Pregnancy vomiting, also known as pregnancy vomiting in Chinese medicine, refers to nausea and vomiting in early pregnancy, dizziness and anorexia, or even vomiting after eating. In early pregnancy, a small number of pregnant women will experience frequent and severe nausea and vomiting, which will persist and worsen progressively, often affecting normal work and life, and even endangering the life of the pregnant woman, this phenomenon is medically known as pregnancy vomiting. This phenomenon is medically known as pregnancy vomiting. It is usually seen in pregnant women who are pregnant with their first child. This is a normal physiological reaction, which usually appears in the sixth week of pregnancy and will gradually improve and disappear on its own in about 12 weeks.
I. Causes of morbidity
1. Western medical understanding: Given that the process of appearance and disappearance of early pregnancy reaction coincides with the rise and fall of chorionic gonadotropin (HCG) value in the blood of pregnant women; pregnant women with gravida and multiple pregnancies have significantly higher HCG value in the blood and heavier early pregnancy reaction, and even severe pregnancy vomiting; moreover, the symptoms disappear immediately after the termination of pregnancy. Therefore, it is believed that severe pregnancy vomiting is closely related to the increase of HCG level in blood. However, the severity of symptoms varies greatly among individuals and is not necessarily proportional to HCG. Clinically, it is observed that some pregnant women with nervousness, anxiety and depression are more likely to have severe pregnancy vomiting, suggesting that the disease is related to mental and social factors.
2, the understanding of Chinese medicine: Chinese medicine believes that the disease is located in the stomach, and is closely related to the liver and spleen. The main mechanism of the disease is the upward rebellion of the Qi of the Punching Vessel (one of the eight odd meridians in Chinese medicine) and the loss of harmony and descent of the stomach. After pregnancy, the menstrual blood stops and the blood gathers in the uterus and cellular vessels to nourish the fetus. If the spleen and stomach are weak, the stomach loses its harmony and descends, and the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Stomach goes up and down, resulting in nausea and vomiting; or because the spleen is deficient in transportation, phlegm and dampness are internally generated, and the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Stomach goes up and down, resulting in nausea and vomiting. After pregnancy, Yin Blood is gathered in the lower part of the body to nourish the fetus, and the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Qi of the Liver. The symptoms are especially pronounced in people with strong liver fire. Liver qi and liver fire go up and offend the stomach, and the stomach loses harmony and descent, which also leads to nausea and vomiting. Repeatedly, it is difficult to eat and drink, vomiting becomes more and more intense, consuming qi and hurting yin, resulting in both qi and yin injury, mixed with deficiency and reality, and the condition is repeated and difficult to heal.
Main clinical manifestations
Pregnancy vomiting is mostly seen in young first-time pregnant women. The early pregnancy reaction usually appears around 40 days after menopause and gradually worsens until vomiting becomes frequent and unable to eat, with bile or coffee-colored residue in the vomit. Severe vomiting causes water loss and electrolyte disorders, and lowers serum potassium; prolonged starvation causes the body to use adipose tissue for energy supply, resulting in the accumulation of ketone bodies, an intermediate product of fat metabolism. Patients may develop emaciation, extreme fatigue and weakness, dry skin and mucous membranes, sunken eyes, increased pulse rate, decreased urine output, and urinary ketone bodies (positive urinary ketone bodies are the most commonly used clinical test). Patients may have elevated bilirubin and transaminases in blood biochemical indexes and protein in urine due to impaired liver and kidney function.
Chinese medicine treatment
There are deficiencies and realities in severe pregnancy vomiting. The deficiencies are mostly due to weakness of the spleen and stomach, while the realities are mostly due to disharmony of the liver and stomach, and there are also cases of mixed deficiencies and realities, such as weakness of the spleen and stomach and internal stagnation of phlegm and dampness.
(I) Identification and typing treatment
The identification is mainly based on the nature of the vomit and the patient’s taste: if the mouth is light and vomits clear saliva, it is mostly due to weakness of the spleen and stomach; if the mouth is bitter and vomits sour or bitter water, it is mostly due to disharmony of the liver and stomach; if the mouth is sticky and vomits phlegm and saliva, it is mostly due to stagnation of phlegm and dampness; if the mouth is dry and thirsty, dry vomiting or vomiting blood, it is mostly due to injury of both qi and yin.
1.Weak spleen and stomach type
Main manifestations: nausea and vomiting after pregnancy, or vomiting immediately after eating, vomiting clear water or food, body fatigue, fatigue and sleepiness, light tongue, thin white fur, slow and slippery pulse.
Basic prescription: 15g each of Radix Codonopsis and Rhizoma Atractylodis Macrocephalae, 10g each of Poria, Pericarpium Citri Reticulatae and Stachybotrys, 6g each of Radix et Rhizoma Stachybotrys and 3 slices of ginger. 1 dose per day, combining two or three decoctions of the liquid, divided into 2 to 3 warm doses, 100-200ml each time.
