Spleen and stomach damp-heat

　　According to traditional Chinese medicine, spleen and stomach weakness is the root cause of disease. The 'Qingming of a Hundred Diseases' says, 'Without deficiency, evil cannot harm a person.' Although the formation of damp-heat syndrome in the spleen and stomach has various causes and pathogenesis, the functional state of the spleen and stomach is the determining factor. In clinical practice, some patients may experience symptoms such as distension and fullness in the epigastrium, frequent nausea, lack of appetite, or abnormal bowel movements, with a yellow and greasy tongue coating, after a meal or due to external attacks or 'eating too much.' Tracing the root, whether it is due to insufficient endowment or maladjustment after birth, the root cause of spleen and stomach weakness can always be found. Spleen and stomach weakness cannot normally transport grain and water, and water becomes dampness, grain becomes retention, and dampness and retention transform into heat over time, forming damp-heat. At the same time, various disease factors are very likely to cause functional disorders of the weakened spleen and stomach, leading to damp-heat.

　　Exposure to external pathogens

　　Due to the physiological characteristics of the spleen and stomach, dampness and dryness are prone to invade the spleen and stomach. The spleen is the damp earth, the 'area prone to dampness,' and dampness is most likely to injure the spleen; the stomach is the dry earth, which prefers moisture and dislikes dryness and is prone to dry diseases. Dryness is the evil of Yang heat, and excessive dryness leads to heat. The combination of stomach heat and spleen dampness is damp-heat. Other external pathogens of six excesses, such as wind-heat, in the case of internal dampness due to spleen deficiency and failure to transport, the combination of external wind-heat and internal dampness can also form damp-heat. As Xue Shengbai said: 'Sun Qi is internally injured, dampness and fluid stop, and the external pathogen again arrives, attracting internally and externally, causing damp-heat disease.' At the same time, when external pathogens attack the lung, causing chest stuffiness, cough, and irregular movement of Qi, it can also injure the weakened spleen and stomach, leading to internal dampness, stagnation, and transformation into heat, forming damp-heat.

　　Irregular diet

　　Excessive and unregulated diet is the most common cause of damage to the spleen and stomach. 'When food intake is doubled, the spleen and stomach are injured.' Excessive drinking, overeating, eating rich and sweet foods, and unclean food, as well as irregular eating habits, are all prone to damage the spleen and stomach, causing food retention, damp obstruction, and Qi stagnation, which can all transform into heat over time. The nature of alcohol itself is 'hot in Qi and damp in nature,' and Qi stagnation is also an important factor in the accumulation of dampness and water. Rich and sweet foods have the characteristic of promoting dampness and heat. It can be seen that many factors of irregular diet can become causes of damp-heat syndrome in the spleen and stomach. Although the stomach prefers moisture and dislikes dryness, the formation of damp-heat in the spleen and stomach is also directly related to the stomach. Food is first accepted by the stomach, and in clinical practice, symptoms of abnormal stomach function such as distension and fullness in the epigastrium, lack of appetite, and nausea are often seen first. The spleen and stomach are both central soil, coordinating and cooperating in physiological functions, and influencing each other in pathological conditions, so the relationship between damp-heat syndrome and the stomach is inseparable, and it is therefore called 'damp-heat syndrome of the spleen and stomach'.

　　Emotional factors

　　"The spleen is in the mind of thought", "thinking leads to Qi congestion". Zhang Jingyue once said: "But it is difficult to relieve the sorrow and it will hurt the spleen". Overthinking, emotional discomfort, can affect the drainage function of the liver, the normal drainage of the liver is an important condition for the coordination of the spleen rising and the stomach descending, that is, "the earth reaches the wood". Liver failure to drain without regulating Qi, spleen and stomach disorder, spleen failure to operate produces dampness, dampness transforms into heat, damp-heat is formed.

　　Of course, the above causes can cause different spleen and stomach syndromes in different individuals, which is determined by the different physical constitution, different spleen and stomach function characteristics, and different forms of response to the causes.

