Gastroptosis means that when standing, the lower edge of the stomach reaches the pelvic cavity and the lowest point of the small curved arc of the stomach falls below the iliac crest line, which is called gastroptosis. Mild gastroptosis is mostly asymptomatic, and those above moderate degree often have symptoms such as poor gastrointestinal motility and indigestion. Clinical diagnosis is mainly X-ray, barium meal fluoroscopy and B-ultrasound, which can make a definite diagnosis. Table of Contents Symptoms and Signs Etiology and Pathology Overview Pathogenesis Clinical Diagnosis Auxiliary Examination Gastroptosis Differential Diagnosis Self-care Complications Treatment Efficacy Standard Western Medicine Treatment Chinese Medicine Treatment Chinese Medicine Syndrome Differentiation Treatment The main methods are soothing the liver and resolving phlegm, clearing the liver and resolving depression, promoting gallbladder digestion, regulating liver and removing blood stasis, acupuncture and physiotherapy, scalp acupuncture, body acupuncture and acupoint injection to prevent health care, eating less and eating more meals. Chew slowly, eat soft food, balance nutrition, reduce irritation, prevent constipation, be dynamic and moderate, not overeating, eat less and eat more meals, treat gastroptosis, treat gastroptosis with dietotherapy, treat gastroptosis with Huangqi Decoction, pig spleen, jujube, rice porridge, lotus seeds, yam porridge, symptoms and signs, pathogenesis, clinical diagnosis, auxiliary examination, syndrome differentiation, gastroptosis, self-care complications, etc. Regulating liver and removing blood stasis, acupuncture and physical therapy, awn needle electroacupuncture, scalp acupuncture, body acupuncture and acupoint implantation, acupoint injection, prevention and health care, eating less and eating more, chewing slowly, food is soft and balanced, reducing irritation, preventing constipation, so it is not suitable for overeating. Therefore, asymptomatic patients who should eat less and eat more diet therapy to treat gastroptosis, pig stomach, astragalus soup, pig spleen, jujube, rice porridge and lotus seed yam porridge may be obviously drooping. 2, abdominal pain: mostly persistent dull pain. It often happens after meals and is related to food intake. The greater the food intake, the longer the pain time and the heavier the pain. At the same time, pain is related to activities, and activities after meals often aggravate the pain. 3, nausea, vomiting: often occurs after meals, especially when eating too much. This is because 1 time eating a lot increases the tension of the ligament in the stomach wall, causing pain, and then nausea and vomiting. 4. Constipation: Constipation is mostly intractable. The main reason may be that the transverse colon prolapse exists at the same time, which makes the liver curvature and spleen curvature of the colon acute and leads to slow passage. 5, neuropsychiatric symptoms: because many symptoms of gastroptosis torment patients for a long time, their mental burden is too heavy, resulting in insomnia, headache, dizziness, dullness, depression and other neuropsychiatric symptoms. Hypotension, palpitation, and standing syncope may also occur. 6. Physical examination: It can be seen that the figure is slender, and the tenderness point of the upper abdomen is not fixed due to the change of standing and lying position. Sometimes when percussive palpation is used, or when the patient changes his position rapidly, underwater vibration can be heard. Aortic pulsation is easily detected in the upper abdomen, often accompanied by signs of liver prolapse, kidney prolapse and colon prolapse. Edit the etiological and pathological summary of this paragraph. The occurrence of this disease is mostly due to the lack of diaphragmatic suspension, the relaxation of hepatogastric ligament, the decrease of intra-abdominal pressure, the relaxation of abdominal muscles and other factors, plus the body shape or physique, which makes the stomach look like a fishhook with extremely low tension, which is the tension-free stomach seen by gastroptosis. The fixation of abdominal visceral position with normal etiology mainly depends on three factors: 1, diaphragm position and diaphragm activity. 