Vomiting is a disease in which the stomach loses its balance, the stomach qi moves upward, and food and phlegm are spit out from the mouth. It is one of the common symptoms of various acute and chronic diseases. Doctors in past dynasties "spat" their stomachs with sounds and objects; The silence of one thing is called "spitting"; Nothing is called "bang"; Clinically, it is difficult to completely separate vomiting from vomiting, so it is generally called vomiting. Vomiting can be seen in many diseases of western medicine, such as acute gastritis, nervous vomiting, heart spasm, pyloric spasm and obstruction, pancreatitis, cholecystitis and so on.

1, etiology and pathogenesis: the spleen governs the ascending and the stomach governs the descending, keeping the qi flowing smoothly, so that Shui Gu's subtle energy can be transmitted. If pathogenic factors attack the stomach or stomach deficiency and disharmony. Vomiting due to the headwind of qi. "Vomiting" records: "Vomiting, stomach gas goes up but not down."

The causes of vomiting are as follows:

(1) Exogenous pathogens invade the stomach: wind, cold and dampness, turbid qi and other pathogens invade the stomach fu-organs, causing the stomach to lose balance and descend, and Shui Gu vomited against the qi. As the ancient and modern physician "Vomiting at the Door" said: "When a person dies and vomits, it must be caused by pathogenic factors in the stomach, which is caused by the evil factors of long summer and long summer, and the cold in autumn and winter."

(2) Irregular diet: Eating too much, or eating too much cold, greasy and unclean things can damage the spleen and stomach, leading to food retention, poor stomach qi and vomiting.

(3) Emotional disorder: Anger hurts the liver, the liver loses its function of dispersing qi, and the stomach qi goes up; Worry will damage the spleen, the spleen will lose its health, it is difficult to stop eating, and the stomach will lose its balance, all of which will cause vomiting.

(4) Spleen and stomach weakness: overwork, qi failure, or chronic illness due to yang deficiency and spleen deficiency, Shui Gu's subtle qi and blood can't be biochemical, resulting in stagnation of cold and turbidity, or phlegm accumulated in the stomach, and vomiting due to excessive drinking. It can also cause vomiting due to insufficient stomach yin and loss of its moistening and descending. As "Treating Buou Based on Syndrome Differentiation" said: "Yin deficiency leads to vomiting, and the disease is not only the stomach, but the so-called absence of Yin leads to vomiting."

2, syndrome differentiation and treatment of vomiting, when the detailed distinction between excess and deficiency. The excess syndrome is mostly caused by exogenous pathogenic factors and diet, with acute onset and short course of disease; Deficiency syndrome is mostly spleen and stomach dysfunction with slow onset and long course of disease. "The Complete Book of Pure Moon" classifies vomiting into two categories: deficiency and excess, and treats it according to syndrome differentiation. The empirical evidence is mainly to eliminate pathogenic factors and turbidity, harmonize the stomach and reduce adverse reactions; Deficiency syndrome commonly uses methods of warming middle warmer, strengthening spleen, nourishing yin, nourishing stomach and strengthening body resistance.

(1) empirical research:

① Exogenous pathogen invading the stomach: Syndrome: sudden vomiting, accompanied by fever and aversion to cold, head and body pain, chest fullness, white and greasy tongue coating and slow pulse.

Treatment: dispel cold and relieve exterior syndrome, and aromatic and turbid.

Prescription: Huoxiang Zhengqi Powder.

② Diet stagnation: Symptoms: Vomiting, acid rot, abdominal distension, belching and anorexia. The worse eating, the less symptoms after vomiting, thin, smelly or secret stool, thick and greasy tongue coating and slippery pulse.

Treatment: digestion and stagnation, regulating stomach and descending adverse flow.

Prescription: Baohe Pill.

③ Internal resistance of phlegm: Syndrome: Vomiting is mostly clear water, expectoration, chest tightness, loss of appetite, dizziness, palpitation, white greasy tongue coating and slippery pulse.

