Gas, Bloating, Belching

Chai Hu Shu Gan Yin
52 cases of functional dyspepsia were treated with Chai Hu Shu Gan Yin. This formula consisted of Chai Hu (Bupleurum), Chuan Xiong (Cnidium), Ru Xiang (Mastic), Zhi Qiao (Aurantium Fruit), Hou Pu (Magnolia Bark), Bai Shao (White Peony Root), and Gan Cao (Licorice). The formula was modified according to symptoms of the individual patient. After boiling the herbs in water, one dose per day was administered. During the period of treatment, patients were asked to maintain a positive mood, a diet devoid of heavy grease, strong flavor, and pungent, raw, cold, and indigestible foods. One month comprised one course of treatment. The results showed that 29 cases had marked improvement, 19 cases showed some effectiveness, and 4 cases had no improvement.(1)

He Wei Tong Qi Tang
32 cases of abdominal distension induced by functional dyspepsia were treated with He Wei Tong Qi Tang (decoction for regulating stomach and dispersing qi). This formula used the following single herbs: Su Geng (Perilla Stalk), Fu Pi (Betelnutpalm Pericarp), Shen Qu (Leaven), Shan Zha (Crataegus), Xiang Fu Zi (Cyperus Seed), Yu Jin (Curcuma Root), Mu Xiang (Saussurea), Dang Gui (Chinese Angelica Root), Chuan Xiong (Cnidium), Sha Ren (Amomum Fruit), Gan Cao (Licorice), and Bai Shao (White Peony Root). Each dose was prepared into a decoction and was divided into 3 portions to be administered at three separate times during the day. The results showed that 21 cases had marked improvement, 10 cases had some improvement, and 1 case had no improvement. The total effectiveness rate was 96%.(2)

Yi Qi Yang Zhong Tang
146 cases of abdominal distension originating from atonia of the stomach were treated with Yi Qi Yang Zhong Tang (a decoction for invigorating qi to smooth Middle-Jiao). The formula consisted of Huang Qi (Astragalus), Dang Shen (Codonopsis), Fu Ling (Poria), Hou Bu (Magnolia), Su Geng (Perilla Stalk), and Chai Hu (Bupleurum). The total effectiveness rate was 99.3%.(3)

Shu Gan Xiao Zhang Tang
65 cases of abdominal distension caused by the liver were treated with Shu Gan Xiao Zhang Tang (a decoction for dispersing liver and reducing fullness). The formula consisted of Chai Hu (Bupleurum), Bai Shao (White Peony Root), Chen Pi (Citrus), Chuan Xiong (Cnidium), Ze Lan (Lycopus), Xiang Fu (Cyperus), Ji Nei Jin (Membrane of Chicken's Gizzard), Hu Zhang (Giant Knotweed Rhizome), and Gan Cao (Licorice). The formula was modified according to the patients' symptoms. One dose of this decoction was administered per day. After 6 weeks of treatment, 23 cases showed marked improvement, 35 cases showed some improvement, and 7 cases had no improvement. The total effectiveness rate was 89.2%.(4)

Yun Pi Xiao Pi Tang
69 cases with a mass in the right hypochrondrium were treated with Yun Pi Xiao Pi Tang (a decoction for promoting transportation function of spleen to disperse the mass). The formula contained Dang Shen (Codonopsis), Chao Lai Fu Zi (cooked Raphanus), Fo Shou (Finger Citron), Bai Zhu (White Atractylodes), Zhi Shi (Immature Bitter Orange) Salvia (Dan Shen), Yu Jin (Curcuma), Shi Chang Pu (Grassleaved Sweetflag Rhizome), and Gan Cao (Licorice). The formula was modified according to individuals' symptoms. One dose consisted of 300 ml of a decoction, which was taken in two administrations daily. Western medications were avoided during the treatment. After 35 to 65 days of treatment, 38 cases were resolved, 16 cases had marked improvement, 13 cases improved, and 2 cases showed no change. The total effectiveness rate was 97.1%.(5)

Xin Zhi Xiao Zhang Fang
45 cases of abdominal distension induced by injury were treated with Xin Zhi Xiao Zhang Fang (a formula for relieving stasis to remove fullness). The formula contained Chen Pi (Citrus), Hou Pu (Magnolia), Mu Xiang (Saussurea), Xuan Fu Hua (Inula), Lai Fu Zi (Raphanus), and Bin Lang (Areca Seed). The formula was modified according to each patient's symptoms. A decoction was administered 30 to 50ml per hour. 8 hours constituted one dose. The results showed that all cases were resolved.(6)

Da Huang Mu Dan Tang
46 cases of post-operative abdominal distension were treated with Da Huang Mu Dan Tang. 8 to 12 hours after administration, 34 cases had an intestinal gurgling sound with exsufflation and defecation. In 10 cases, exsufflation and defecation occurred 12 to 24 hours after the formula was taken. The total effectiveness rate was 95.5%.(7)

