1. Introduction
Stomachache is a common digestive system disease in clinics. Stomachache is also called “epigastric pain”. Clinical symptoms are mostly epigastric pain, acid regurgitation, nausea, etc., and the course of the disease is prolonged and repeated, which has a serious impact on patients’ healthy life [1]. According to research in recent years, the incidence of stomachache is gradually increasing, among which the stomachache of deficiency cold type of spleen and stomach is the most common. It is considered that the location of the disease is closely related to the stomach and spleen and liver. Traditional Chinese medicine believes that the main causes of stomachache of spleen-stomach deficiency-cold type are deficiency of spleen-stomach yang-qi, abdominal cold, overeating, cold, fatigue, re-feeling of cold evil in injury, which leads to yin-cold stagnation of stomach fu-organs [2]. The spleen governs transportation and transformation, and the stomach governs storage. If cold evil invades the stomach and does not disperse, it will block qi activity and cause stomachache [2][3]. Acupuncture and moxibustion have the function of dredging meridians, harmonizing yin and yang, strengthening body resistance and eliminating pathogenic factors, and has the characteristics of bidirectional regulation. It can make up for the shortcomings of traditional Chinese medicine, which is economical, effective, wide in application range and has few adverse reactions. It is convenient to use and simple to operate and is loved by clinical doctors and patients of traditional Chinese medicine. This article mainly discusses the treatment of acupuncture on stomach pain of spleen-stomach deficiency cold type. In order to summarize and improve the accumulation of clinical curative effects, the relevant literature on acupuncture treatment in recent years is sorted out and discussed as follows.
2. The Cause of Stomachache
Stomach pain is also called “epigastric pain”. Su Wen Liu Yuan Zheng Ji Da Lun said: “People’s disease epigastric care and pain”. TCM etiology is mainly summarized as the cold pathogen, stomach food injury, stomach liver qi nausea, stomach collaterals obstruction and spleen and stomach weakness and other factors. Cold pathogen and stomach cold belong to yin pathogen stagnation. The occurrence of stomachache is closely related to people’s eating habits, mental mood and life [4]. In Neijing, “thinking hurts the spleen”, “anger hurts the liver” and “diet hurts the stomach and intestines”, which clearly tells us that the incidence of stomachache is related to diet and mental emotion. Our current clinical research in medicine has also proved that [5] about 80% of patients with stomachaches have mental and emotional discomfort and unsatisfactory life. Traditional Chinese medicine believes that the disease is caused by deficiency and excess, that is, spleen and stomach are the acquired source of qi, blood and biochemistry. Shengji always records the cloud: “People with deficiency work are weak in qi, stomach deficiency in the diet, and the evil of moving cold air is positively related… Therefore, it makes all confidants hurt [6]”.
Stomach pain of spleen-stomach deficiency-cold type is mainly caused by cold pathogen in the stomach or poor emotion, intake of raw, cold and spicy diet, etc., which leads to weakness of spleen and stomach, deficiency of spleen-yang, deficiency of middle energizer, deficiency of qi and blood, deficiency of stomach, deficiency of qi and blood, and pain at the same time, stagnation of cold pathogen leads to stagnation of stomach qi and loss of qi activity, and arrest of descending meridians [7].
3. Acupuncture of Treatment
3.1. Acupuncture Therapy
Lv Xiaorui [8] and other 50 patients with epigastric pain due to deficiency and cold of spleen and stomach were treated by warming and dredging acupuncture, with remarkable curative effect. Acupuncture points at Zhongwan, Zusanli, Xiawan, Qihai, Weishu and Pishu have a total effective rate of 98%, which is worthy of clinical application. Zheng Zuoheng [9] and others used acupuncture at Zhongwan point (located 4 inches above Renmai navel) combined with Lizhong Pill to treat 94 patients with stomach pain of spleen and stomach deficiency, with a total effective rate of 100%. Jiang Mengjiao [10] treated 30 patients with stomach pain due to deficiency-cold of spleen and stomach with acupuncture at Shu point and Mu point, and the total effective rate was 93.33%. Guan Xinglong [11] used acupuncture plus Xiaojianzhong decoction to treat 60 cases of stomach pain with spleen-stomach deficiency and cold, and selected points: Weishu, Pishu, Zhongwan, Zhangmen, Gongsun, Neiguan and Zusanli, with a total effective rate of 93.3%.
