Regulating Qi Mechanism for Gastric Atony
Gastric atony is a common complication after surgery in patients with gastric cancer and various abdominal diseases, leading to functional gastric emptying disorders and causing the stomach to "shut down," resulting in severe discomfort. Dr. Liu Zhiqiang, Director of the Department of Traditional Chinese Medicine at the Affiliated Tumor Hospital of Harbin Medical University, has developed a differentiated treatment approach based on syndrome differentiation using acupuncture combined with herbal decoctions, achieving excellent results.
After surgeries for gastric cancer, colorectal cancer, esophageal cancer, and pancreatic cancer, gastric atony primarily manifests as upper abdominal distension, abdominal pain, acid regurgitation, hiccups, nausea, and vomiting. The vomitus consists of gastric contents mixed with bile, averaging about 1,500 ml per day; symptoms temporarily improve after vomiting. Gastric atony typically occurs 5–8 days post-gastrointestinal surgery, though some cases may present symptoms weeks later. Current treatments include fasting, continuous gastrointestinal decompression, saline lavage, and nutritional support. However, these methods carry high risks of infection and yield unsatisfactory clinical outcomes.
Dr. Liu selected more than ten acupoints including Quchi (LI11), Neiguan (PC6), Zhongwan (CV12), Zusanli (ST36), Sanyinjiao (SP6), and Taichong (LR3). He applied tonification or reduction techniques according to the patient’s condition and used electroacupuncture for moderate stimulation. Furthermore, he was the first to classify gastric atony into several syndromes: spleen-stomach stagnation, stomach qi reversal, qi stagnation with blood stasis, and qi-blood deficiency. Corresponding decoctions—Dachengqi Tang, Xuanfu Dazhe Tang, Xuefu Zhuyu Tang, and Shiquan Dabuxue Tang—were prescribed accordingly. This approach achieved nearly 100% cure rate, with an average treatment duration of only six days, significantly shorter than conventional therapy.
Dr. Liu believes that the main clinical features are abdominal pain, vomiting, and distension, caused by stagnation in the stomach and impaired qi circulation. Postoperative damage to the spleen and stomach impairs their functions: the spleen fails to transport properly, the stomach loses harmony and descent, meridians are injured, qi stagnates and blood stasis forms, obstructing the middle burner, thus producing distension, nausea, vomiting, and hiccups. Since “the six fu organs function through unobstructed flow,” treatment should focus on regulating qi movement, supplemented by reinforcing vital energy, eliminating pathogenic factors, activating blood circulation, resolving stasis, descending rebellious qi, and promoting bowel movements. These herbs restore normal gastric function, relieving pain, vomiting, and distension.