2, abdominal muscle strength, the role of abdominal fat layer thickness. 3. Fixation of adjacent organs or some related ligaments. Any factors that can affect the position decline of diaphragm, such as diaphragm activity, abdominal pressure, abdominal muscle contraction, gastric diaphragm ligament, gastric liver ligament, gastric spleen ligament, gastric colon ligament, etc. , will lead to sagging. Due to the difference of etiology, primary disease and constitution, the degree of muscle weakness, ligament relaxation, drooping degree and clinical manifestations are different. For example, weak people are often accompanied by systemic organ prolapse, and all tissues and ligaments that suspend and fix organs are low in tension. However, people with chronic wasting diseases or lying down for a long time with little exercise are often mainly caused by decreased abdominal muscle tension, insufficient suspension of diaphragm and relaxation of gastro-hepatic ligament, and are often not accompanied by systemic organ prolapse. The clinical diagnosis of this section is based on the patient's medical history and clinical manifestations, as well as the ultrasonic examination of drinking water. X-ray results are easy to diagnose. Generally, the small curvature notch is mild when it is lower than the line connecting the two iliac ridges 1 ~ 5 cm, moderate when it is 6~ 10cm, and severe when it is above1/cm. Edit this inspection 1. The tenderness of the upper abdomen is not fixed, but can change with the body position. Some patients can hear infraumbilical vibration sound during palpation, and a few patients with obvious ptosis have signs of ptosis of liver, right kidney and colon at the same time. 2.x-ray examination and gastrointestinal barium meal examination showed that: (1) the stomach body was obviously displaced downward to the left, and the severe cases were almost completely located on the left side of the spinal midline. (2) The lowest point of gastric minor curvature arc is below the iliac crest line. (3) The tension-free stomach is vertical, wider than the bottom, with sinus below pyloric level, weak peristalsis, decreased tension and barium meal retention. After 6 hours, 1/4 ~ 1/3 remained in the stomach. (4) The ampulla of duodenum is elongated and its upper corner is sharp. The second part of the duodenum is often located behind pyloric canal, that is, to the left. (5) The third segment of duodenum may cause duodenal stagnation due to the compression of mesenteric artery. 3. After ultrasonic examination of drinking water, the lower edge of the stomach was detected to move into the pelvic cavity. Edit this paragraph. What diseases are the differential diagnosis of gastroptosis easily confused with? 1. Unlike acute bloating, acute bloating often occurs within a few hours to a day or two after trauma, anesthesia, surgery, or shortly after a full meal. Patients feel full or persistent abdominal distension, and then vomit, mainly stomach contents, but frequent attacks. Although vomiting will not reduce abdominal distension, patients can quickly develop water and electrolyte disorders and even shock. X-ray plain film of abdomen shows saturated and dense food residue shadow in enlarged stomach. Asking about medical history is helpful for differentiation. 2. Gastric retention Functional gastric retention is mostly caused by insufficient gastric tension. In addition, gastric motility disorder caused by stomach or other abdominal operations, central nervous system diseases, neuropathy caused by diabetes, vagotomy, etc. can all cause this disease. Uremia, acidosis, hypokalemia, hyponatremia, systemic or intra-abdominal infection, severe pain, severe anemia and the application of antipsychotic drugs and anticholinergic drugs can also cause this disease. Vomiting is the main manifestation of this disease. It can happen day and night. Vomiting is often overnight food, which generally does not contain bile, and fullness and pain in the upper abdomen are also common. If there is vomiting and food, there is a vibrating sound in the abdomen on an empty stomach, indicating gastric retention. It can be confirmed that after eating for 4 hours, food can still be regurgitated from the stomach