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Chinese Clinical Med 1 > Digestive system 1 > Flashcards

Digestive system 1 Flashcards

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1
Q

What is the digestive system in TCM?

A
  • Based on Spleen, Stomach and Intestine pathologies
  • Liver, GB and Kidney can also contribute to many common digestive health issues
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2
Q

What is the biomedicine viewpoint on the digestive system?

A

Digestive diseases or disorders could involve any part of the digestive system pathologies.

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3
Q

What are some TCM digestive conditions?

A
  • Liver and GB: disharmony between Wood and Earth
  • Kidney and Spleen Yang Xu patterns
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4
Q

What are some biomedicine digestive system conditions?

A

Biomedicine conditions:
* Gastroesophageal reflux disease (GERD)
* Peptic ulcer (PUD), IBD, Chrohn’s, ulcerative colitis, IBS
* Constipation, diarrhoea, gallstones, hepatitis, pancreatitis, celiac disease, colon cancer etc.

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5
Q

What is the management of digestive system pathologies with TCM?

A
  • Acupuncture
  • Auxiliary treatments
  • Chinese herbal medicine
  • Tui Na
  • Dietary and lifestyle
  • Exercise therapies
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6
Q

What is the management of digestive system pathologies with biomedicine?

A
  • Pharmaceutical drugs
  • Non-pharmaceutical interventions and surgery
  • Epigastric pain, abdominal pain, abdominal distension, acid reflux, nausea and vomiting are NOT medical diseases but common symptoms.
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7
Q

What pain assessment scales can be used for digestive system disorders?

A
  • OPQRST most used for pain
  • Applied to epigastric pain, abdominal pain assessment
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8
Q

What are symptoms of Stomach channel pathologies?

A
  • Madness
  • Frequent yawning
  • Neck swelling
  • Throat pain
  • Nose bleeds
  • Runny nose
  • Borborygmi
  • Epigastric pain and swelling
  • Sweating
  • Malaria
  • Pain and swelling along the channel pathway to the middle toe
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9
Q

What are symptoms of LI channel pathologies?

A
  • Toothache
  • Neck swelling
  • Yellow eyes
  • Dry mouth
  • Nose bleeding
  • Running nose
  • Throat blockage
  • Shoulder pain
  • Pain and swelling along the channel down to the index finger
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10
Q

What are symptoms of SI channel pathologies?

A
  • Pain and swelling in the throat
  • Unable to turn head side to side
  • Shoulder pain with a pulling sensation
  • Hearing loss
  • Yellow eyes
  • Swollen cheeks
  • Pain along the channel pathway
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11
Q

What are symptoms of Spleen channel pathologies?

A
  • Stiffening of base of tongue
  • Heaviness in the body
  • Vomiting
  • Abdominal distension
  • Epigastric pain
  • Loose stools
  • Urinary difficulty
  • Pain and swelling along inner aspect of thigh, knees and lower leg, to the big toe
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12
Q

What are some Stomach organ patterns and treatment principles?

A
  • Stomach Qi Xu / Tonify the stomach Qi
  • Blood stasis in the stomach collateral / Activate blood and resolve stasis, free the collateral vessels
  • Stomach Yang Xu / Tonify the Stomach Yang
  • Stomach Yin Xu / Nourish the Stomach Yin
  • Stomach excess cold / Warm the stomach, dissipate cold
  • Stomach heat / Clear the stomach heat
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13
Q

What are some LI organ patterns and treatment principles?

A
  • Large intestinal heat / Clear large intestine, engender fluid
  • Gastrointestinal Qi stagnation / Move qi in the LI
  • Cold stagnating in Stomach and Intestines / warm the interior, tonify LI
  • Intestinal heat / bowel excess / clear intestinal heat, cold purgation
  • Large intestinal fluid deficiency / engender fluid, moisten the intestines
  • Blood Xu and intestinal dryness / tonify blood and engender fluid
  • Large intestinal damp-heat / clear heat and resolve dampness
  • Worms accumulating in the intestines / Quiet ascaris to relieve pain, kill worms
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14
Q

What are some SI organ patterns and treatment principles?

