1. Prescription Source & History

1. Classic Origin

Guizhi Fuling Pills (Cinnamon Twig and Poria Pill) originated from 'Synopsis of the Golden Chamber' written by Zhang Zhongjing in the Eastern Han Dynasty. This is a classic work of traditional Chinese medicine and has a profound impact on clinical practice of traditional Chinese medicine. It is recorded in 'Treatise on Miscellaneous Diseases of Women, Chapter 20: Diagnosis and Treatment of Diseases During Pregnancy in Synopsis of the Golden Chamber': 'If a woman has a long-standing mass disease, and her menstruation stops before three months have passed since the last menstrual period, and there is continuous vaginal bleeding with fetal movement above the umbilicus, this is due to the harm of the mass. If fetal movement occurs in the sixth month of pregnancy, and the menstruation was normal in the three months before, it is the fetus. The vaginal bleeding is due to the stasis of blood in the three months after the last menstrual period. The reason for the continuous bleeding is that the mass has not been removed. Therefore, the mass should be expelled, and Guizhi Fuling Pills are the main treatment.' This record clearly elaborates on the application of Guizhi Fuling Pills in treating pregnancy-related diseases caused by a woman's long-standing mass disease.

2. Historical Evolution

Since the publication of 'Synopsis of the Golden Chamber', Guizhi Fuling Pills have undergone a long historical inheritance and development. Gui Zhi Fu Ling Wan (桂枝茯苓丸), known in English as Cinnamon Twig and Poria Pill, is one of the most important classical formulas in Traditional Chinese Medicine for treating Blood stasis in the uterus. Created by the famous physician Zhang Zhong-jing, this gentle yet effective formula moves Blood, resolves stasis, and clears mild Heat while supporting the Spleen. It is particularly indicated for dysmenorrhea (painful menstruation), uterine fibroids, endometriosis, ovarian cysts, and irregular menstruation with dark clotted blood. In modern clinical practice, Gui Zhi Fu Ling Wan is widely used in TCM gynecology for conditions involving fixed lower abdominal pain, masses, and infertility due to Blood stasis. Because it moves Blood without being overly aggressive, it is suitable for long-term use and is often combined with tonifying formulas according to the patient’s constitution.

3. Cultural Influence

Guizhi Fuling Pills not only hold an important position in the medical field but also reflect to a certain extent the influence of Chinese traditional culture on traditional Chinese medicine. Traditional Chinese medicine emphasizes the harmony and unity between man and nature, and among the various zang-fu organs of the human body. The application of Guizhi Fuling Pills embodies this holistic concept. It achieves the purpose of treating diseases by regulating the qi and blood circulation in the human body, which is in line with the ideas of 'yin-yang balance' and 'harmonious qi and blood' in Chinese traditional culture. At the same time, the inheritance of the prescription also carries the continuation of traditional Chinese medicine culture and witnesses the medical wisdom of the Chinese nation over thousands of years.

2. Composition Introduction (King, Minister, Assistant, Guide)

1. King Drug - Cinnamon Twig

- Nature, flavor, meridian tropism

Ramulus Cinnamomi is pungent and sweet in flavor, warm in nature, and belongs to the heart, lung, and bladder meridians.

- Efficacy and function

It has the effects of inducing sweating to relieve exterior syndrome, warming the channels and promoting the flow of qi and blood, and assisting yang to transform qi. In Guizhi Fuling Pills, Ramulus Cinnamomi can warm the channels and promote blood circulation, driving the blood to move, and is the main drug exerting its effects in the prescription. It can promote the circulation of qi and blood and eliminate various diseases caused by blood stasis in the channels. For example, for gynecological diseases such as dysmenorrhea and amenorrhea caused by cold coagulation and blood stasis, the warming and dredging effect of Ramulus Cinnamomi can disperse cold pathogens, dredge the channels, make qi and blood unobstructed, and thus relieve the pain symptoms.

- Dosage characteristics

Generally, the dosage in the prescription is three liang. Its dosage is moderate to give full play to the role of warming and dredging the blood vessels without being too drastic, so as to avoid consuming the healthy qi.

2. Minister Drug - Poria

- Nature, flavor, and meridian tropism

Poria cocos is sweet, light in flavor, and neutral in nature, and it pertains to the heart, lung, spleen, and kidney meridians.