3.2. Acupuncture Combined with Other Treatment Methods
Zhang Weijiao [12] and others used acupuncture combined with traditional Chinese medicine to treat 30 patients with stomach pain due to deficiency of spleen and stomach, acupuncture combined with moxibustion combined with oral administration of traditional Chinese medicine, and acupuncture selected points: Liang Qiu, Gongsun, Neiguan, Shangwan, Zhongwan, Xiawan and Liangmen. After taking the needle, moxibustion was performed on the upper, middle, lower and both sides of liangmen in turn. The total effective rate was 96.7%. Wu Ying [13] treated 31 cases of stomachache due to deficiency-cold of spleen and stomach with acupuncture combined with heat-sensitive moxibustion, and the total effective rate was 83.87%. Jin Weigui [14] and others treated 30 cases of stomachache of spleen-stomach deficiency-cold type with acupuncture at Qihai, Gongsun (double), Zhongwan, Tian Shu (double), Xiawan, Liangmen (double), Neiguan (double) and Zusanli (double) and Baixiao moxibustion at Shenque point, with a total effective rate of 96.67%. Yang Lu [15]et al. treated 30 cases of stomachache due to deficiency-cold of spleen and stomach with oral administration of Western medicine plus acupuncture and cupping combined with massage. Acupuncture was combined with cupping at corresponding points, and the points were selected: Zhongwan, Neiguan, Zusanli, Weishu and Pishu; operation method of abdominal massage: make the patient take the supine position, and tell the patient not to be nervous, breathe normally and relax the abdominal muscles. The operator first rubs his hands until he gets hot, puts the palm root of his right hand on the xiphoid process, pushes it down to the navel along the front midline, and then pushes it to the abdomen from the lower part of both sides of the chest and hypochondrium for several times. The manipulation is from light to heavy, and the operation lasts for 5 minutes. Then press points such as Liangmen, Shangwan, Tian Shu, Zhongwan, Qihai and Xiawan with your thumb for about 5 minutes. Finally, place your hands on the patient’s epigastric region with the navel as the center, start from the epigastric region along the intercostal region, and gently rub the abdomen clockwise by massage for about 5 - 8 minutes, and then end the treatment. The total effective rate is 90.0%.
3.3. Moxibustion
“Introduction to Medicine” “The medicine is not as good as the needle, so it is taken from moxibustion”. Wu Huijun [16] used moxibustion combined with traditional Chinese medicine to treat 60 cases of stomach pain due to deficiency-cold of spleen and stomach by foot bath. The total effective rate was 86.6%, and the curative effect was remarkable, which can be widely used in clinic. Lv Xiaorui [8] used sparrow-pecking moxibustion to treat 50 patients with stomach pain of spleen-stomach deficiency-cold type, and the total effective rate was 92%. Li Qiongxian [17] used oral Western medicine combined with moxa stick moxibustion to treat 60 cases of stomach pain due to spleen and stomach deficiency and cold, and the total effective rate was 91.67%. Mo Yingxia [18] treated 55 cases of stomach pain with deficiency-cold of the spleen and stomach with moxa box moxibustion assisted by traditional Chinese medicine, and the total effective rate was 90.9%.
3.4. Warm Acupuncture
He Jinsong [19] and others used the method of warm acupuncture combined with oral administration of Anshen Bunao Liquid to treat 72 patients with stomach pain due to spleen-stomach deficiency and cold, and the total effective rate was 97.22% at acupoints such as Zhongwan, Zusanli, Guanyuan and Gongsun, which was remarkable and worthy of clinical application. Yue Hongmei [20] and others treated 48 cases of stomachache with spleen-stomach deficiency and cold syndrome by warm acupuncture at Tian Shu (bilateral), Zhongwan, Zusanli (bilateral) and Guanyuan, and then orally taking Buzhong Yiqi Decoction. The total effective rate was 95.83%. Zou Zhengyun [21] and others treated 37 cases of stomach pain with spleen-stomach deficiency-cold syndrome by warming acupuncture at Tianshu, Guanyuan, Zhongwan and Zusanli points combined with oral administration of traditional Chinese medicine decoction, with a total effective rate of 94.6%. Li Zhifang [22] treated 36 cases of stomachache with spleen-stomach deficiency-cold syndrome by simply warming acupuncture at Zhongwan, Gongsun, Neiguan, Zusanli, Qihai, Pishu and Weishu, with a total effective rate of 91.6%. Zhang Jing [23] treated 75 cases of stomachache due to spleen-stomach deficiency and cold by acupuncture at Xiawan, Zusanli (Shuang), Zhongwan and Neiguan (Shuang) points with ginger warming, with a total effective rate of 100%. Conclusion: Ginger warming acupuncture is a combination of ginger warming moxibustion and acupuncture, which is also the further development direction of warming acupuncture, thus making ginger warming acupuncture more effective.