A
  • Excess heat in the SI / Clear heart and small intestine fire
  • Deficiency cold in the SI / warm the interior to dissipate cold, invigorate Yang
  • SI Qi stagnation / Move qi to relieve pain, soothe the Liver
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15
Q

What are some Spleen organ patterns and treatment principles?

A
  • Spleen Qi Xu / fortify the spleen and replenish Qi
  • Spleen Yang Xu / fortify the Spleen and support Yang
  • Spleen failing to control blood / tonify spleen qi and support yang
  • Sunken Spleen Qi / Upraise the middle Qi
  • Spleen Xu with dampness encumbrance / Fortify the Spleen and drain damp
  • Spleen xu with water flooding / warm the Spleen and induce diuresis
  • Cold-Dampness encumbering the Spleen / dissipate cold and dispel dampness
  • Damp-heat in the Spleen / clear heat and eliminate dampness
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16
Q

What is Epigastric pain?

A
  • Called Wei Wan Tong
  • Pain in the area defined as epigastric region
  • Area medial to the nipples, above the umbilicus and beneath the ribs
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17
Q

What points can be used for epigastric pain?

A

XI CLEFT POINTS
* ST34, SP8
YUAN SOURCE
* In yang meridians LI4, ST42, GB40

Are good for acute excessive epigastric pain or abdominal pain

FRONT MU + BACK SHU
* CV12, LR13, CV4, ST25
* BL20, BL21, BL18, BL19, BL23)
* Good for the involved Zang-Fu dysfunctions in treatment, this is a common prescription

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18
Q

What is abdominal pain?

A
  • Called Fu Tong
  • Pain in the area defined as the abdomen
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19
Q

What are the sections that the abdomen is divided into?

A
  • Divided into three sections: Shang Fu (upper abdomen, the areas from epigastric to hypochondriac regions over the ribs and flanks and above the umbilicus)
  • Shao Fu (lateral abdominal regions where the lumbar and iliac regions of abdomen are)
  • Xiao Fu (lower abdomen area beneath umbilicus)
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20
Q

What is abdominal distension?

A
  • Fu Zhang
  • A sense of fullness, discomfort, blockage or obstruction affecting the upper abdomen predominantly or experienced across the abdomen as a whole
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21
Q

What is acid reflux?

A
  • Fan Suan
  • Ascending acid of the stomach through the cardiac sphincter into the oesophagus, throat and mouth, usually accompanied with heart burn, nausea or sometimes vomiting
22
Q

What is nausea and vomiting?

A
  • E Xin
  • An unpleasant, sickly sensation in the stomach with involuntary urge to vomit
  • IT may precede vomiting
23
Q

How does the HuangDi NeiJing Suwen describe the digestive system?

A
  • All illnesses arise from the Qi
  • Qi obstructed or stagnant or accumulated due to improper diet, lifestyle or emotions can lead to epigastric or abdominal pain and other discomforts, like distension, constipation or diarrhoea, nausea/vomiting, reflux/burping
24
Q

What is Bian Bing?

A

Disease diagnosis
All diseases progress differently and clinically present different patterns in a certain stage of diseases development

25
Q

What is Bian Zheng?

A

Pattern diagnosis
* With many bio-medicines disease-based research evidence, it is not uncommon to combine biomedicine disease-based (bian Bing) and CM pattern-based (bian zheng) for diagnosis and treatment in the modern-day CM practice.

26
Q

What is YI BING TONG ZHI & TONG BING YI ZHI?

A

YI BING TONG ZHI: treating different disease with the same approach
TONG BING YI ZHI: Treating the same disease with different approaches

27
Q

What is YI BING TONG ZHI?

A
  • Treating different diseases with the same approach: suggests that even though patients may present with different diseases or conditions, there might be similarities or underlying patterns. Therefore, TCM practitioners may employ similar treatment approaches or strategies to address these shared underlying patterns. Highlights the individualised assessment of the patient and the identification of common patterns to guide treatment decisions.
28
Q

What is TONG BING YI ZHI?

