By Ba Yuanming et al
　　 (The Affiliated Hospital of Hubei College of Traditional 
Chinese Medicine, Wuchang 430061, China )

Abstract: 140 cases of epigastralgia were divided into two groups at random. The 100 cases in the treatment group were treated with Huweigo externally applied at Shenque (CV8), and the 40 cases in the control group by oral administration of Weinaian capsule. After a one-month treatment, the total symptom-relieving rate and the gastroscopy-proved effective rate were 94.0% and 52.6% respectively in the treatment group, much superior to those in the control group. From March l995 to September l997, the therapeutic effects of Huweigao was tested and verified on a clinical trial basis. A report is as follows.

General Data
There were l40 cases in this series, including l04 inpatients and 36 outpatients. 70 cases were male and 70 female. The age range varied from l8 years to 65 years, averaging 36.3 years. 87 cases were diagnosed as epigastralgia of the deficiency-cold type, and 53 of the type of stagnation of Qi and blood; 55 with peptic ulcer, and 85 with chronic gastritis. Epigastralgia was severe in 7 cases, moderate in 83 cases, and mild in 50 cases. They were randomly divided into the treatment group (l00 cases) and the control group (40 cases). General conditions of the patients in both groups were similar without any statistical difference (P>0.05).
For TCM diagnosis, the criteria for epigastralgia stipulated by the Ministry of Public Health were followed. And the diagnosis was also made in accordance with the results of gastroscopy and pathological examination. All the patients in the study met the above diagnostic criteria, and their disease was confirmed to be epigastralgia of the deficiency-cold type or the type of stagnation of Qi and blood.

Therapeutic Methods
Developed by the Medicinal Research Center, Wan Nanwei Scientific and Technological Development Company, Huweigao is an extract composed of Baizhu (Rhizoma Atractylodis Macrocephalae), Wuzhuyu (Fructus Euodiae), Dingxiang (Flos Caryophylli), Rougui (Cortex Cinnamomi), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Yanhusuo(Rhizoma Corydalis), Houpo (Cortex Magnoliae Officinalis), and Bingpian(Borneolum Syntheticum). The extract is completely mixed with spongy rubber as a ground material, and the mixture is spread on plaster and wrapped in small package. The plaster is 7cm×l0cm in size, each piece containing 5g of the crude drugs. One piece of Huweigao was externally applied at Shenque(CV 8) every morning, and kept for l2 hours. For severe cases, another piece was applied at the pain region. 30 days constituted one therapeutic course. The patients in the control group were given Weinaian (0.3g/capsule, produced by Guangzhou First Pharmaceutical Factory of Traditional Chinese Drugs), 1.2g each time, for oral intake t.id. One therapeutic course is also 30 days. The items observed included the symptoms, gastroscopic results and adverse side-effects of the drugs. For symptom-observation, epigastralgia, anorexia, vomiting, nausea, eructation, hiccup, cold limbs, intolerance of cold, lassitude and weakness were recorded, and the condition was evaluated respectively as severe, moderate, and mild.

Therapeutic Results
The effective rates of Huweigao for epigastralgia, cold limb and intolerance of the cold, anorexia, feeling of fullness in upper abdomen, lassitude and weakness, vomiting and nausea, eructation and hiccup were 99.0%,76.0%, 88.4%, 69.4%, 88.4%, 82.5% and 81.4% respectively, while those of Weinaian were 80.0%, 79.4%, 80.0%, 73.7%, 86.7%,41.7% and 67.7% respectively. Huweigao showed better therapeutic effects than Weinaian (P<0.05).
The curative rate, markedly effective rate, effective rate, and total effective rate of Huweigao for epigastralgia syndrome were l6.0%, 45.0%, 33.0% and 94% respectively; and those of Weinaian were 7.5%, 20.0%,65.0% and 92.5% respectively. No significant difference between the total effective rates of the two groups was found (P>0.05), but the curative rate and markedly effective fate in the treatment group of Huweigao were much higher than those in the Weinaian group (P<0.01).

Table 1. Comparison of the Therapeutic Effects for 
Diseases in the Two Groups  

 Tabe l showed that the total effective rates of Huweigao for chronic gastritis and peptic ulcer were similar to those of Weinaian(P>0.05), but the curative rate and markedly effective rate in the group of Huweigao for chronic gastritis were much better than those in Wenaian group (P<0.0l).
It can be seen from Table 2 that the total effective rates of Huweigao for the deficiency-cold type and the type of stagnation of Qi and b1ood were similar to those of Weinaian(P>0.05), but the curative rate and markedly effective rate of Huweigao were much better than those in Weinaian group (P<0.05).

Table 2. Comparison of the Therapeutic Effects for
the Syndromes in the Two Groups 

Altogether 88 cases received gastroscopy, 57 cases from the Huweigao group (39 cases with chronic gastritis and 18 cases with peptic ulcer), and 3l cases from the Weinaian group (l6 cases with chronic gastritis and l5 cases with peptic ulcer). The markedly effective rate, effective rate and total effective rate of the Huweigao group were 17.5%, 3l.1% and52.6% respectively, and those in Weinaian group were 3.2%, 29.0% and 32.3% respectively. There was no significant difference between the two groups (P>0.05).
According to Table 3, Huweigao did not show significant difference with Weinaian in markedly effective rate, effective rate and total effective rate when using gastroscopic results as the indicators (P>0.05).

Table 3. Comparison of the Therapeutic Effects 
Using Gastroscopic Results as the Indicators 

Table 4 showed that the markedly effective rate, effective rate and total effective rate of Huweigao group for deficiency-cold type were better than those of Weinaian group, using gastroscopic results as indicators (P<0.05).

Table 4. Comparison of the Therapeutic Effects for the 
Syndromes,Using Gastroscopic Results as Indicators 

It can be seen from Table 5 that the ulcer area was markedly decreased after treatment with Huweigao, showing a significant difference with the control group (P<0.05).

Table 5. Comparison of Therapeutic Effects for Ulcer Area in the Two Groups

 * P<0.05, compared with control group after treatment

In the group of Huweigao, cutaneous pruritus appeared in 7 cases, and 2 of them with slight skin erythema. But all the patients with these adverse effects could keep the treatment. The cutaneous pruritus and skin erythema disappeared after withdrawal of the drug. No other adverse side-effects were found.

Comment
　　Huweigao exhibits the actions of warming the middle-jiao, invigorating the spleen and stomach, promoting the flow of Qi and blood, and relieving pain in the stomach. It shows better therapeutic effects for epigastralgia of both the deficiency-cold type and the type of stagnation of Qi and blood. In addition, Huweigao can be easily applied with little adverse side-effects, so it is a good drug for external treatment of epigastralgia.