Zuojin Pill, a Commonly Used Chinese Patent Medicine for TCM Treatment of Stomach Disorders
As a Chinese saying goes, "nine out of ten stomachs are diseased." China's gastric cancer incidence is also the second highest in the world, which is related to the excessively high H. pylori infection rate and Chinese dietary habits. In southern China about 40-50% of the population is H. pylori-positive, while in the north over 60% are positive.
In July 2019, The Lancet surveyed dietary habits across 195 countries and found that the disease and death burden caused by the Chinese diet ranked first among the 195 countries. This is because the Chinese diet contains too many high-salt and pickled foods, and Chinese people like hot drinks and scalding food; these habits damage the digestive tract and the cardiovascular and cerebrovascular systems. So our long-held belief that Chinese food is healthy and Western food is junk is wrong.
Common stomach disorders include gastritis and gastric ulcer. H. pylori positivity, chronic atrophic gastritis, and gastric ulcer are all precancerous lesions of gastric cancer. The most common symptom caused by these stomach disorders is excess gastric acid, which produces acid regurgitation and heartburn.
Western medicine commonly uses proton pump inhibitors (PPIs) to control excess gastric acid. Clinically common PPIs include omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole. I believe every household with a stomach patient is familiar with these names, because patients frequently take such drugs.
PPIs have some side effects, such as nausea, bloating, diarrhea, constipation, and upper abdominal pain. Rash, elevated ALT, and elevated bilirubin also occur, generally mild and transient, mostly not affecting treatment. Long-term use of PPIs is very harmful: PPIs can cause acute and chronic kidney disease; they can lead to vitamin B12 deficiency, which in turn causes dementia; long-term PPI use also causes reduced gastric acidity and hypergastrinemia, and can cause parathyroid hyperplasia and reduced bone density; their cardiac side effects are also serious, causing myocardial infarction; they disturb the intestinal flora, leading to colitis; they promote the growth of aerobic bacteria in the stomach, which, after tiny aspiration into the lungs, colonize there and induce pneumonia; PPIs can also cause rhabdomyolysis and anemia; some scholars point out that PPIs can cause hepatic encephalopathy; I have myself observed that long-term PPI use causes intestinal metaplasia and gastrointestinal polyps, which are also precancerous lesions of the digestive tract.
There is a very important principle in medicine: all drugs should be given at the lowest effective dose and for the shortest time. In practice this is hard to achieve, especially for stomach patients, whose conditions recur again and again, forcing repeated medication; most chronic stomach patients overuse PPIs.
The Chinese patent medicine Zuojin Wan (Left-Gold Pill) can actually replace PPIs. Zuojin Wan comes from Danxi Xinfa (Teachings of Zhu Danxi) by the Jin-Yuan dynasty physician Zhu Danxi. Zuojin Wan is a water-pill made from Huang Lian (Coptidis Rhizoma) and Wu Zhu Yu (Evodiae Fructus) in a 6:1 ratio. Traditional TCM holds that Zuojin Wan drains fire, soothes the liver, harmonizes the stomach, and stops pain. It is used for liver fire invading the stomach, epigastric and hypochondriac pain, bitter mouth with gastric discomfort, vexation and insomnia, vomiting of sour fluid, and dislike of hot drinks. These symptoms are caused by excess gastric acid from various stomach disorders.
Huang Lian in Zuojin Wan is an important herb for treating gastritis; berberine tablets extracted from Huang Lian are widely used for various gastroenteritides. Wu Zhu Yu, on the other hand, is one of the most important TCM herbs for vomiting caused by stomach disorders; the Wu Zhu Yu Tang of the Shanghan Lun is a classic famous formula for vomiting. Combining Huang Lian with Wu Zhu Yu treats both the root and the branch of gastritis and is the optimal root-branch combination. The formula is extremely simple, containing only two herbs. By the TCM theory of four qi and five flavors, Huang Lian is a cold-natured herb and Wu Zhu Yu a hot-natured herb; combining them achieves a balance of cold and heat.
Zuojin Wan's side effects are not as strong as those of PPIs, but long-term use is also unfavorable. Stomach patients should take care of themselves, avoid overwork, and avoid irritating and high-salt foods in the diet. H. pylori-positive patients may consider Western medicine's quadruple therapy to eradicate H. pylori. However, H. pylori eradication requires the whole family to be treated together, and after eradication one should avoid sharing utensils with others.