Western diagnosis Chronic gastritis, hypertension.

[Western diagnosis] Chronic gastritis, hypertension. [TCM diagnosis] Spleen and stomach damp-heat, damp-heat stagnation. [Treatment principle] Clear heat and transform dampness, regulate qi and harmonize the stomach. [Prescription] Huopu Xialing Tang, GuaWei BaiBanXia Tang, Guanxin No. 2 with modifications: Huoxiang 10g, Houpu 10g, Baodoukou 10g, Xingren 10g, Yiren 30g, Gancao 6g, Fuling 10g, Zexie 10g, Huanglian 10g, Danshen 20g, Cheshao 10g, Jiangxiang 10g, Honghua 6g, GuaWei 10g, Tanbai 10g, Banxia 6g. Decoct in water and take one dose daily for a total of 14 doses orally. Second visit: After taking the medicine, stomach pain and nausea improved, bitterness and sweating lessened, but still experiencing stomach bloating and discomfort, lower limb soreness, red tongue, thin yellow coating, slippery rapid pulse, blood pressure measured at 130/85 mmHg. The condition is characterized by lingering damp-heat, residual evil remaining, so the above formula reduced Huanglian to 6g, added Cangzhu 10g, Chenpi 6g, and continued taking the medicine for over two months, resulting in improvement and normal blood pressure. Case 6: Ms. Chen, 28 years old. Chief complaint: Stomach pain accompanied by oral and lingual erosion for half a year. Six months ago, she developed stomach pain after consuming unclean food, with oral and lingual erosion varying in severity, dry and parched mouth, emaciation and fatigue, and dry stools. Tongue red with little coating, cracks, and a fine rapid pulse. Oral examination: Gum bleeding, small pustules on the inner oral mucosa. Gastroscopy: Gastric mucosa shows patchy red and white areas, chronic atrophic gastritis. [Western diagnosis] Chronic atrophic gastritis, oral ulcers. [TCM differentiation] Deficiency of stomach yin, internal accumulation of damp-heat. [Treatment principle] Nourish yin and nourish the stomach, clear heat and remove dampness. [Prescription] Pei’s Stomach-Nourishing Soup and Banxia Xiexin Tang with modifications: Beisha Shen 10g, Maidong 10g, Yuzhu 10g, Shihu 10g, Bai Biandou 30g, Banxia 6g, Huangqin 10g, Huanglian 6g, Dangshen 10g, Gancao 6g, Dazao 4 pieces, Danshen 20g, Zhizi 10g, Dahuang 6g, Shengshi 20g. Decoct in water and take one dose daily for a total of 14 doses orally. Second visit: After taking the medicine, stomach pain lessened, oral ulcers improved, gum bleeding reduced, tongue red with little coating, pulse weak, still experiencing dry mouth and fatigue. The condition is characterized by dual deficiency of qi and yin, so the above formula removed Dahuang, added Taizishen 15g to tonify qi and strengthen the spleen, and continued taking the medicine for half a year, resulting in improvement. Case 7: Ms. Da, 55 years old. Chief complaint: Intermittent stomach pain for over 11 years, worsening for half a year. She frequently takes Omeprazole, Weikangling, and other medications, with fluctuating conditions. In the past six months, due to frequent drinking, her stomach pain has gradually worsened, and eating cold and greasy foods leads to diarrhea with mucus. Stool occult blood test is positive, she feels fatigued, afraid of cold, with white and greasy tongue coating, cracks, dark red tongue with bruising, and a wiry, stiff pulse. Gastroscopy shows congested and swollen gastric mucosa with bruising. [Western diagnosis] Chronic gastritis with erosion and bleeding. [TCM differentiation] Cold deficiency of the organs, blood stasis obstructing the stomach meridians. [Treatment principle] Activate blood circulation and remove blood stasis, dispel cold and unblock the meridians to relieve pain. [Prescription] Huoluo Xiaoling Dan and Shixiao San with modifications: Danggui 10g, Baishao 10g, Chuanxiong 10g, Huangjing 20g, Huangqi 10g, Gaoliangjiang 6g, Zhi Ruxiang 6g, Zhi Meiyao 6g, Sanleng 10g, Ezhu 10g, Wuzhuyu 6g, Wuyao 10g, Puhuang 6g, Wulingzhi 10g, Rougui 6g, Quanshi 10g, Danshen 20g, Dahuang Tan 6g, Huarui Shi 15g. Decoct in water and take one dose daily, for a total of seven doses orally. Second visit: After taking the medicine, the bleeding stopped, stomach pain lessened, self-reported fatigue, lack of appetite, dark red tongue, thin white coating, wiry fine pulse. The above formula removed Huarui Shi and Dahuang Tan, added Dangshen 15g, Baizhu 10g, Huangqi 15g to strengthen the spleen and tonify qi, reinforce