Question 1: I have been suffering from chronic gastritis for many years and have been treated systematically by Western medicine, but my symptoms have not improved. I have taken a lot of Chinese medicines on the market for gastric diseases, but they have no significant effect, I wonder why? The reason for this is that the chronic gastritis is a common and frequent disease of the digestive system. In recent years, modern medical research has concluded that the occurrence of this disease is related to Helicobacter pylori (Hp) infection, gastric dysfunction, alkaline fluid reflux, etc. However, the clinical treatment of Hp removal, gastric dysfunction and gastric mucosa protection sometimes cannot completely relieve the symptoms and cure the disease, because the etiology of chronic gastritis is very complex. In Chinese medicine, chronic gastritis is mostly caused by long-term emotional disorders, poor diet, and abnormal work and rest, resulting in liver qi stagnation, spleen loss of health, and stomach loss of harmony and descent, which leads to various symptoms. In clinical practice, patients should be treated according to their actual condition. For example, some patients present with distension and pain in the stomach, or attacking the two sides of the stomach, belching with acidity, often due to emotional factors such as stress at work, anger and fire, with a red tongue, thin white fur and string pulse, which is stomach pain caused by liver qi offending the stomach. If the stomach pain is burning, irritability, dry mouth, bitterness, red tongue, yellowish moss, and slippery pulse, it is stomach pain caused by liver stagnation and fire, and liver and stomach heat. If the stomach pain is caused by weakness of the spleen and stomach, it is vague and painful, aggravated by cold, but lighter when warm, painful when hungry, slightly reduced by eating, loose stools, fatigue, pale tongue, fat, with tooth marks on the side, thin white moss, sunken and weak pulse, etc. Other conditions include stomachache due to food accumulation, stomachache due to yin deficiency, stomachache due to blood deficiency, etc. The clinician has to carefully identify and prescribe the right medicine to achieve curative effect. There was a patient who had been taking Mu Xiang Shun Qi Pills for a long time because of vague stomach pain and dry stools, but the disease did not heal but added a new disease. When he came to the clinic, he saw a dry mouth and tongue, restless sleep at night, a red tongue with little fluid and a thin pulse with little moss, a sign of deficiency of stomach yin. The reason for the aggravation of the disease was related to the large amount of aromatic and dry drugs in Mu Xiang Shun Qi Pills, which consume Qi and hurt Yin with prolonged use and aggravate the disease. After using some drugs that nourish stomach yin and clear heat and fluid, the symptoms were quickly alleviated. The efficacy of Chinese medicine is determined by the level of evidence-based treatment and empirical use of drugs. In addition, chronic gastritis is a long and lingering disease, and modern research has proven that it takes about 3 to 5 months to regenerate, rebuild and restore the function of the gastric mucosa, with a minimum treatment period of 3 months. Now the market for the treatment of chronic gastritis, a variety of proprietary drugs, even if the choice of drugs, but frequent replacement, the course of treatment is too short, will also affect its effectiveness. The actual fact is that you will be able to get a lot more than just a few of the most effective and most effective products. Question 2: Why is chronic gastritis prolonged and difficult to cure, and what are the countermeasures for TCM treatment? Patients with chronic gastritis often have their upper gastrointestinal symptoms reduced or relieved during medication, but after stopping the medication, the symptoms return, and many patients believe that the disease cannot be cured, and some physicians believe that it is difficult to cure the disease for life. The main reason for this is that H. pylori is not eradicated or reinfected, as well as gastrointestinal dysfunction, duodenal reflux is not corrected, resulting in a gradual increase in inflammation of the gastric mucosa or even glandular atrophy, intestinal epithelial hyperplasia or atypical hyperplasia, aggravating the disease. In recent years, the proportion of H. pylori drug resistance is increasing year by year, and clearing heat, nourishing yin, moving qi, beneficial qi class of traditional Chinese medicine on HP inhibition and killing efficacy, such as Huang Lian, rhubarb, tiger scepter, party ginseng, thick park, Tian Qi, Yuan Hu, maitong, etc., in the compound formula more than very good efficacy. The method of pungent opening and