Chu Zhang He Ji
Chu Zhang He Ji (a mixture for removing fullness) was used to treat abdominal distention. The formula consisted of Dang Shen (Codonopsis), Bai Zhu (White Atractylodes), Fu Ling (Poria), Mu Xiang (Saussurea), Bin Lang (Areca Seed), Hou Pu (Magnolia), Lai Fu Zi (Raphanus), Chai Hu (Bupleurum), Shou Da Huang (cooked Rhubarb), and Gan Cao (Licorice). It was processed into an oral solution, and then taken 10ml, 3 times a day. For the first administration, the dosage was doubled. The treatment lasted for 6 consecutive days. In the control group, a Bo He solution (10ml) was given to 30 cases. The results for the two groups showed the following: marked effectiveness in 62, 2 cases, some effectiveness in 45,12 cases, and no effectiveness in 13, 16 cases. The total effectiveness rates were 89.2% and 46.7% (P<0.01).(8)

49 cases of gastrointestinal gas distension were treated by local application of an herbal paste on the umbilical region. The herbs used were powdered Lai Fu Zi (Raphanus), Pu Xiao, and Cong Bai. The paste applied was 0.5cm thick and the area was covered with gauze and bandaged. If necessary, the herbal dressing was changed every 4 hours. The results showed that after 1 to 3 sessions, 47 cases showed exsufflation and defecation with subsidence of abdominal distension. 2 cases had no improvement. The total effectiveness rate was 95.9%.(10)

30 cases of abdominal distension, which occurred after apoplexy, were treated by regional application of an herbal paste. The paste included 10g of Lai Fu Zi (Raphaus) powder, which was then mixed with rice wine. The paste was made into a cake shape with a diameter of 3 cm. After routine sterilization, the herbal cake was placed on the umbilical region and fixed with gauze. The herbal cake was changed every 12 hours. The effectiveness of this treatment was measured in the reduction of abdominal distension. The results were: 19 cases showed effectiveness within 12 to 48 hours after treatment, 8 cases showed effectiveness within 48 to 72 hours, and 3 cases showed no effectiveness. The total effectiveness rate was 90%.(11)

Enema treatment
An enema was used in 20 cases for prevention and treatment of post-operative abdominal distension. Tong Fu Tang was used. This formula consisted of Da Huang (Rhubarb), Yuan Min Fen, Zhi Shi (Immature Bitter Orange), Hou Pu (Magnolia), Chi Shao (Peony Red), Dan Pi (Moutan), Sheng Di (Rehmannia Root), Huang Qi (Astragalus Root), Dang Shen (Codonopsis), Tao Ren (Persica), and Gan Cao (Licorice). These herbs were immersed in 500ml water for an hour and boiled for 30 minutes. This mixture was then decocted until the total volume was reduced to 200ml. This resulting mixture was boiled for 15 minutes and then 100ml of the mixture was taken and then 10g of powdered Yan Hu Suo (Corydalis) was added. The mixture was used as an enema. The tube for the enema was inserted into the rectum 15 to 18cm. The flow rate of enema fluid was 80 to 120 drops per minute and the temperature of the fluid was 39 to 40 degrees. No drugs were used in the control group of 20 cases. The results showed that exsufflation and spontaneous defecation in the enema group occurred earlier than the control group (P<0.05,P<0.01).(12)

Combined treatment of acupuncture and herbs
34 cases of abdominal distension of liver origin were treated by acupuncture on the points Qi Men (Liv14), Zhong Wan (Ren 12), Zu San Li (S36), Tai Chong (Liv3), Gan Shu (B18), Pi Shu (B20), and San Yin Jiao (Sp6) by the enforcing and reduction method. The needles were retained for 30 minutes, once a day. Also, Xiao Zhang San (a powder of relieving fullness) was externally applied to the umbilical region. The formula contains Chen Xiang (Aquilaria), Da Huang (Rhubarb), Zhi Shi (Immature Bitter Orange), and Bing Pian (Borneol). The herbal application was changed every other day. 14 days constituted one course of treatment. 34 cases in the control group were treated with an oral administration of Xiao Zhang Pian (a tablet form of Xiao Zhang San) for removing fullness. After therapy of 2 to 3 courses, the results for the treatment and control groups were respectively: marked impro

53 cases of abdominal distension from post-operation on abdominal organs were treated. The points used were Zu San Li (S36), Nei Guan (P6), Xia Ju Xu (Ren 10), Shang Wan (Ren 13), Xia Wan (Ren 10), and Zhong Wan (Ren 12). The total effectiveness rate was 96.23%.(14)

26 cases of abdominal distension in children were treated by acupuncture on the following main points: Tian Shu, Qi Hai, Zu San Li, Zhong Wan, and Nei Guan. If pain occurred in the upper umbilical region, the main points used were combined with Liang Men. If pain occurred in the lower umbilical region, Guan Yuan and Zhong Ji were added to the main points. Pain in the lateral region was treated with a combination of the main points and Yang Lian Quan. The needle was inserted at a depth of 1.5-2cun. The needle was retained for 5 to 30 minutes after the needling sensation was achieved. The results showed that 10 to 20 minutes after the acupuncture, there was complete recovery in 16 cases, marked improvement in 8 cases, and 2 cases improved.(15)

39 cases of abdominal distension were treated by electro-acupuncture on Zu San Li. The needle was inserted perpendicularly using strong stimulation for 10 minutes followed by the reduction method after the needling sensation was achieved. This was followed by a connection to electro-stimulation, which lasted 20 to 30 minutes with moderate intensity, once or twice a day. The results showed that all cases were resolved after 1 to 5 days of treatment.(16)