- Efficacy and function

It has the effects of promoting diuresis to eliminate dampness, strengthening the spleen, and calming the mind. Poria cocos plays the role of strengthening the spleen and promoting diuresis in Cinnamon Twig and Poria Pill, which helps to regulate the body's water metabolism. It can promote the excretion of dampness and water, expelling the excess water in the body and relieving the swelling and discomfort caused by the stagnation of dampness and water. At the same time, Poria cocos can also strengthen the spleen, enhancing the transportation and transformation function of the spleen and stomach, providing a good foundation for the generation and circulation of qi and blood. For example, for some diseases such as increased leukorrhea and irregular menstruation caused by spleen deficiency and excessive dampness, the function of Poria cocos in strengthening the spleen and promoting diuresis can improve the symptoms.

- Dosage characteristics

The dosage is three liang. In combination with Cinnamon Twig, one warms and dredges, one promotes diuresis and percolates, jointly regulating the body's qi and blood and water metabolism.

3. Assistant Drug - Peach Kernel

- Nature, flavor, and meridian tropism

Peach kernels are bitter, sweet, and neutral in nature. They enter the heart, liver, and large intestine meridians.

- Efficacy and functions

They have the effects of promoting blood circulation to remove blood stasis and moistening the intestines to relieve constipation. Peach kernels are commonly used drugs for promoting blood circulation and removing blood stasis. In Guizhi Fuling Pills, they can enhance the effect of promoting blood circulation and removing blood stasis of the formula. It can break blood and promote blood stasis, disperse blood stasis lumps, and has good therapeutic effects on various diseases caused by blood stasis blockage, such as incomplete lochia after childbirth and abdominal masses. At the same time, the effect of moistening the intestines and relieving constipation of peach kernels also helps to keep the stool unobstructed and avoid the stagnation of intestinal qi caused by internal blood stasis obstruction.

- Dosage characteristics

The dosage is fifty pieces. Its dosage may be adjusted according to factors such as the condition and constitution, but generally, it should be sufficient to promote blood circulation and remove blood stasis without excessively damaging healthy qi.

4. Assistant Drug - Cortex Moutan

- Nature, flavor, and meridian tropism

Moutan bark is bitter, pungent, and slightly cold in nature. It enters the heart, liver, and kidney meridians.

- Efficacy and functions

It has the effects of clearing heat and cooling blood, and promoting blood circulation to remove blood stasis. In Guizhi Fuling Pills, Cortex Moutan can clear heat and cool blood on the one hand to prevent the transformation of blood stasis into heat due to long-term accumulation; on the other hand, it can enhance the effect of promoting blood circulation to remove blood stasis. It can cool the blood and disperse stasis, enabling the blood stasis to dissipate, and at the same time, it will not cause adverse reactions such as bleeding due to excessive blood circulation. For example, for some diseases accompanied by heat syndrome caused by blood stasis, such as irregular menstruation in women accompanied by symptoms such as fever and abdominal pain, the effects of clearing heat and cooling blood and promoting blood circulation to remove blood stasis of Cortex Moutan can effectively relieve the condition.

- Dosage characteristics

The dosage is two liang. It acts synergistically with drugs such as Semen Persicae to jointly exert the therapeutic effect of the prescription.

5. Guiding Drug - Paeonia Lactiflora

- Nature, flavor, meridian tropism

Paeonia lactiflora Pall. is bitter and sour in flavor, slightly cold in nature, and belongs to the Liver and Spleen meridians.

- Efficacy and function

It has the effects of nourishing blood and regulating menstruation, astringing yin and stopping sweating, soothing the liver and relieving pain, and suppressing hyperactive liver yang. In Guizhi Fuling Pills, Paeonia lactiflora Pall. mainly plays the roles of nourishing blood and harmonizing blood, and relieving spasm and pain. It can nourish the blood and soothe the liver, regulate the function of the liver, make the liver qi smooth, and avoid aggravating the symptoms of blood stasis due to liver qi stagnation. At the same time, Paeonia lactiflora Pall. can also relieve the pain caused by blood stasis obstruction, achieving the effect of relieving spasm and pain. For example, for diseases such as dysmenorrhea and abdominal pain in women, the effects of nourishing blood and harmonizing blood and relieving spasm and pain of Paeonia lactiflora Pall. can reduce the degree of pain.

- Dosage characteristics

The dosage is four liang. It is combined with other herbs to regulate the properties of the formula, enabling the whole formula to promote blood circulation and remove blood stasis while also taking into account nourishing blood and relieving spasm and pain, etc.

