腹痛
Alias肚子疼
Traditional Chinese Medicine Definition
Abdominal Pain, known as "stomachache" in traditional Chinese medicine (TCM), falls under the category of脾胃系 diseases. According to the records in "Internal Medicine of Traditional Chinese Medicine," abdominal pain refers to the symptom of abdominal pain caused by the dysfunction of the spleen and stomach, liver, gallbladder, and large intestine, leading to the obstruction of Qi and blood circulation. Abdominal pain can be classified into various patterns, such as internal obstruction by cold evil, damp-heat congestion, food retention, and Qi stagnation and blood stasis, each with its unique etiology, pathogenesis, and clinical manifestations.
Abdominal pain is a common disease in TCM clinical practice, with the core pathogenesis being mostly the stagnation of Qi and blood in the spleen and stomach. Common triggers include improper diet, exposure to cold and dampness, and emotional disturbances. In the process of differentiation, attention should be paid to the following key points: the nature of abdominal pain, such as cold pain, burning pain, or stabbing pain; the location of abdominal pain, such as epigastrium, flanks, or lower abdomen; and the regularity of abdominal pain over time, such as fixed pain location, exacerbation at night. In addition, it is necessary to differentiate between cold and heat, deficiency and excess, in order to accurately administer treatment.
In TCM clinical practice, the differentiation of abdominal pain mainly includes patterns such as internal obstruction by cold evil, damp-heat congestion, food retention, and Qi stagnation and blood stasis. The pattern of internal obstruction by cold evil is characterized by acute abdominal pain, exacerbation with cold, and alleviation with warmth. The pattern of damp-heat congestion is mainly manifested by resistance to palpation, constipation, or loose stools. The pattern of food retention is characterized by epigastric distension and pain, belching, acid regurgitation, and loss of appetite. The pattern of Qi stagnation and blood stasis is manifested by stabbing pain in the abdomen, fixed pain location, and exacerbation at night. According to traditional Chinese medicine, different patterns should be treated with corresponding adjustment strategies, such as dispelling cold and warming the interior, purging the bowels and clearing heat, digesting food and promoting the flow, and activating blood circulation to remove blood stasis, with the aim of promoting Qi and alleviating pain, and restoring the function of the spleen and stomach.
Common Syndrome Types and Key Points of Differentiation
寒邪内阻证
Main Manifestations：腹痛急暴，遇寒痛甚，得温痛减
Management Approach：散寒温里，理气止痛
湿热壅滞证
Main Manifestations：腹痛拒按，大便秘结或溏滞不爽
Management Approach：通腑泄热，行气导滞
饮食停滞证
Main Manifestations：脘腹胀满疼痛，嗳腐吞酸，厌食
Management Approach：消食导滞，理气止痛
气滞血瘀证
Main Manifestations：腹部刺痛，痛处固定，入夜尤甚
Management Approach：活血化瘀，行气止痛
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
In clinical observation of abdominal pain, it is often necessary to carefully differentiate between cold and heat, deficiency and excess. For cold pain, warmth should be applied; for heat pain, cooling measures are required.
— 李明久 中医执业医师
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)