Treatment: Warming and resolving phlegm, regulating stomach and descending adverse flow.

Prescription: Xiao Banxia Decoction combined with Gui Ling Shugan Decoction.

④ Liver-qi invading the stomach: Syndrome: Vomiting, acid swallowing, frequent belching, dull pain in chest and hypochondrium, red tongue edge, white and greasy fur and thready pulse.

Treatment: soothing the liver and regulating the stomach, reducing adverse reactions and stopping vomiting.

Prescription: Banxia Houpu Decoction combined with Zuojin Pill.

(2) Deficiency syndrome:

① Deficiency and cold of spleen and stomach: syndrome: slight carelessness in diet, namely abdominal discomfort, nausea and vomiting, intermittent rest, loss of appetite, listlessness, pale complexion, dry mouth, tepid limbs, aversion to cold, thin stool, pale tongue, white and wet fur and weak pulse.

Treatment: Warming the middle energizer and strengthening the spleen, harmonizing the stomach and descending the adverse.

Prescription: Lizhong Decoction.

② Deficiency of stomach yin: Syndrome: repeated vomiting, sometimes retching, dry mouth and throat, hunger without food, red tongue with little body fluid and rapid pulse.

Treatment: nourishing yin and stomach, reducing adverse reactions and stopping vomiting.

Prescription: Maimen Dongtang.

3, dialectical nursing

(1) Syndrome of exogenous pathogens invading the stomach:

① This type is mostly pathogenic, because patients have fever and aversion to cold, and tend to cold evil. Ward should be warm and sunny, quiet and comfortable, and the air is fresh.

② Observe body temperature, pulse, tongue picture, epigastric changes and vomit. If the body temperature continues to rise, vomiting is jet-like, headache is severe, pupils on both sides are unequal, fidgety, drowsiness, deep breathing, etc. These are all symptoms of evil spirits trapping the brain and should be reported to the doctor immediately for rescue.

③ This type is prone to sudden illness, frequent vomiting, impatience and anxiety. It is necessary to do a good job of explanation, eliminate tension, make it supine, minimize walking and not disturb the patient's rest.

④ Acupuncture scraping on both sides of Zhongwan, Neiguan, Zusanli and Jiaji points can relieve symptoms.

⑤ People with severe vomiting can temporarily fast, and after vomiting is relieved, they will be given liquid and semi-liquid, and gradually move towards general food, avoiding greasy, sweet and sticky products. If you vomit a lot, you should pay attention to replenish water and infusion according to your doctor's advice to prevent damage to body fluids. Www.med66.com Medical Education Network

(2) Eating stagnation syndrome:

(1) Clean up vomit and change contaminated clothes in time, and pay special attention to indoor ventilation to eliminate odor.

② Encourage patients to spit out the accumulated food in the stomach as much as possible, and if necessary, explore vomiting method can be adopted. You should not eat immediately after vomiting. When the feeling in the stomach returns to normal, start a small amount of liquid food, don't vomit after meals, and then gradually change to semi-liquid food and soft food. Hard and indigestible products and the taste of thick frying are forbidden, and the food intake should be limited, so as not to overeat, so as not to cause food recovery.

(3) Choose foods that can help digestion and digestion, such as hawthorn, malt and japonica rice.

④ Observe the nature, color, smell, quantity and frequency of vomit. If the patient vomits brown liquid or is accompanied by bright red blood, it is gastrointestinal heat accumulation and vein damage, so we should be vigilant and notify the doctor in time.

⑤ Observe whether defecation is unobstructed. If you vomit at dusk, vomit at dusk, or vomit with fecal odor, accompanied by abdominal pain, amine excretion, and no loose stool or asphyxia, it is the obstruction of fu-organs and qi. You should send the vomit to the laboratory for examination and take immediate measures.