Chinese herbal medicine: Ginseng and Atractylodes macrocephala, Xiang Sha Liu Jun Wan can be used.
2.Liver and stomach disharmony type
Main manifestations: intense nausea and vomiting after pregnancy, inability to eat, vomiting sour or bitter water, disturbed heart, dry mouth, bitter mouth, chest and hypochondriacal pain, red tongue, thin yellow coating, smooth pulse.
Basic prescription: 15g each of Ginger and Bamboo Roo, Atractylodes Macrocephala, White Peony, 10g each of Scutellaria Baicalensis, Su Stem and Chen Pi, 6g of Green Plum Blossom, 3g of Yellow Lotus. take as above.
Chinese herbal medicine: can be used to use Prosperity Pill, Anshin Wenzhiwan.
3.Phlegm and dampness obstruction type
Main manifestations: nausea and vomiting of phlegm after pregnancy, not thinking about eating, sticky mouth, abdominal distension and loose stools, light tongue, white greasy coating, slippery pulse.
Basic prescription: 15g each of ginger, bamboo, atractylodes, poria, yam, lOg each of Chen Pi and Semen, 3 slices of ginger. Dosing method is the same as above.
Chinese patent medicine: can be used Xiang Sha Yang stomach pill.
4.Qi and Yin deficiency type
Main manifestations: intense vomiting after pregnancy, fatigue, emaciation, sunken eyes, dry mouth and throat, dry urine and stool, red tongue, thin yellow coating and dry or flaking, thin and weak pulse.
Basic prescription: 15g each of prunus ginseng, Radix Rehmanniae Praeparata, Radix Medlar, Radix Salviae Miltiorrhizae, Radix Rehmanniae, 10g each of Schisandrae, Ocimum sanctum, Chen Pi.
Prepared Chinese medicine: Huangqi Shengve Drink can be used.
Patients with severe pregnancy vomiting often have difficulty swallowing food and drink, or even vomit when water enters, and some even vomit when they smell food. They are often afraid to take Chinese medicine, and even if they take it reluctantly, they will often vomit immediately, making it difficult to achieve the desired therapeutic effect. In order to minimize the occurrence of this situation, you can dip your tongue in soy sauce, or chew several slices of soy cucumber, or take several drops of ginger juice, or take ginger juice with grit powder before taking the medicine.
(B) simple prescription
The following prescriptions can be used for vomiting in pregnancy. It can also be used for those who refuse to take Chinese medicine because of fear of severe vomiting, or those who have taken Chinese medicine but vomit immediately after taking it. It is suitable for weak spleen and stomach and phlegm and dampness obstruction type, and it is also effective for liver and stomach disharmony type.
1. 100g of coriander (cilantro), 3g of sorrel, 3g of patchouli, 3g of sand, brewed with boiling water, aim at the nostrils of pregnant women and inhale the air. This aromatic gas, inhalation can broaden the chest and rebellion, spleen and wake up the stomach, and then you can try to serve a little food, often can be accepted and no longer vomit.
2. 2g of Su Ye, 2g of Huang Lian, 2g of Sha Ren, 2g of Chen Pi. brewed with boiling water, aimed at the nostrils of pregnant women, so as to inhale its breath. After that, you can drink it frequently in place of tea. If the liver heat is not obvious or the taste of bitterness is unbearable to drink, remove the Huang Lian.
Four, external treatment method
1.Auricular acupuncture point therapy Take auricular points esophagus, stomach, cardia, spleen (choose 2 of them), with the Shen Men, sympathetic, endocrine (choose 1 of them). Fix Wang Bu Liuxing Zi in the middle of about 0,7cm×0,7cm size adhesive tape block, wipe the bilateral ear-cone with 75% alcohol cotton ball, find the right point and then align the medicine to the point and apply pressure. Then use the index finger and thumb to press against each other. The patient is instructed to apply the medicine to the ear drums every morning, noon and night. Ask the patient to press once a day before breakfast, lunch and dinner, and 7 days is a course of treatment.
2.Acupressure at acupuncture points Press and rub the Neiguan point (inside the arm, two inches above the wrist, in the depression between the tendons on both sides), and the foot Sanli (three inches straight down from the outer knee eye, one horizontal finger from the outer edge of the tibia) for 3 to 5 minutes each time.
Pregnancy vomiting is a common symptom in pregnant women. Ear point therapy and acupressure at acupuncture points are simple and easy to perform, painless, without side effects, with good efficacy and easy for patients to accept. You can press the ear point or Nei Guan point before eating or taking Chinese medicine to reduce the occurrence of vomiting.
V. Qigong therapy
Take a sitting position, adjust the breathing, breathing should be long and short, the intention to keep the part should be down not up, can keep the feet Chung Quan point. And supplemented with different matching gong, can choose to relaxation gong, loose static gong or internal nourishment gong.
