Symptoms: Sudden onset of stomach pain, aversion to cold with preference for warmth, pain alleviated by warmth and aggravated by cold, bland taste without thirst or preference for warm drinks, pale tongue with thin white coating, tight and wiry pulse.
Formula: Modified Xiangsu Powder combined with Liangfu Pills.
Common herbs: Galangal, Evodia, Cyperus, Lindera, Tangerine peel, Aquilaria.
(II) Gastric Injury from Dietary Factors
Symptoms: Epigastric pain, distension with aversion to pressure, belching of putrid odors and acid regurgitation, or vomiting of undigested food with rancid taste. Pain eases after vomiting. Loss of appetite. Unpleasant stools; slight relief after flatulence or defecation. Thick greasy coating on tongue. Slippery pulse.
Treatment Principle: Promote digestion, resolve food stagnation, harmonize the stomach, and relieve pain.
Formula: Modified Baohe Pill.
Common Herbs: Shenqu, Shan Zha, Lai Fu Zi, Fu Ling, Ban Xia, Chen Pi, Lian Qiao.
(3) Liver Qi Invading the Stomach
Symptoms: Distended and painful epigastrium radiating to both flanks. Pain exacerbates with emotional distress or becomes severe. Relief occurs with belching or flatulence. Chest oppression with frequent belching. Tendency to sigh deeply. Constipation. Thin white tongue coating. String-like pulse.
Treatment Principle: Soothe the liver and resolve depression; regulate qi and relieve pain.
Formula: Modified Chaihu Shugan San.
Common herbs: Bupleurum, Peony, Ligusticum, Curcuma, Cyperus, Tangerine Peel, Citrus Aurantium, Citrus Aurantium, Licorice.
(IV) Damp-Heat Obstructing the Middle Jiao
Symptoms: Epigastric pain with urgent onset, burning sensation in the epigastrium, dry mouth with bitter taste, thirst without desire to drink, heaviness and fatigue, poor appetite with nausea, dark yellow urine, constipation, thick yellow greasy tongue coating, slippery rapid pulse.
Treatment Principle: Clear and transform damp-heat, regulate qi and harmonize the stomach.
Formula: Modified Qingzhong Decoction.
Common Herbs: Coptis rhizome, Gardenia fruit, processed Pinellia rhizome, Poria, Cardamom, dried tangerine peel, licorice.
(5) Stagnant Blood in the Stomach
Symptoms: Epigastric pain resembling needle pricks or knife cuts, localized with worsening on pressure, persistent duration, aggravated after meals, intensifying at night, occasionally accompanied by hematemesis or melena. Purple-dark tongue with ecchymoses,涩 pulse.
Treatment Principle: Resolve stasis, unblock collaterals, regulate qi, and harmonize the stomach.
Formula: Modified Shixiao Powder combined with Danshen Decoction.
Key Herbs: Pollen, Wu Ling Zhi, Danshen, Sandalwood, Sha Ren.
(VI) Depletion of Stomach Yin
Symptoms: Dull burning pain in epigastrium, sensation of hunger without appetite, dry mouth and throat, heat in palms and soles, emaciation and fatigue, thirst with desire for drinks, dry stools, red tongue with scant coating, fine and rapid pulse.
Treatment Principle: Nourish yin, tonify the stomach, harmonize the middle, and relieve pain.
Formula: Yiguan Decoction combined with Peony and Licorice Decoction with modifications.
Common herbs: Glehnia root, Ophiopogon tuber, Rehmannia root, Lycium fruit, Angelica root, Melia fruit, Peony root, Licorice root.
(7) Spleen-Stomach Deficiency-Cold
Symptoms: Dull, persistent epigastric pain relieved by warmth and pressure; worsens on an empty stomach and improves after eating; exacerbated by exertion or exposure to cold; clear fluid regurgitation; fatigue and poor appetite; limb lassitude; cold hands and feet; loose stools; pale tongue with white coating; weak or slow pulse.
Treatment Principle: Warm the middle burner, fortify the spleen, harmonize the stomach, and relieve pain.
Formula: Modified Huangqi Jianzhong Decoction.
Common Herbs: Astragalus root (Huangqi), Cinnamon twig (Guizhi), Ginger (Shengjiang), Peony root (Shaoyao), Fried licorice root (Zhi Gancao), Maltose (Yitang), Jujube (Dazao).