bitter lowering is an important rule in the treatment of HP-related gastritis. Chinese medicine is not like antibiotics that simply play an inhibitory role on Hp, but there are also mobilization of the body’s immune function, improve gastric mucosal blood flow, enhance gastric mucosal protection, etc., and play a synergistic effect on western medicine against Hp and its causative factors. After treatment by TCM, then use triple or quadruple therapy to clear HP, or reduce drug resistance and improve the efficacy. In addition, theoretically, morphine, cisapride and other gastrointestinal motility drugs have pro-gastric motility and adjust the role of the gastrointestinal sphincter, and clinically have some effect, but in fact, many patients with a long time also does not work, physical weakness of patients with dizziness, or diarrhea side effects, affecting the compliance of this part of the patient. However, Chinese medicine treatment methods such as strengthening the spleen and nourishing the stomach, moving qi and lowering rebellion, the efficacy is more significant, abide by the law and keep the prescription, flexible addition and subtraction, combined with diet, living, spiritual conditioning, after a considerable period of Chinese medicine treatment, chronic gastritis can be completely cured. Question 3: Chronic atrophic gastritis is prone to intestinal epithelial hyperplasia and atypical hyperplasia, which are known as precancerous lesions of the gastric mucosa. Chronic gastritis with intestinal epithelial hyperplasia and atypical hyperplasia, especially colorectal-type hyperplasia and moderate to severe atypical hyperplasia, are more closely related to cancer and are considered precancerous lesions. For the above two types of gastric precancerous lesions, there is no western medicine that can definitively stop their progression, and sterilization treatment for H. pylori or treatment with pro-gastric motility drugs for bile reflux are not helpful for the accompanying gastric precancerous lesions. Chinese medicine has done a lot of research work in reversing gastric precancerous lesions. It is believed that this lesion is mostly caused by chronic gastritis that damages the spleen and stomach over time, and under the condition of positive deficiency, qi stagnation and blood stasis, internal toxicity is generated. Clinically, the commonly used drugs to benefit qi are Astragalus, Radix Codonopsis, Poria, Atractylodes, etc., to nourish yin are Salvia, Medlar, Radix et Rhizoma, Radix et Rhizoma, etc., to move qi are Yujin, Yanhuosuo, Fructus, Muxiang, etc., and to dispel stasis are Trigonella, Curcuma, Salvia, Peach kernel, etc. This may be a comprehensive and coordinated effect of Chinese medicine on many aspects of the etiology of chronic gastritis. Question 4: Does TCM diagnosis of gastrointestinal disease also require endoscopy? The answer is yes. Because endoscopy not only can clearly diagnose and exclude peptic ulcer, gastric cancer and other diseases, but also provides a basis for treatment. According to the results of the examination, western medicine such as acid suppression and HP removal can be given clinically. As far as Chinese medicine is concerned, the four diagnostic methods of looking, smelling, asking and cutting are the main means of diagnosing diseases, and looking is especially important. The endoscopy is an expanded diagnosis. The TCM practitioner can not only diagnose the disease based on the four diagnoses, but also directly observe your stomach cavity and intestinal cavity, and determine the cold, heat, deficiency, qi, blood, yin and yang of the disease based on the changes of the local mucosa. Some scholars have observed that those who see mucous membrane thinning and pale under the microscope, submucous blood vessels clearly visible, and weakened peristalsis of the stomach wall mostly belong to the weak spleen and stomach type, while those who have red mucous membrane, congestion, edema, erosion, and foul-smelling secretions are mostly seen in patients with spleen and stomach damp-heat type gastrointestinal diseases. Therefore, by combining local visualization under the speculum with the traditional four diagnoses, it is possible to identify and classify the symptoms and legislate prescriptions, making the diagnosis more accurate and the treatment more effective. In addition, for patients with moderate or above heterogeneous hyperplasia of gastric mucosa or intestinal epithelial hyperplasia, even if the clinical symptoms are not typical, according to the theory of “prolonged disease enters the ligament, deficiency for a long time leads to stasis”, blood activating, detoxifying and anti-cancer drugs can be added to prevent and treat the disease early, so as to stop the trend of malignant transformation.