or extracted from the stomach cavity. When the gastrointestinal barium meal is examined, 50% barium remains after 4 hours, or it has not been emptied after 6 hours, which is the evidence of this disease. This disease should be differentiated from peptic ulcer, chronic gastritis, chronic hepatitis, gastric neurosis, chronic cholecystitis, gastric cancer, gastric distention and pyloric obstruction. Patients with this self-care gastroptosis mainly feel loss of appetite, loss of food intake, abdominal distension, belching, abdominal distension, severe discomfort in the heart socket and constipation, and some have loose stool or frequent defecation. At the same time, it is accompanied by symptoms such as listlessness, fatigue, dizziness and insomnia. For example, X-ray barium meal perspective shows that the lowest point of the curve of gastric minor curvature is below the iliac crest line, and the shape of the stomach is weak. To treat gastroptosis, it is important to take care of yourself. Strengthen exercise and enhance physical fitness. This is the key to cure the disease. Appropriate participation in sports activities can not only exercise abdominal muscles and enhance physical fitness, but also enhance gastrointestinal secretion and peristalsis, stimulate appetite and improve digestion and absorption capacity. Exercise items, exercise times and time should be determined according to your physical condition, such as taking a walk before meals, running in the morning, practicing horizontal bar and sit-ups. , so as not to feel nervous and overtired. After each exercise, I feel refreshed, my appetite is greatly increased, and my sleep is sweet, indicating that the amount of exercise is appropriate. Otherwise, it means that the amount of exercise is too large and must be adjusted in time. Patients with gastroptosis should be nursed back to health regularly and eat less and more meals. Eat 3- 5 meals a day, 7-80% full each time, chew slowly. It is necessary to control cold foods, especially cold water, cold dishes, lettuce and raw food. When cooking soup, add some seasonings such as onion, ginger, cinnamon, fennel and pepper. Patients with gastroptosis are prone to nutritional deficiency due to the limitation of intake and food types. Therefore, the diet should be rich in protein and easy to digest. Avoid indigestible foods, such as fried and fried meat, bacon, dried fish, sticky cakes and leeks. Patients with gastroptosis can do the following gastroptosis treatment exercises. Section 1: Put the pillow on the pillow, bend your legs, keep your heel as close as possible to your hips, and keep your abdomen as half-bridge as possible, and then restore it. Do it for 3- 5 minutes. Section 2: Put your legs together, lift your straight legs, stop at 20-30 cm away from the bed for 10 second, and then restore. Do it again. The third quarter: put your legs together, lift your straight legs, stop at 20- 30 cm away from the bed, and then slowly swing back and forth to both sides. Section 4: prone, body bending. Section 5: Lie on your back, lift your arms to your abdomen and sit up. After sitting up, the lower body will resume lying on your back. This therapy needs to start with a small amount of exercise, and it is best to arrange it within 1- 2 hours after dinner and exercise for 20- 30 minutes each time. The movement rhythm should be moderate or slow, and the breathing should be even and coordinated. For those with a long course of this complication, due to psychological and mental factors or anemia, emaciation and other factors, patients often have symptoms such as dizziness, headache, insomnia, palpitation, fatigue, and a few even have symptoms of depression. Severe cases accompanied by liver, spleen, kidney, transverse colon and other ptosis are called visceral ptosis. Edit the curative effect standard of this paragraph and cure: clinical symptoms disappear, X-ray reexamination, and the lower gastric pole rises to the normal position. The effect is remarkable: the clinical symptoms are obviously relieved, and the lower end of the stomach is raised more than 4 cm by X-ray. Effective: the clinical symptoms were relieved, and the gastric pole was raised above 65438±0cm under X-ray film; Or the clinical