​Miao medicine,-Mengqi Zuole (Stomach Pain)​​

In Miao medicine, stomach pain is termed “Mengqi Zuole”, encompassing “Mengbudou” and “Sukaigu”. Mengbudou arises from qi stagnation and blood stasis impairing circulation. Qi counterflow causes belching and acid reflux; blood impairment leads to poor digestion; heat from stagnant qi-blood causes black stools; severe stagnation triggers intense pain; chronic heat damages meridians, weakening gastrointestinal function. Sukaigu results from dietary impurities, imbalances, constitutional weakness, or irregular habits, presenting with acute pain, nausea, fatigue, bloating, flatulence, appetite loss, and irregular stools.

In TCM, this condition stems from gastric qi obstruction, collateral stasis, or malnourishment, manifesting as epigastric pain. Western equivalents include gastritis, ulcers, spasms, prolapse, functional disorders, or malignancies with similar presentations.

​Miao Medical Classification​
Both subtypes include Heat-Channel and Cold-Channel variations.

​Etiology​
Predisposing factors: Irregular eating, spicy/alcohol excess, emotional stress, exposure to water/cold/damp/heat pathogens, or contaminated/overcooled foods.

​Pathogenesis​
Qi stagnation → blood stasis → pain; reversed qi → acid reflux; heat transformation → melena; severe stasis → acute pain; chronic heat → meridian damage → GI weakness. External pathogens invade, disrupting qi-blood harmony → violent epigastric pain.

​Diagnostic Criteria​

Key indicators:
(1) Epigastric tenderness
(2) Associated dyspepsia: anorexia, fullness, nausea, acid regurgitation
(3) Precipitants: dietary indiscretion, stress, exhaustion, chilling
Investigations:
Upper GI series, C14 breath test, endoscopy, histopathology.

​Differential Diagnosis​

1. Jiaoqi Zuoli (Gastric Stagnation): Predominant distension without acid reflux.
2. Guomumengwa (Cardiac Pain): Substernal/left chest stabbing/colicky pain.
3. Gejichuorou (Hypochondriac Pain): Hepatic-region discomfort with emotional lability.

​Therapeutic Classification​
Mengbudou

Heat-Channel Type
Symptoms: Postprandial radiating thoracodorsal pain, heartburn, hematemesis, melena.
Treatment: Clear heat, harmonize stomach, resolve stagnation.
Formula:

Coptis chinensis (Shuihuanglian) 10g
Evodia rutaecarpa (Wuzhuyu) 18g
Preparation: Decoction.

Cold-Channel Type
Symptoms: Fasting dull pain relieved by food, cold limbs, loose stools.
Treatment: Warm middle jiao, strengthen spleen-stomach.
Formula:

Valeriana jatamansi (Zhizhuxiang) 20g
Cyperus rotundus (Xiangfu) 10g
Lindera aggregata (Wuyao) 15g
Preparation: Decoction.

Sukaigu

Heat-Channel Type
Symptoms: Paroxysmal colic, alternating constipation/diarrhea.
Treatment: Dredge liver qi, drain damp-heat.
Formula:

Cynanchum paniculatum (Xuchangqing) 15g
Mahonia fortunei (Shidagonglao) 15g
Acorus tatarinowii (Shichangpu) 10g
Valeriana jatamansi (Zhizhuxiang) 12g
Preparation: Decoction.

Cold-Channel Type
Symptoms: Cold-aggravated pain relieved by warmth.
Treatment: Dispel cold, fortify middle jiao.

Formula:

Cyperus rotundus (Xiangfu) 10g
Zingiber officinale (Ganjiang) 10g
Valeriana jatamansi (Zhizhuxiang) 3g
Citrus reticulata (Chenpi) 10g
Preparation: Decoction.

​Preventive Care​

1. Dietary: Frequent small meals; avoid irritants/alcohol.
2. Emotional: Manage stress; avoid anxiety.
3. Activity: Balance work-rest; rest during exacerbations.

​Appendix Conditions​
Mengganggu (Epigastric Burning)

1. Heat-Type: Heartburn, halitosis – Paederia scandens (Jishiteng) 3g + Valeriana jatamansi (Zhizhuxiang) 3g (pounded, oral).
2. Cold-Type: Non-hunger discomfort – Dioscorea opposita (Shanyao) 20g + Bergenia purpurascens (Yanbaicai) 15g + Litsea cubeba (Mujiangzi) 10g (pounded, oral).
3. Blood-Deficiency Type: Palpitations, insomnia – Cleyera japonica (Shanzhicha) 10g + Ganoderma (Lingzhi) 15g + Polygonum multiflorum (Shouwuteng) 20g + Morus alba (Sangshen) 20g (decoction).

Touxiao (Acid Regurgitation)

1. Heat-Type: Bitter taste, hypochondriac distention – Coptis chinensis (Shuihuanglian) 6g + Gentiana scabra (Longdancao) 15g + Gardenia jasminoides (Zhizi) 10g + Ophiopogon japonicus (Maidong) 15g + Bambusa tuldoides (Zhuru) 10g (decoction).
2. Cold-Type: Cold limbs, loose stools – Zingiber officinale (Ganjiang) 10g + Magnolia officinalis (Houpo) 10g + Valeriana jatamansi (Zhizhuxiang) 15g + Cinnamomum cassia (Rougui) 5g (decoction).

​Clinical Note​
Miao medicine emphasizes qi-blood harmony, dietary discipline, and emotional equilibrium. Treatment requires channel differentiation (heat/cold), supported by lifestyle modifications to （helps maintain） recurrence.