Chief Complaint: Heartburn and pain in epigastrium
Western Diagnosis: Chronic gastritis
Medical History: In the last five years, the patient had very stressful life when she studied in college and tried to find a job. Her eating was not in a regular base and she did not do any exercise.
Questioning exam: She always felt fullness and dull pain in the epigastrium especially if she got upset or angry, the situation got worse. Some times she also felt the fullness or pain in hypochondria area. She was in fatigue all the time and the appetite was poor. Occasionally she had diarrhea.
Pulse exam: The Guan pulse on the left hand is wiry and weak in the left hand.
Tongue exam: The body of tongue is pale and swelling with tooth press, and coating is white and grease.
OM Diagnosis: Liver Qi stagnation and Spleen qi deficiency with wetness accumulation.
Treatment Principle: Tonify spleen and treat qi stagnation in liver
Point Prescription: Taichong, Gongsun, Neiguan, Zusanli, Qihai, Qunyuan, Qimen, pishu, Zhongwan.
At beginning I have treated the patient twice a week for three weeks, then ones a week up to now.
Ear point: liver, spleen, kidney, shemen
Herbal Formula: I did not use herbs for the patient.
Lifestyle Prescription: Try eat more than three times per day and eat less each time. Try to avoid to feel angery, to get more relax and do more exercise.
Results: After one month treatments, the patient felt 80% better.
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