　　Damp-heat in the spleen and stomach can easily lead to gastrointestinal dysfunction, anorexia, chronic diarrhea, and is prone to cause malnutrition in patients. Patients with damp-heat in the spleen and stomach, due to nutritional disorders, weakened body resistance, are prone to various infectious diseases.

　　Common clinical symptoms of damp-heat in the spleen and stomach include:

　　1. Burning pain in the epigastrium, acid regurgitation.

　　2. Dry mouth and bitter taste, thirst without desire for drinking, sweet and sticky taste, acid regurgitation after eating sweet food, nausea and vomiting, heavy limbs and fatigue.

　　3. Yellow urine, poor defecation, yellow greasy tongue coating, slippery and rapid pulse.

　　The main cause of damp-heat syndrome in the spleen and stomach is that the above diseases have not been effectively treated, resulting in repeated activity and development of the lesions. Secondly, it is related to poor lifestyle, such as overeating, preference for rich and greasy foods, preference for spicy foods, smoking, and excessive drinking, which lead to injury of the spleen and stomach, accumulation of dampness and generation of heat. It can be seen that in order to prevent the occurrence of damp-heat in the spleen and stomach, it is necessary to actively treat the above basic diseases first. At the same time, it is necessary to change poor lifestyle, eat in moderation, do not smoke, do not drink, and so on.

　　Damp-heat in the spleen and stomach is common in diseases of the digestive system, and the examination items include:

　　(One) Laboratory examination

　　Fecal occult blood test and urine bile test are simple and valuable inspection methods. Gastric juice analysis and duodenal drainage can provide diagnostic evidence for gastric and biliary tract diseases. Liver function tests are numerous and have different meanings, so appropriate selection is required. Cytological examination is very helpful for the diagnosis of esophageal, gastric, and colon cancer. The examination of tumor markers, such as AFP, CEA, and CA19-9, has certain value. The examination of autoantibodies, such as anti-mitochondrial antibodies, can help in the diagnosis of digestive system autoimmune diseases.

　　(Two) Ultrasonic Examination

　　It can display the size and contour of the liver, spleen, and gallbladder, which is helpful in differentiating liver cancer and liver abscess, and can also display gallstone, splenic portal vein diameter, bile duct dilation, as well as liver, pancreatic cysts and other abdominal masses. The examination method is safe and easy to perform, and is very helpful for diagnosis.

　　(Three) Endoscopic Examination

　　It can directly observe the lesion, due to its high brightness, clear field of view, few blind areas, and convenient operation, its application is expanding. The fiberoptic gastroscopy is very helpful for the early diagnosis of gastric cancer, as the application of gastroscopy has made it possible for more than 30% of gastric cancers to be diagnosed at an early stage (referring to cancer tissue that has not invaded the muscular layer). ERCP is very helpful for the diagnosis of liver, biliary, and pancreatic diseases. The fiberoptic colonoscopy can be inserted into the ileum, while the fiberoptic laparoscopy can help in diagnosing liver, pancreas, and abdominal masses, and determine the cause of ascites.

　　(Four) X-ray Examination

　　Barium meal and barium enema examinations of the digestive tract help to understand the overall motility status of the gastrointestinal tract and are helpful for the diagnosis of tumors, ulcers, and diverticula. Recently, the use of air-barium double contrast imaging has increased the positive rate. Cholescintigraphy helps to understand the concentration function of the gallbladder, judge the presence of stones; percutaneous liver bile ductography can differentiate the causes of obstructive jaundice. Selective abdominal aortic angiography is of diagnostic value for the liver and other tumors, gastrointestinal bleeding, etc. CT and MRI are used for the diagnosis of abdominal tumors, and patients are willing to accept them. Liver vein and inferior vena cava pressure measurement and angiography, as well as blood flow and oxygen consumption measurement, help in the diagnosis of Budd-Chiari syndrome and liver cancer.

