Heart

Heart

External: Gastric perforation, acute pancreatitis, liver abscess, and other conditions often cause severe epigastric pain. If left untreated, these conditions can be life-threatening. Once the above diagnoses of epigastric pain are confirmed, subsequent TCM syndrome differentiation will naturally be much more accurate. Peptic ulcer disease is typically accompanied by heartburn, belching, abdominal distension, loss of appetite, fatigue, and pallor, often indicating spleen-stomach qi deficiency. Commonly used formulas include Xiangsha Liujunzi Tang, Huangqi Jianzhong Tang, and Liangfu Wan. Chronic atrophic gastritis, on the other hand, often presents with burning epigastric pain and thick, greasy tongue coating, usually indicating damp-heat accumulation in the upper abdomen. Commonly used formulas include Banxia Xiexin Tang, Huanglian Tang, and Huanglian Jiedu Tang. Biliary tract diseases are often associated with bitter taste in the mouth, dry throat, right flank pain radiating to the back, commonly seen in cases of pathogenic factors invading Shaoyang. Commonly used formulas include Daxiaochaihu Tang, Xiaochaihu Tang, Chaihu Shugan San, Baidao Paishi Tang, Qianjin Cao, Banzhilian, and Huzhang. Pancreatic diseases often present with pain radiating to the left upper abdomen, accompanied by low back pain, loose or hard stools, and during acute attacks, the pain can be severe, even leading to cold extremities and a weak, nearly absent pulse—symptoms of yang deficiency. Commonly used formulas include Chaihu Shugan San, Danshen Yin, Jinlingzi San, Dajianzhong Tang, Sanhuang Xiexin Tang, and Wuwei Xiaodu Yin. For chronic gastric perforation, TCM also recommends Huoluo Xiaoling Dan and Taohong Siwu Tang with modifications; for acute perforation, if conservative treatment fails, surgical intervention should be sought immediately.