, not on, the area. Emit Qi for a period of 14 normal respirations. The pushing and leading manipulations should then be used to guide Qi to flow towards the Dantian along the Ren Channel or to flow downward along the Stomach Channel of Foot Yangming. Stop emitting when the functional activities of Qi are balanced.
With the patient lying prostrate, knead the points Pishu (U.B.20), Weishu (U.B.21), Ganshu (U.B.18) as well as the entire Urinary Bladder and the Du Channel. Emit outgoing Qi using the vibrating manipulation on the points of Pishu (U.B.20) and Weishu (U.B.21) for a period of 14 normal respirations. The Flat Palm gesture and the pulling-leading manipulations are used to guide the flow of Qi downward along the Urinary Bladder Channel of Foot Taiyang.
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