symptoms are obviously relieved, but the X-ray reexamination has no change. Ineffective: the symptoms have improved slightly or not, and the signs have not changed. Western medicine can refer to chronic gastritis to treat epigastric discomfort, dull pain and indigestion. For patients with abdominal distension and slow gastric emptying, motilium 19mg three times a day, or metoclopramide 5- 10 mg three times a day. Mosapride tablets are the first choice for constipation patients, each time 1 tablet, three times a day. Try ATP treatment, intramuscular injection of 20mg every morning and half an hour before lunch, twice a day, 25 days for 1 course of treatment, and then the second course of treatment after 5 days. If necessary, place a gastric stent. Edit the main method of traditional Chinese medicine treatment of auricular acupuncture in this paragraph: select the handle of filiform needle and press it in the "gastrointestinal area" of the ear shell to find the sensitive point, and press it at this point for 2-3 minutes,/kloc-0 times a day. Moxibustion: Moxibustion on points such as Qihai, Guanyuan, Zusanli and Shu Wei. Qigong: Breathing in supine position: the patient takes supine position, raises his hips or the foot pad of the bed by 5cm, inhales first and then breathes, stops and repeats; When inhaling, lick the upper jaw and say the word 1. When exhaling, put down your tongue and say the second word. When stopping to close, say the rest words and say these words silently, such as "stomach rising" and "stomach body rising". The TCM syndrome differentiation characteristic therapy of gastroptosis refers to that when standing, the lower edge of the stomach reaches the pelvic cavity, and the cutting angle of the stomach is lower than that of the iliac crest line. The main symptoms are abdominal distension, aggravation after eating, decreased supine position, nausea, anorexia, epigastric pain, constipation or diarrhea. Clinically, there are many doctors who use the methods of tonifying middle energizer and invigorating qi, rising yang and relieving depression, which often leads to the disadvantages of spleen and stomach qi stagnation. The author treats the liver and obtains many excellent curative effects, which are summarized into five methods, which are briefly described as follows. Soothing the liver and stomach is mostly used to stagnate soil, but it is ineffective to absorb rot. Gastroptosis is especially serious after eating. The upper abdomen is full and even threatening, with frequent belching, slight discomfort, or nausea and vomiting, bitter taste and poor stool. Every symptom is aggravated by emotional factors. The tongue is pale, the coating is thin and white, and the pulse is thin. Jiawei Chaihu Shugan Powder: Bupleurum, Radix Paeoniae Alba, Fructus Toosendan, Radix Curcumae, Radix Aucklandiae, Fructus Amomi, Fructus Aurantii, Radix Codonopsis, Poria, Atractylodis Rhizoma, Rhizoma Chuanxiong and Rhizoma Cyperi. The method of resolving phlegm and relieving depression is mostly used for spleen and stomach qi deficiency, water and dampness are not transported, and phlegm is accumulated; Or long-term stagnation of dampness will hurt the spleen and stomach. Symptoms include gastroptosis, abdominal distension, listlessness, loss of appetite, nausea and belching, or throat obstruction, loose stool or discomfort, white and greasy tongue coating and slippery pulse. Jiawei Banxia Houpu Decoction and Wendan Decoction: Pinellia ternata, Magnolia Officinalis, Fructus Aurantii Immaturus, Poria, Folium Perillae, Pericarpium Citri Tangerinae, Caulis Bambusae, Atractylodis Rhizoma, Semen Sinapis Albae, Rhizoma Cyperi, Radix Codonopsis, Coicis Semen, Radix Curcumae and Herba Lycopi. Clearing the liver and relieving depression is mostly used for qi stagnation and excessive fire, stomach heat and depressed bowels, or chronic illness and yin deficiency, or excessive irritability and dryness, resulting in disharmony with the stomach. Symptoms include gastroptosis, distension and hypochondriac pain in the upper abdomen, noisy upper abdomen or burning pain in the stomach. When the pain is irregular, it is bitter taste, dry mouth, constipation, red tongue, yellow body fluid or less, and thin or thin