A
  • Treating the same disease with different approaches: patients who have been diagnosed with the same disease or condition may exhibit different patterns due to variations in the individual presentations, constitutions or underlying imbalances. TCM pracs may employ different treatment approaches for the same disease based on the different pattern’s diagnosis. Emphasises the importance of tailoring treatments based on patterns which is also called Bian Zheng Lun Zhi.
29
Q

What is the significant of the GI microbiome in GI conditions?

A

Evidence based practice:
* Gastrointestinal microbiome plays a vital role in various physiological and pathological processes including digestion, nutrient absorption, immune system development and regulation. Of metabolic functions

30
Q

What is pain in TCM?

A
  • Pain in CM terms is always due to blockage or obstruction to the circulation and free movement of Qi and Blood
  • Restore the free flow by removing/clearing the obstruction/blockage for excessive types of pain, and by strengthening the insufficient motive force for deficient types of pain
31
Q

What are red flags in digestive disorders?

A
  • Severe and sudden onset pain
  • Persistent pain that worsens overtime
  • Presence of blood in vomit or stool
  • Difficulty swallowing or painful swallowing
  • Unintentional weight loss
  • Yellowing of the skin or eyes
  • Family history of gastrointestinal cancer
  • Suspected ulcer disease
  • Previous history of gastric surgery
32
Q

What symptoms require referral in digestive complaints?

A
  • Abdominal pain associated with trauma or injury
  • Severe and acute abdominal pain
  • Abdominal pain with fever or chills
  • Distended or rigid abdomen
  • Presence of blood in vomit or stool
  • Inability to pass gas or have a bowel movement
  • Signs of appendicitis (rebound tenderness, pain in the lower right abdomen)
  • Signs of intestinal obstruction (severe pain, vomiting, inability to pass stool)
  • Signs of GB or Liver disease (jaundice, right upper quadrant pain)
33
Q

What referrals are required for red flags in digestive complaints?

A
  • Recurrent heart burn or long-term indigestion may need further medical investigation
  • Red flagging for epigastric and abdominal pain is one possible referral to medical emergency
  • Referral to dietitian or nutritional medicine clinician
  • Severe or worsening pain requires immediate medical attention and should be referred to an emergency department
  • Referral to gastroenterologist or primary care physician for further evaluation and appropriate medical management
  • Epigastric pain may be the start of a heart attack
34
Q

What points tonify deficiency?

A

YUAN SOURCE
* SP3, LR3, KI3
* Yin channels, are good for tonifying deficiency

35
Q

What points harmonise the Spleen and Stomach?

A

THROUGH YUAN + LUO PAIR UP
* SP3 + ST40
* ST42 + SP4

36
Q

What points nourish yin / clear damp?

A

WATER HE SEA POINTS
* ST36, LI11, SP9 or lower are good to use to nourish yin or clear heat/damp-heat
* Lower He-Sea point ST37

37
Q

What local and distal points can be used in digestive conditions?

A
  • CV12 + LR3 to treat stomach pain due to disharmony of Wood-Earth
  • CV4 + KI7 to treat lower abdominal pain due to internal deficient cold
38
Q

What points can be used for excessive heat or heat toxicity in digestive system complaints?

A

JING WELL POINT
* ST44, LI1 could be used to clear yangming heat or stomach fire

39
Q

What One foot, one hand points can be used for digestive disorders?

A
  • SP9 + LI11 for damp-heat accumulation in the MJ/LJ
40
Q

What points can be used for discomfort in Stomach and abdomen?

A

EXPERIENCED POINTS OR COMMAND POINTS
* ST36 AND LI10
* LI4 good for release exterior attacks and face-mouth problems
* PC6 is good for discomfort in stomach, heaty and chest including stops nausea/reflux/vomiting

41
Q

How is Moxa therapy used for digestive complaints?

A
  • Used in cold patterns to expel the external wind-cold/cold or warm up Spleen/Kidney Yang to resolve empty cold
42
Q

What extra points can be used for digestive issues?

A
  • Inner-Neiting (EX-LE14) is used to extinguish wind and promote digestion treatment
43
Q

How is Fire cupping and Gua Sha used in digestive complaints?

