TCM Pattern Differentiation for Gastritis: Herbal Formulas for Each Type

Gastritis is a common and frequently occurring condition that includes erosive gastritis, atrophic gastritis, and gastric ulcers. In Traditional Chinese Medicine (TCM), treatment is based on pattern differentiation. Below are herbal formulas tailored to specific patterns to help patients manage their symptoms.

Chronic stomach pain, prolonged heat damaging yin, and failure of the stomach to be moistened lead to a burning sensation in the stomach, a gnawing hunger, dry mouth and throat, dry stools, a red tongue with scant coating, and a thin, rapid pulse. The treatment method is to nourish yin and benefit the stomach. The modified Yi Guan Jian (One Continuous Decoction) is used:

Decoct in water and take orally.

Irregular eating, overwork, or prolonged illness injuring the spleen and stomach leads to spleen yang insufficiency and middle burner cold. Symptoms include dull stomach pain, vomiting of clear fluid, preference for warmth and pressure, poor appetite, loose stools, fatigue, cold limbs, a pale tongue, and a thin, weak pulse. The treatment method is to warm the middle burner and strengthen the spleen. The modified Huang Qi Jian Zhong Tang (Astragalus Decoction to Fortify the Middle) is used:

Decoct in water and take orally.

External cold invades the stomach, obstructing stomach yang and causing qi stagnation. Symptoms include sudden stomach pain, aversion to cold with preference for warmth, pain relief with warmth, preference for hot drinks, a thin white tongue coating, and a wiry, tight pulse. The treatment method is to disperse cold and stop pain. Mild cases can use local warm compresses or ginger and brown sugar soup. For more severe cases, the modified Liang Fu Wan (Galangal and Cyperus Pill) is used:

Decoct in water and take orally.

Overeating or excessive drinking leads to food and fluid retention, obstructing stomach qi. Symptoms include stomach pain, abdominal distension and fullness, belching with sour odor, difficult bowel movements, a thick, greasy tongue coating, and a wiry, slippery pulse. The treatment method is to promote digestion and guide stagnation. The modified Bao He Wan (Preserve Harmony Pill) is used:

Decoct in water and take orally.

Smoking, alcohol consumption, strong tea and coffee, medications that damage the gastric mucosa, extremely hot or cold foods, coarse foods, and bacterial toxins can all severely harm the stomach lining. The gastric mucosa protects the stomach wall from food irritation; when damaged, it can lead to stomach pain, bloating, and even gastric ulcers. Avoiding these factors is essential for recovery and prevention.

References

Huangdi Neijing (Yellow Emperor's Inner Classic) – foundational text on pattern differentiation and treatment principles for stomach disorders.
Shanghan Lun (Treatise on Cold Damage) – classical formulas such as Huang Qi Jian Zhong Tang are derived from this work.
Bencao Gangmu (Compendium of Materia Medica) – detailed descriptions of herbs like Bei Sha Shen and Gao Liang Jiang used in these formulas.
Jingui Yaolue (Synopsis of Prescriptions of the Golden Chamber) – source of formulas like Yi Guan Jian and Bao He Wan.