　　(Five) Radioisotope Examination

　　The number of projects is increasing, liver scanning has been in use for a long time, and the γ-camera, ECT can provide diagnostic evidence for locoregional lesions such as liver cancer. Recently, some researchers have developed imaging diagnosis using radiotagged monoclonal antibodies against tumors, which can help in diagnosing liver and pancreatic tumors. In addition, the application of radioimmunoassay (RIA) can detect tumor markers or gastrointestinal hormones, which is of great value for the diagnosis of some tumors and diseases in the digestive system.

　　(Six) Esophageal Pressure and Vitality

　　and Biliary Pressure Measurement

　　Measurement of the intraluminal pressure at the lower end of the esophagus is very valuable for the diagnosis of reflux esophagitis. Understanding the vitality of each segment of the esophagus is very helpful for the diagnosis and differentiation of esophageal motility disorders such as achalasia of the esophagus and cardia. Endoscopic cannulation of biliary pressure measurement is helpful for the diagnosis of incomplete biliary obstruction, cholangitis, biliary atresia, and dysfunction of the papillary sphincter.

　　(Seven) Biopsy

　　Liver biopsy is one of the most valuable methods for the definitive diagnosis of chronic liver disease. Currently, fine needle aspiration is mostly used, which rarely causes the risk of bleeding. Small intestine biopsy involves passing a small biopsy instrument through the mouth into the jejunum or ileum (can be guided through the pylorus by endoscopy), taking mucosal tissue for pathological examination, which is very diagnostic for diarrhea and malabsorption of the small intestine. Strict control of indications should be maintained during the examination. In addition, histopathological diagnosis can be made through biopsies under endoscopic visualization, fine needle percutaneous aspiration biopsies for solid masses under B-ultrasound guidance, and surgical biopsies, etc.

　　Dietary aspects:

　　1) Eating麦冬 is very effective for damp-heat, and it can be bought in drugstores. It's very cheap. It can be cooked into porridge, soaked into chrysanthemum tea, or eaten like sugar every day.

　　1) Taking medicine can harm the stomach, liver, and kidneys, so food therapy is the best. You can eat millet bean porridge, eat more winter melon, do not drink milk or soy milk, try not to eat rich and greasy foods, and seafood.

　　The beginning of the millet bean porridge is millet: red bean = 1:1, and the other half is rice. After eating for more than 20 days, the ratio of millet to red bean becomes 2:1, and the other half is rice, and the porridge should not be too thick or too thin.

　　Adhering to food therapy is not a matter of ten or eight days, the key is to persevere!

　　When regulating the spleen and stomach, it is also necessary to promote lung Qi. Because the spleen is responsible for transporting and transforming grains and cereals, transforming grains like fermentation, the lung is responsible for spreading the essence and refining it like mist, the spleen needs the assistance of the lung to complete the distribution of the essence and grain, as stated in the 'Su Wen: Discussion on the Channels': 'The spleen is responsible for scattering essence, ascending to the lung, regulating the waterways, and descending to the bladder.' The lung is responsible for promoting and descending, the spleen and stomach are responsible for ascending the clear and descending the turbid, and they both govern the ascending and descending of Qi. Therefore, when treating the spleen, one should not forget to regulate the lung, and when treating the lung, one must investigate the spleen. Clinical medication should add the properties of invigorating the spleen and harmonizing the stomach, and moderately add the properties of promoting lung Qi and resolving depression, such as almonds, loquat, and ephedra. Ye Tianshi used almonds to promote lung Qi and resolve depression in the 'Medical Record of Clinical Experience', making the damp obstruction move, and initiating the practice of promoting lung Qi, benefiting water, and invigorating the spleen.

　　In Western medicine, treatment needs to be specific according to the primary disease condition. Syndrome of damp-heat in the spleen and stomach involves various diseases of multiple systems such as digestion, tumor, and urinary system, and diseases of the digestive system are more common, such as chronic gastritis, reflux esophagitis, gastric or duodenal ulcer, gastritis, chronic hepatitis B, cirrhosis of the liver, fatty liver, cholelithiasis, and gallbladder polyps. At different stages of development after surgery for liver cancer, esophageal, gastric, or intestinal cancer, various conditions may arise, and chronic gastritis accounts for the first place.