Indigestion refers to a group of clinical syndromes with uncomfortable symptoms such as epigastric pain, epigastric distension, early satiety, belching, loss of appetite, nausea, vomiting, etc., and the organic diseases causing the above symptoms are excluded by examination.
I. Symptoms related to indigestion
Postprandial fullness, epigastric distension, early satiety, epigastric pain, epigastric burning sensation, belching, nausea, vomiting.
Second, symptom analysis
1.Postprandial fullness: the uncomfortable feeling caused by the food staying in the stomach for too long after eating.
2, early satiety: soon after the start of the meal, the stomach feels too bloated, appetite disappears in the process of eating, this feeling is not proportional to the amount of food, so that you can not eat the whole meal.
3, epigastric pain: unpleasant sensation in the area under the sternum, above the navel, and between the midline of the clavicles on both sides.
4, epigastric distention: subjective feeling of tightness and distension in the upper abdomen.
5, belching: gas is expelled from the mouth through the stomach or esophagus.
Third, indigestion can be divided into two categories
1, organic indigestion: there is a clear organic or metabolic disease caused by indigestion symptoms. Such as: gastric ulcer, duodenal ulcer, gastric tumor, pyloric obstruction, some gallbladder stones, pancreatic factors, drug factors, diabetes, etc.. With the treatment of the original disease and control of its indigestion symptoms will be reduced or disappear.
2.Functional dyspepsia: dyspepsia symptoms exist and no organic or metabolic disease is found in the examination, or the disease found in the examination cannot explain the occurrence of dyspepsia symptoms.
Fourth, the relationship between
Long-term functional dyspepsia can cause organic lesions, can be transformed into organic dyspepsia.
Five, treatment
1.Western medicine treatment
Western medical diagnosis and treatment of functional dyspepsia guidelines recommend the use of acid-suppressing drugs (such as omeprazole, esomeprazole), pro-dynamic (such as morpholine, mosapride), or a combination of drug therapy, for treatment failure can be given a small dose of antidepressant therapy (such as Dextran) or psychological intervention therapy.
For some patients, acid suppression, motivation and antidepressant therapy can achieve good results, but some patients still do not get satisfactory results after the above treatments. For example: symptomatic treatment can only target some symptoms, but cannot effectively relieve the main symptoms or can only relieve some of the symptoms; can only relieve the symptoms of the digestive tract, but can hardly improve the mental and psychological state and quality of life; can hardly change the patient’s disease physique and pathophysiological state, and can hardly completely relieve the symptoms, solve the problem of relapse after stopping the medication, and require long-term maintenance medication.
2.Chinese medicine treatment
Functional dyspepsia belongs to the category of “fullness” and “stomach pain” in TCM, and the postprandial discomfort syndrome of the Rome III standard and typology of FD is equivalent to “fullness” in TCM. In contrast, epigastric pain syndrome belongs to the category of “stomach pain” in TCM. From the distribution of the symptoms, FD is most closely related to spleen deficiency (including spleen deficiency and dampness, spleen deficiency and qi stagnation, etc.), followed by liver depression (including liver and stomach qi stagnation, liver and stomach heat, etc.). According to the clinical distribution pattern, functional dyspepsia is mainly divided into 4 types of evidence.
(1) Damp-heat-induced obstruction evidence.
(2) Spleen deficiency and qi stagnation evidence.
(3) liver and stomach stagnation.
(4) Stagnant heat in the liver and stomach. Under the guidance of holistic concept and evidence-based treatment, the clinical treatment of this disease in Chinese medicine has achieved very good clinical efficacy, with an effective rate of 75-90%.