pulse. Danzhi Xiaoyao Powder plus Zuojin Pill: Cortex Moutan, Fructus Gardeniae, Radix Bupleuri, Radix Paeoniae Alba, Radix Angelicae Sinensis, Herba Menthae, Rhizoma Cyperi, Rhizoma Coptidis, Radix Curcumae, Scutellariae Radix, Poria, Radix Adenophorae and Dendrobium. The method of promoting gallbladder and promoting digestion is mostly used for those who have abnormal mature function of Donna due to improper diet or improper diet. "Bold wood falls by stomach soil". When the stomach loses harmony and falls, the gallbladder loses its relief, and the harmony of qi is blocked, so the turbidity cannot rise and fall, and the turbidity is coherent. Symptoms are gastroptosis with abdominal distension and pain, loss of appetite, fullness and discomfort after eating a little, frequent or sour belching, unpleasant stool, thick and greasy tongue coating, and slippery or heavy pulse. Baohe Pill plus Banxia Xiexin Decoction: Massa Medicata Fermentata, Fructus Hordei Germinatus, Poria, Rhizoma Pinelliae, Semen Raphani, Radix Aucklandiae, Rhizoma Cyperi, Radix Curcumae, Rhizoma Coptidis, Fructus Aurantii Immaturus, Fructus Crataegi and Radix et Rhizoma Rhei. The method of regulating liver and removing blood stasis is mostly used for the elderly with gastroptosis or gastroptosis. At this time, the stomach collaterals are malnourished, the qi and blood circulation are not smooth, and the qi stagnation is not smooth. Long-term illness into the blood leads to blood stasis, which leads to turbidity and stagnation, disharmony, stagnation of yang, and inability to lift. It is often accompanied by abdominal distension, hypochondriac pain, vomiting refusal, pale face, emaciation and fatigue, dizziness and palpitation, purple and dark tongue coating or ecchymosis. Treated with Sini Powder and Taohong Siwu Decoction: Bupleurum, Radix Paeoniae Alba, Fructus Aurantii Immaturus, Semen Persicae, Carthami Flos, Herba Lycopi, Saviae Miltiorrhizae Radix, Rhizoma Cyperi, Radix Curcumae, Fructus Toosendan, Radix Rehmanniae, Poria and Glycyrrhrizae Radix. Edit this paragraph of acupuncture physiotherapy (1) and select the key points: Juque, under xiphoid process 1 inch. Matching points: Chengman (right) and dovetail. (2) Only two commonly used acupoints are used for treatment. If the main point is invalid, the matching point is used. Take only one point at a time. Choose 28 ~ 32 7 ~ 8 inch long awn needles. The patient lies flat, relaxes abdominal muscles and breathes evenly. Juque point needling method: the needle tip quickly pierces the skin, so that the needle body pierces the left umbilical Shu point along the subcutaneous layer. Then, the handle holding the needle is slowly lifted, forming a 45-degree angle with the skin, which makes the operator feel that the needle tip is heavy, and the patient feels that the navel and lower abdomen are lifted. If you can't feel the needle, take it out and insert it again, or insert it under the xiphoid 1 inch. Lift the needle slowly, it takes 20 minutes for the first time, and it can be shortened to 3 minutes later. Subxiphoid 1 inch needling method: use a 28-gauge 8-inch millineedle to quickly pierce the skin, making a 30-degree angle with the skin, and pierce the left umbilical subcutaneous layer. After the above-mentioned needling sensation occurs, change the angle to 15 degrees, slowly lift the needle for 40 minutes without twisting, and shake the needle 10 to 10 before taking out the needle. All patients lie flat for 2 hours after acupuncture. Right Chengman point acupuncture method: No.28 7-inch awn needle makes a 45-degree angle with the subcutaneous acupuncture, and goes straight through the needle to the left Tianshu point. When you feel heavy, twist it again for 7 ~ 8 times, and then twist it in the same direction to stop the needle. Retract the needle and lift it. The patient's upper abdomen is empty, and he has the feeling of stomach peristalsis. At this time, the doctor can press the abdomen down with his hand and push the lower pole of the stomach up. Withdraw the needle slowly, Zhong Song the needle once every 5 minutes, and withdraw 1/3, and then twist in the same direction to stop the needle. In this way, * * * is divided into three times, and the needle is pulled