① abdomen gossip: that is, the two hands according to the clockwise direction gently transport the lower abdomen, 15-20 minutes each time, 3 times a day. Applicable to evidence of weakness of the spleen and stomach.
② Inhale the qi from the Dantian to the two Yongquan points to lower the hyperactive yang qi. For evidence of liver and stomach disharmony.
③Shun qi and resolve phlegm method: first use the intention to push the phlegm and drink obstruction in the diaphragm and cavity away, down the large intestine, and expel it from the anus to smooth its qi. Applicable to evidence of phlegm-dampness obstruction.
④ nourishing yin and generating fluid: first rub the two foot heart Yongquan points each 49 times, then use the tongue against the palate, to wait for the fluid out, in the mouth lightly transported. When swallowing fluid, the idea of sending down to the Yongquan point. Applicable to both Qi and Yin deficiency evidence.
Six, daily care
(A) life care
1. Psychological care Patients with severe pregnancy vomiting, especially in the first pregnancy and in every pregnancy with recurrent pregnancy vomiting, will have different stress, fear and anxiety, which will affect the psychological condition of pregnancy and the health of mother and child. Therefore, we should fully understand the patient’s psychological state, fully mobilize the patient’s initiative, help the patient analyze the condition, make the patient understand that vomiting is a common pregnancy disease and can be prevented and cured through treatment and care, in order to eliminate the patient’s ideological concerns, overcome the discomfort caused by vomiting, establish confidence in pregnancy and improve psychological comfort.
2.Home care
(1) The living room should be as neat, quiet and comfortable as possible to avoid the stimulation of odor. The bed rest environment is quiet and ventilated to reduce unpleasant scenes and odors within the line of sight.
(2) pregnant women want to vomit when the feeling of vomiting is obvious for deep breathing and swallowing action, that is, a big mouth gasping for air. Vomiting should be removed immediately after vomiting to avoid malignant stimulation, and rinse the mouth with warm boiled water to keep the mouth clean.
(3) Care and consideration for pregnant women to relieve their worries.
(4) Pregnant women should maintain a happy mood and avoid impatience and emotional excitement.
(5) If the pregnant woman vomits, resulting in a rise in body temperature, increased pulse, sunken eyes, inelastic skin and mental abnormalities, she should be sent to the hospital immediately.
(2) Dietary care
Choose food that is acceptable to pregnant women. The diet should be light, easy to digest, rich in protein and sugar, avoid greasy and offensive odors, eat less and more meals, and eat properly after vomiting stops. Advocate vomiting to vomit, eat to eat. Multiple feeding supplements can still maintain the body’s nutritional needs, while avoiding too cold, too hot, spicy food. You can always eat bananas, oranges, tomatoes and other fruits and foods rich in potassium, and drink oral rehydration salts if necessary.
1. 1 tablespoon of fresh ginger juice and 1 cup of sugar cane juice, mix well together and serve warm with heat. This formula is used to treat vomiting in pregnant women, difficult to eat and drink, with the effect of strengthening the stomach, lowering the gas and stopping vomiting.
2, sand kernel carp soup Sand kernel 9g, fresh carp 1 (about 150g), ginger 10g, white onion 3 stems, salt a little, pepper 10 grains. Put the grit into the carp abdomen, then put the fish in the casserole and add water. Boil it on a high flame, then add ginger, onion, pepper and salt, stew it on a low flame, drink the soup and eat the fish while it is hot. For weak spleen and stomach evidence.
3, bamboo rhizome porridge fresh bamboo rhizome 30g, japonica rice 50g. decoction of bamboo rhizome juice, with japonica rice porridge, cool, drink a little. For liver and stomach disharmony evidence.
4, poria porridge white poria powder 15g, japonica rice 50g. will poria powder with japonica rice porridge, add a little salt, while hot to eat. If the effect is not obvious, can be made of half summer, ginger 10g each, with the decoction to get juice, and poria, polished rice porridge to eat. For phlegm and dampness obstruction evidence.
5.Mai Dong Tang: 15g Bei Sha Shen, 15g Mai Dong, 10g Han Xia, 6g licorice, 60g japonica rice. first decoction, remove the residue, take 1000ml juice, boil japonica rice into porridge, eat in portions, also can be used with American ginseng, Mai Dong water for tea. Applicable to both Qi and Yin deficiency evidence.
6, 45g of raw yam, 9g of Qingxia, a little rock sugar. Qingxia wash with warm water until no alum taste, put into a clean and odorless vessel, add 200ml of water, decoction on a rapid fire and then slow decoction for 30 minutes, take 100ml of broth, grind yam into the soup and cook into a porridge, add a little sugar to taste, eat frequently, 1 dose daily. This formula has the effect of lowering the rebellious stomach qi and tonifying the spleen and stomach. It is suitable for people with weak spleen and stomach with phlegm and dampness.