the foundation. The above formula was continuously adjusted and modified for over three months, resulting in improvement, with better spirits and appetite. Case 8: Mr. Ren, 72 years old. Chief complaint: Intermittent upper abdominal pain for 15 years. Fifteen years ago, he suffered upper gastrointestinal bleeding once due to excessive drinking, vomiting about 60ml of blood at the time, and was rushed to the hospital for emergency treatment. After more than a month of symptomatic supportive treatment, his condition improved and he was discharged. Later, he frequently took Famotidine, Omeprazole, and other medications, keeping his condition stable. In the past two years, due to frequent business trips, improper diet, drinking and singing, and imbalance between work and rest, he again experienced stomach pain, vomiting blood once, about 20ml of blood, dark red in color. Abdominal stabbing pain, aggravated by eating cold and greasy food, obvious tenderness in the upper abdomen, acid reflux, bitter mouth, black stools, purple-dark tongue, thick and greasy tongue coating, bruises on the edges, and a wiry rapid pulse. [Western diagnosis] Peptic ulcer, upper gastrointestinal bleeding. [TCM differentiation] Blood stasis obstructing the stomach meridians, damp-heat stagnation, liver fire attacking the stomach. [Treatment principle] Remove blood stasis and unblock the meridians, clear heat and remove dampness. [Prescription] Shixiao San and Huoluo Xiaoling Dan with modifications: Danggui 10g, Baishao 10g, Chuanxiong 10g, Huangjing 20g, Huanglian 6g, Zhi Ruxiang 6g, Zhi Meiyao 6g, Sanleng 10g, Ezhu 10g, Wuzhuyu 6g, Puhuang 6g, Wulingzhi 10g, Rougui 3g, Quanshi 10g, Danshen 20g, Dahuang 6g (added later), Huarui Shi 15g, Han Sanqi 3g (divided and dissolved). Decoct in water and take one dose daily for a total of seven doses orally. Second visit: After taking seven doses, ulcer bleeding lessened, stomach pain improved, stool color normalized. Still experiencing fatigue, lack of appetite, red tongue with bruises on the edges, thin yellow coating, wiry fine pulse. The condition is characterized by blood stasis obstructing the stomach meridians, and spleen deficiency affecting transportation and transformation. The above formula removed Wuzhuyu and Huarui Shi, added Huangqi 15g to tonify qi and strengthen the spleen, and Wuzigu 15g to constrict acid secretion, taking a total of 14 doses. Third visit: No further gastrointestinal bleeding, spirits and appetite both improved, no need to change the formula, treatment effect stable, the above formula was adjusted and modified for half a year, resulting in complete recovery. Seven. A compilation of theories from ancient and modern schools “Shanghan Lun” (149 articles): “……but if it’s full without pain, this is a痞, Chaihu is not suitable for it, Banxia Xiexin Tang should be used instead.” “If pressing doesn’t cause pain, it’s deficiency; if it does, it’s excess.” This provides some reference value for differentiating deficiency and excess in this disease and for treatment principles. “Shanghan Lun · Chapter Ten on Differentiation and Treatment of Taiyin Disease Symptoms”: “The symptom of Taiyin disease is abdominal fullness and vomiting, inability to eat, self-interest is very strong, sometimes the abdomen itself hurts, and if you purge, there will definitely be hardening below the chest.” It proposes the so-called “Taiyin disease,” whose clinical symptoms are essentially the main typical symptoms and treatment contraindications for the spleen-stomach deficiency-cold type of this disease. The Shaoyang disease described in “Shanghan Lun”—bitter taste, dry throat, dizziness, chest and flank fullness, silent unwillingness to eat, irritability and tendency to vomit, wiry pulse—basically also matches the symptoms of the liver-stomach disharmony type of this disease. The “Jingui Yaolue” records the differentiation of abdominal fullness, cold hernia, retained food, water intake, and deficiency-fatigue, as well as the formulation of various Xiexin Tang, Jianzhong Tang, Chaihu Tang, Si Ni San, Quanshi Wan, Ling Gui Shu Gan Tang, etc., which not only established the standard for differential diagnosis and treatment of this disease, but also effectively guided clinical treatment. The “Qianjin Fang”’s Binglang San, composed of ginseng, Baizhu, Fuling, Chenpi, Wuzhuyu,

<!-- translated-chunk:6/22 -->