呕吐
Alias恶心呕吐
Traditional Chinese Medicine Definition
In traditional Chinese medicine, vomiting is referred to as "恶阻" (ě zǔ), which describes a pathological condition where the stomach loses its normal descending function, leading to qi reversal upwards, forcing stomach contents to be expelled from the mouth. According to the records in "Internal Medicine of Traditional Chinese Medicine," vomiting can be caused by factors such as external pathogenic invasion, irregular diet, emotional disorders, and weakness of the spleen and stomach. The disease primarily affects the stomach, and is closely related to the liver, spleen, and gallbladder.
Vomiting is a common gastrointestinal disorder in clinical practice of traditional Chinese medicine, with its core pathogenesis being the loss of the stomach's descending function and qi reversal upwards. Common triggers include improper diet, emotional fluctuations, and external invasion of the six pathogenic factors. In the process of differentiation, attention should be paid to the following key points:
1. Cold and heat, deficiency and excess: Patients with cold invasion of the stomach often present with vomiting of thin, watery sputum, with a preference for warmth and pressure. Those with heat invasion of the stomach tend to have vomit that is turbid, with bitter taste and dry mouth. The differentiation between deficiency and excess is reflected in the fact that those with food retention usually present with excess symptoms, while those with weakness of the spleen and stomach usually present with deficiency symptoms.
2. Accompanying symptoms: Patients with symptoms such as aversion to cold, fever, headache, and body ache usually have external pathogenic invasion of the stomach; those with belching, aversion to food, epigastric distension, and fullness usually have internal retention of food; and those with chest and hypochondriac distension, acid regurgitation, usually have liver qi invasion of the stomach.
Overall adjustment direction: In clinical practice of traditional Chinese medicine, the treatment of vomiting should adopt corresponding adjustment methods based on different patterns. For external pathogenic invasion of the stomach, it is advisable to disperse the pathogen, relieve the exterior, transform turbidity, and harmonize the stomach; for internal retention of food, it is advisable to eliminate food retention, harmonize the stomach, and reverse the qi; for internal obstruction of phlegm and dampness, it is advisable to resolve phlegm and dampness, harmonize the stomach, and reverse the qi; for liver qi invasion of the stomach, it is advisable to soothe the liver and regulate qi, harmonize the stomach, and reverse the qi. Traditional Chinese medicine believes that adjusting the spleen and stomach, and restoring the normal ascending and descending function of the stomach, is the key to treating vomiting.
Common Syndrome Types and Key Points of Differentiation
外邪犯胃证
Main Manifestations：突然呕吐，起病较急，伴恶寒发热，头身疼痛
Management Approach：疏邪解表，化浊和胃
食滞内停证
Main Manifestations：呕吐酸腐，嗳气厌食，脘腹胀满，吐后反快
Management Approach：消食导滞，和胃降逆
痰饮内阻证
Main Manifestations：呕吐清水痰涎，脘闷不食，头眩心悸
Management Approach：温化痰饮，和胃降逆
肝气犯胃证
Main Manifestations：呕吐吞酸，嗳气频繁，胸胁胀痛
Management Approach：疏肝理气，和胃降逆
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
Patients with vomiting often suffer from upward reversal of stomach qi. In treatment, it is necessary to harmonize the stomach and reverse the qi, while also paying attention to liver depression leading to fire.
— 李明久 中医执业医师
Related Popular Articles
Guidance for Nearby Treatment
花园岗地铁站、三墩社区、衢州路社区等周边居民可就近到正规中医医疗机构就诊，具体地址、电话及营业时间请查看关于我们。
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)