A
  • Cupping: used to expel external wind-cold / wind-damp-cold patterns
  • Gua Sha: used for Qi and Blood stagnation or heat patterns
44
Q

What are some TCM patterns common in digestive issues?

A
  • Cold pattern (excessive cold invading and internal cold from Yang Xu)
  • Heat pattern (excessive heat from external heat/damp-heat invading and internal heat accumulation/stagnation and deficient heat from Yin Xu
  • Phlegm Damp, food stagnation, blood stasis, Liver Qi constraint, Spleen and Stomach Qi
  • Disharmony of Wood or Earth (Liver-Spleen/Stomach
  • Heat and cold mingling in the middle burner ( a mix of Spleen qi or Yang Xu with damp-heat congesting the middle burner)
45
Q

What points and techniques should be selected for digestive system disorders?

A
  • Tonifying needling techniques for deficiency
  • Reducing for excess patterns
  • Even method is used for not tonifying and reducing points
  • Tui Na: basic routines for specific pattern, tonifying and strengthening applied to identified meridians such as SP, ST and KI
  • Clear heat and cooling/calming techniques for the heat patterns on the identified meridians (LI, ST, LR, GB)
46
Q

What TCM herbs can be used for digestive symptoms?

A
  • Tonify Spleen and Stomach: Chinese yam, Jing Shen, Huang Qi, Bai Zhu, Fu Ling, Da Zao
  • Dampness: Fu Ling, Yi Yi Ren, Bai Bain Dou, Chi Xiao Dou
  • Warm up the middle burner: ginger, cao dou kou, cao guo and xiao hui xiang, ba jiao
  • Ginger: good to stop nausea and vomiting. If boiled with spring onion mixed with black sugar it will relieve epigastric pain from wind-cold attack
  • Cinema is warm and pungent and good for relieving external wind-cold and muscular aches
47
Q

What dietary advice should be given in digestive complaints?

A
  • Advice includes: regular meals and balancing diet, avoiding long term or excessive cold and raw, or greasy, excessive hot/spices
  • Aim: support digestion, reduce potential triggers for discomfort, keep the qi dynamic in epigastric and abdomen regions, harmonise the spleen and stomach
  • Avoid heating foods: in heat patterns and avoid cold and raw foods (but introduce warm or yang tonifying cooked foods) for patients with cold patterns
48
Q

What chinese exercise therapy can be used for digestive system disorders?

A
  • Ba Duan Jin is good to strengthen the Spleen and Stomach, restore the Qi dynamic and relieve stress
49
Q

What TCM herbal formulas can be used for digestive disorders?

A
  • Si Jun Zi Tang for Spleen and Stomach Qi Xu
  • Li Zhong Yang is good for MJ Yang Xu treatment
  • Xiao Jian Zhong Tang use for Spleen Qi/Yang xu epigastric pain
  • Sheng Ling Bai Zhu Tang for Spleen Qi Xu with Damp-Phlegm accumulation treatment
  • Huo Xiang Zheng QI San for wind-cold-damp attack or accumulation in MJ
  • San Ren Tang and Huo Po Xia Ling Tang are used for dampness-heat accumulation in the TB
  • Chai Hu Shu Gan San is used for soothing Liver Qi to relieve Qi constraint
  • Xiao Yao San or Jia Wei Xiao Yao San are good to harmonise Liver-Spleen/Stomach when the Spleen is deficient, and Liver Qi stagnated and overact on to Spleen and Stomach
  • Huang Lian Jie Du Tang, Bai Hu tang, Da Cheng Qi Tang are usually used to clear heat in the Yangming
  • Bao He Wan and Jian Pi Wan are used for food stagnation
  • Ban Xiao Hou Pu Tang is for the plum pit syndrome due to phlegm Qi combined accumulation
50
Q

What are the outcome measures for digestive complaints?

A
  • TCM checklist, patient reported outcome measures (PROMS), Pain numeric rating scale (NRS), and gastrointestinal symptom rating scale (GSRS)
51
Q
A

Chinese Clinical Med 1 (21 decks)

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