out for * * * 15 minutes. Finally, lift the needle handle to a 90-degree angle, shake the needle for 7-8 times, and then take it out. Iliac spine was fixed with adhesive tape before and after connection. Let the patient lie on his back for 30 minutes, then lie on his right side for 20 minutes, and finally lie in the recovery position for 2 ~ 3 hours. Weekly 1 time, * * * 3 times. Generally not more than 10 times. Acupuncture at Kyubi no Youko point: Schilling patients lie on a hard bed, and there is obvious tenderness at the lower left of navel, which is equivalent to the downward bending of stomach. Use No.32 8-inch awn needle to quickly feed the needle from Kyubi no Youko point, twist the needle along the subcutaneous edge, and feed the needle when it reaches the stopping point. After that, twist the needle counterclockwise with your right hand. When the needle handle feels dull, slowly withdraw the needle and keep a certain tension under the needle. At the same time, hold the lower pole of the stomach with your left hand and push it up slowly. The patient can feel the flatulence in his stomach. When lifting the needle to a distance of about 2 mm below the skin, twist the needle counterclockwise, hold the thumb of the left hand against the needle tip, and lift the needle vertically for 3-5 times with the right hand. The needle withdrawal process takes about 10- 15 minutes. Lie flat for 3 hours after injection. Treatment takes about 20 days 1 time, and 3 times is a course of treatment. (3) Evaluation criteria of curative effect: recovery: the main symptoms disappeared, and barium meal fluoroscopy showed that the lower gastric pole returned to normal position; The effect is remarkable: the main symptoms are obviously relieved, and the barium meal perspective shows that the lower gastric pole is more than 3 mm higher than the original; Effective: the main symptoms have improved, and the lower stomach is extremely elevated; Ineffective: Symptoms and signs did not improve before and after treatment. 1047 cases were treated by the above methods. According to the above or similar criteria, 402 cases (38.4%) were cured, 23 cases1case (22. 1%) were markedly effective, 428 cases (40.8%) were effective and 86 cases (8.2%) were ineffective. The total effective rate was 9 1.8%. Electroacupuncture (1) points: Zhongwan, Shang Wei, Wei Ti and Qihai. Matching points: Zusanli, Neiguan and Pishu. Location of Upper Stomach Point: 4 inches beside Lower Stomach Point. Position of stomach-lifting point: 4 inches next to Zhongwan point. (2) Give priority to the main points, and choose 2-3 times each time. Zusanli and Pishu are added to the elderly and infirm, and Neiguan is added to the sick and vomiting. Qihai point 1 ~ 1.5 "is straight, and the upper abdomen, upper stomach and stomach lifting are all inclined downward at an angle of 45 degrees 1.5 ~ 2". Connect the intermittent electrotherapy machine, the negative pole is connected to Zhongwan point, and the positive pole is divided into five forks, which are connected to stomach, upper stomach, upper stomach and Qi Sea respectively. Using sparse and dense waves, the electric quantity should be the patient's abdominal muscle contraction tolerance, and each stimulation lasts for about 20 ~ 30 minutes. For example, the electrotherapy instrument can be an ordinary commercially available electroacupuncture instrument, which uses intermittent waves or sparse waves. In order to strengthen the curative effect, vitamin B 12 100 μ g (1 ml) or nolone phenylpropionate1/3 (25mg/1 ml) can be injected into Zusanli (the above dosage is for each point). Electroacupuncture 1 time every day and acupoint injection 1 time every other day. Electroacupuncture 12 times is 1 course of treatment (acupoint injection 6 times), and the interval of treatment is 3 ~ 7 days. (3) Evaluation criteria of curative effect: recovery: symptoms disappeared, X-ray barium meal fluoroscopy, and gastric angle notch returned to normal; Remarkable effect: the symptoms were obviously relieved, and the notch of gastric angle increased by ≥ 2 mm compared with that before treatment; Effective: the symptoms were relieved, and the notch of gastric angle was increased compared with that before treatment, but