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Gastroptosis

[Introduction]

Gastroptosis refers to the condition that the lesser curvature notch of the stomach is lower than the iliac crest level in standing position due to looseness of the ligament supporting the stomach and decline of the gastrotonia. The clinical manifestations are dragging distension in the abdomen and stomachache which are immediately allevia-ted when the patient lies flat. This problem is usually seen among women with emaciation, narrow thorax and loose-ness of abdominal muscles. This disease is usually caused by improper diet, overstrain and lack of caring after ill-ness that lead to hypofunction of the spleen and stomach as well as sinking of gastrosplenic qi. Gastroptosis is usually complicated by retention of dampness and phlegm due to abnormal activities of the spleen and stomach in transfor-mation and transportation, leading to the syndrome of mixture of asthenia and sthenia as well as the syndrome of root asthenia and branch sthenia

[Syndrome differentiation]

1. Disharmony between liver and stomach

Distending pain in the epigastrium involving the rib-sides, aggravation after meal, frequent belching, vomi-ting of acid fluid, dysphoria and susceptibility to rage, red tongue with thin and yellow fur, taut and rapid pulse.

2. Spleen asthenia and qi sinking

Fullness and mass in the epigastrium and abdomen, dragging and distending sensation in the abdomen, aggravation after meal, alleviation in flat supination, or regurgitation of clear fluid, phlegm and saliva, dizziness and lassitude, loose stool, light-colored tongue with white fur, soft and slow pulse.

3. Asthenia of both qi and yin

Dragging and distending sensation in the epigastrium and abdomen, aggravation after meal, bitter taste and dryness in the mouth, or dry vomiting and hiccup, hunger without appetite, red tongue with scanty fur and thin and rapid pulse.

[Treatment]

1. Body acupuncture

Prescription: ( 1 ) Qihai (CV 6 ), Baihui (GV 20), Pishu (BL 20), Weishu (BL 21), Zhongwan (CV 12) and Zusanli (ST 36).

(2) Tiwei located 4 cun lateral to Zhongwan (CV 12) or Weishang located 4 cun below Zhongwan (CV 12) pen-etrating Tianshu (ST 25).

These two groups of acupoints are used in alterna-tion.

Modification: For disharmony between the liver and stomach, Qimen (LR 14), Taichong (LR 3) and Ganshu (BL 18) are added; for asthenia of both qi and yin, Sany-injiao (SP 6) and Neiguan (PC 6) are added; for fluid gur-gling in the stomach, Shuifen (CV 9) and Yinlingquan (SP 9) are added; for stomachache, Liangmen (ST 21) is add-ed; for abdominal distension and diarrhea, Tianshu (ST 25) and Xiajuxu (ST 39) are added; for constipation, Zhi-gou (TE 6) and Daheng (SP 15) are added.

Performance: The first group of acupoints can be needled and moxibusted. When needling Tiwei and Wei-shang for the penetration of Tianshu (ST 25), reinforcing needling technique by twirling and rotating the needle is used. When needling sensation is felt, the needle is rotated uni-directionally till tense and astringent sensation being felt beneath the needle and stomach-lifting sensation being felt. Cautions must be taken not to puncture into the abdominal cavity lest the viscera be impaired.

2. Electro-acupuncture

Prescription: The same as that for needling.

Performance. Electro-acupuncture is used with rou-tine operation and intermittent or sparse and dense wave for 20 minutes of strong stimulation till appearance of tic in the abdominal muscles. This treatment is given once a day and 15 - 20 times make up one course of treatment.





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