3.5. Sandwiched Moxibustion
Zhang Ding [24] and others used ginger-separated moxibustion at Zhongwan, Zusanli (both sides) and Guanyuan points to treat 40 patients with stomach pain of spleen and stomach deficiency, with a total effective rate of 87.50%. Liang Yanni [25] and others used Huangqi Jianzhong decoction combined with ginger-separated moxibustion at Zusanli (double), Shenjue (double) and Gongsun (double) and Zhongwan points to treat 46 patients with stomach pain of spleen and stomach deficiency, with a total effective rate of 91.31%. Xie Dongqun [26] observed 80 patients with stomach pain due to deficiency of spleen and stomach cold treated by moxibustion with aconite powder, ginger juice and honey to make aconite cake, and the total effective rate was 92.5%. Yang Shuchao [27] used massage and ginger-separated moxibustion to treat 60 cases of stomach pain with spleen-stomach deficiency and cold, with a total effective rate of 93.33%.
3.6. Thunder-Fire Moxibustion
Gu Ya-nan [28] compared the curative effects of thunder-fire moxibustion combined with acupuncture and simple acupuncture on stomachache (spleen and stomach deficiency cold type), there were 36 cases in each group. The total effective rate of thunder-fire moxibustion combined with acupuncture was 93.55%, and that of simple acupuncture was 78.79%. Conclusion: Both treatment methods can improve the symptoms of patients with epigastric pain (spleen and stomach deficiency cold type). Thunder-fire moxibustion combined with acupuncture is superior to simple acupuncture in improving symptoms and eradicating HP infection, with a high comprehensive effective rate and definite curative effect, which is worth popularizing in clinic. Nie Bin [29] observed the effect of Zhao’s thunder-fire moxibustion on stomach pain of spleen and stomach deficiency and cold type. One group was treated with Zhao’s thunder-fire moxibustion, and the other group was treated with traditional Chinese medicine orally, with 30 cases in each group. It is concluded that the curative effect of thunder-fire moxibustion is obviously better than that of the traditional Chinese medicine group, and it can obviously alleviate the symptoms of stomach pain.
3.7. Apply Moxibustion
Wang Jijun [30] applied acupoints on the bilateral spleen, stomach, Zusanli and stomach, and at the same time, separated by ginger, applied moxibustion on Zhongwan and Tian Shu, treating 24 patients with stomach pain due to deficiency of spleen and stomach, with a total effective rate of 95.83%. Han Baorui [31] compared oral omeprazole with TCM acupoint application at Zhongwan, Guanyuan, Dazhui, bilateral Pishu, Weishu, Zusanli, etc., while ginger moxibustion at Zhongwan and Tianshu, and oral omeprazole alone for patients with stomachache due to deficiency-cold of spleen and stomach. Conclusion: TCM acupoint application and moxibustion therapy for patients with stomachache due to deficiency-cold of spleen and stomach can help relieve stomachache symptoms, shorten the relief time of stomachache, reduce pain, and effectively reduce adverse reactions.
3.8. Crude Herb Moxibustion
Wang Qingbo [32] 56 cases of stomachache due to deficiency-cold of the spleen and stomach were treated by crude herb moxibustion (using Wenwei powder: grinding Rhizoma Corydalis, Herba Asari, Semen Sinapis Albae, and Ramulus Cinnamomi into flour, and concocting them into paste with ginger juice). The total effective rate was 91.2%. Yang Long et al. [33] treatment of spleen and stomach cold type gastric epigastric pain, the selection of Codonopsis 20 g, Atractylodes macrocephala 15 g, Cangzhu l0 g, Poria 15 g, Sandren 15 g, Chenpi 10 g, Hovenia l0 g, Xiangshu l0 g, Yanhuisuo 10 g and other traditional Chinese medicines according to the portion of the research into the end of the production of the paste to apply. Acupuncture points: 1 group take spleen Yu (double) liver Yu (double); 2 group take stomach Yu (double) in the epigastric, foot Sanli (double). 2 groups of acupuncture points alternately applied, every 10d patch medicine 1 time, 3 times for a course of treatment, with the oral administration of Xiangsha Liujun Pills, a total of 2 courses of treatment, gastric pain completely disappeared, continue to consolidate for a course of treatment. The patient was followed up for 1 year, and there was no recurrence of the above symptoms.
4. Summary
In summary, acupuncture and moxibustion for stomachache caused by deficiency and cold of spleen and stomach has relative advantages in clinical practice, with definite efficacy, diverse methods, quick effect, simple operation, low cost, small side effects and high safety. However, there are still many problems to be solved in the current research. First of all, the evaluation of efficacy in clinical research is highly subjective, there is no scientific technical means for efficacy evaluation, nor has a unified evaluation standard been established; secondly, the number of samples in clinical research is small, the differences between individual samples are large, and the selection of treatment acupoints and treatment course is not unified, and the reference significance between various studies is not large; finally, most clinical reports lack large sample, multi-center, randomized, controlled and blinded scientific research design schemes, lack of follow-up, and the short-term efficacy observation is significantly more than the long-term efficacy observation. This article only discusses the efficacy of acupuncture and moxibustion for stomachache caused by deficiency and cold of spleen and stomach, hoping to provide some help for the clinical treatment of stomachache caused by deficiency and cold of spleen and stomach.