(3) Phlegm syndrome:

① Phlegm is yin evil, and warmth turns into heat. Except those with obvious heat syndrome, warm is better. Therefore, the ward should be warm, sunny, wet and dry, quiet and comfortable.

(2) Ensure that patients have adequate rest and less activities, and give sedatives according to the doctor's advice when necessary.

③ When vomiting is serious, you can acupuncture Neiguan or use fresh bamboo to drain water, metoclopramide and other drugs to stop vomiting.

(4) Ginger has the effect of resolving phlegm and stopping vomiting. You can take it orally with a few drops of ginger juice or soak it in light salt water to stop vomiting.

⑤ Eat soft and warm vegetarian meals, avoid cold, fat, sweet and greasy products, and drink plenty of water.

⑥ When there is no obvious heat syndrome, the decoction should be taken by hot side.

All landowners constipation, can give laxatives, such as honey, senna, fruit guide, etc. , in order to clear the fu-organs, reduce turbidity and regulate stomach qi.

(4) Liver-qi invading stomach type:

① Liver-qi is hyperactive and hot, and the treatment should be cold and cool. So the ward should be cool and humid, with soft light and elegant environment.

② The patient is irritable, depressed and angry due to excessive liver yang, which aggravates his condition. Therefore, it is necessary to understand the causes of patients' depression and anger, do a good job in emotional care, and guide them to make them feel at ease.

③ Diet should be light, less greasy, and avoid spicy, tobacco, alcohol and sticky fire-fighting articles. Can guide patients to eat tomatoes, water bamboo, bitter gourd, wax gourd, radish, Sydney, apples, watermelons, kumquat and other foods that have the function of promoting qi circulation.

(4) To keep the stool unobstructed, honey, Maren Runchang Pill and other drugs can be used to moisten the bowels and relax the bowels, so as to make the viscera unobstructed, reduce turbid qi and stop vomiting.

(5) Deficiency and cold syndrome of spleen and stomach:

① Patients with yin deficiency and internal cold like warmth and warmth, so the indoor temperature should be high, the sun is abundant and the air is fresh.

② The patient with this syndrome vomits, but it is not violent, but it is easy to damage healthy qi after a long illness, so he should rest more to maintain healthy qi, but it is not suitable to stay in bed all day, which will lead to poor qi and blood and listlessness, so the activity should be based on not feeling tired.

③ The diet is nutritious, soft and semi-liquid or soft, and a small amount of meals is advocated. Foods with the functions of invigorating spleen and stomach can be properly selected, such as yam, longan, ginger, lentils, jujube, litchi and so on.

④ Acupuncture and hyperthermia can be used to relieve symptoms, such as ginger moxibustion and ginger decoction.

(6) Insufficient stomach yin:

① Patients with yin deficiency are hot and dry, and like to be cool and moist. The ward should be located in a cool place with soft light, low room temperature and slightly higher humidity than normal.

The diet is mainly soft, and it is advocated to eat less and eat more meals. Edible soybean milk, bean products, lean meat, duck eggs, pears, persimmons, bayberry, Chinese cabbage, tomatoes, watermelons, lotus roots, sugar cane, pineapples, honey, etc. For those with dry mouth and throat, use mung bean soup, pear soup and fresh reed root instead of tea.

(3) Do not eat spicy, fragrant and dry products, so as not to help heat get angry and damage yin and body fluids.

④ For constipation patients, only laxatives can be used instead of laxatives, so as to avoid vaginal fluid injury again. If a woman vomits during pregnancy, she usually vomits immediately after eating, and even can't see the diet. She likes to eat sour food. She is tired and annoyed, and her chest and diaphragm are full. Those with mild symptoms do not need treatment. Severe vomiting is poor pregnancy, which can be infused intravenously.

4. Health guidance

(1) Develop good eating habits, pay attention to food hygiene, and pay attention to diet adjustment after recovery to avoid excessive hunger, cold and heavy taste.

(2) Master the etiology and pathogenesis of vomiting and try to avoid all pathogenic causes.