III. Pathogenesis, Effects and Indications

1. Analysis of Pathogenesis

The main pathogenesis targeted by Guizhi Fuling Pills is blood stasis obstruction. The qi and blood in the human body do not flow smoothly, resulting in the retention of blood stasis. Blood stasis can block the uterine cavity, meridians and other parts. In terms of female physiology, blood stasis can affect the normal excretion of menstruation, leading to irregular menstruation, dysmenorrhea, amenorrhea and other diseases; blood stasis can also form masses and accumulate in the abdomen, presenting diseases such as zhengjia. In other aspects, blood stasis obstruction can also cause symptoms such as local pain and swelling. Its formation is mostly related to factors such as emotional disorders, cold pathogen stagnation, qi deficiency and blood stasis. For example, long-term emotional depression can lead to stagnation of liver qi, and qi stagnation leads to blood stasis; when cold pathogens invade the human body, cold coagulates and stagnates blood, which is also likely to form blood stasis; qi deficiency is unable to promote blood circulation, which can also lead to the generation of blood stasis.

2. Summary of Effects

The main effects of Guizhi Fuling Pills are promoting blood circulation and removing blood stasis, and slowly dissipating masses. Through the synergistic effect of herbs for promoting blood circulation and removing blood stasis such as Guizhi, Taoren, and Mudanpi in the formula, it can promote the dissipation of blood stasis and restore the smooth flow of qi and blood. Poria can strengthen the spleen and promote diuresis, helping to improve the abnormal water metabolism caused by blood stasis obstruction. Paeonia can nourish blood and harmonize blood, relieve spasm and pain, relieve the pain symptoms caused by blood stasis, and prevent blood deficiency caused by excessive blood circulation. The whole formula works together to achieve the purpose of eliminating blood stasis masses and regulating the balance of qi and blood in the human body.

3. Indicated Diseases

- Gynecological diseases

- Irregular menstruation: including symptoms such as scanty menstrual flow, unsmooth menstruation, and abdominal pain during menstruation. Blood stasis blocks the uterine cavity, resulting in abnormal excretion of menstruation, presenting the above manifestations of irregular menstruation. Guizhi Fuling Pills can promote blood circulation and remove blood stasis, making the menstrual blood unobstructed, thus improving the symptoms of irregular menstruation.

- Dysmenorrhea: mostly caused by cold coagulation and blood stasis or qi stagnation and blood stasis. Guizhi in the formula can warm the meridians and dredge the channels, Taoren and Mudanpi can promote blood circulation and remove blood stasis, and Paeonia can relieve spasm and pain, effectively relieving the symptoms of dysmenorrhea.

- Amenorrhea: Blood stasis blocks the thoroughfare and conception vessels, resulting in amenorrhea due to the failure of menstrual blood to descend. Guizhi Fuling Pills can break blood and remove blood stasis, dissipate blood stasis, make the thoroughfare and conception vessels unobstructed, and restore normal menstruation.

- Retention of lochia after childbirth: After childbirth, blood stasis remains in the uterine cavity and cannot be discharged in time, which can lead to retention of lochia. Guizhi Fuling Pills can promote blood circulation and remove blood stasis, promote the discharge of lochia, and make the uterus return to normal.

- Mass in the abdomen: It refers to the mass in the abdomen, mostly formed by the accumulation of stasis of blood. Guizhi Fuling Pills can gradually disperse the stasis of blood masses and have a certain therapeutic effect on diseases such as uterine fibroids and ovarian cysts that belong to the category of stasis of blood masses in the abdomen.

- Other diseases

- Chronic pelvic inflammatory disease: It is mostly caused by factors such as damp-heat stasis and qi stagnation with blood stasis. The stasis of blood blocks the pelvic cavity, resulting in symptoms such as local pain and distension. The effect of promoting blood circulation and removing stasis of Guizhi Fuling Pills can improve the blood circulation in the pelvic cavity, reduce the inflammatory reaction, and relieve the symptoms.

- Benign prostatic hyperplasia: Traditional Chinese medicine believes that it is related to the blockage of stasis of blood. Guizhi Fuling Pills can promote blood circulation and remove stasis, and have a certain relieving effect on symptoms such as dysuria and perineal distension caused by benign prostatic hyperplasia.

IV. Analysis of Formula Principles

1. Treating Qi and Blood Simultaneously

In Guizhi Fuling Pills, Ramulus Cinnamomi warms the meridians and promotes the circulation of qi and blood, creating conditions for the qi to promote blood circulation. Semen Persicae and Cortex Moutan promote blood circulation and remove stasis, directly targeting and dispersing the stasis of blood. Paeoniae Radix Alba nourishes blood and harmonizes blood, ensuring that excessive blood loss does not occur during the process of promoting blood circulation and removing stasis, and guaranteeing the normal generation and circulation of blood. Poria cocos strengthens the spleen and promotes diuresis, regulating the body's water metabolism. Normal water metabolism helps the smooth flow of qi and blood. The whole formula achieves the purpose of treating both qi and blood by regulating the circulation and generation of qi and blood, restoring the balance of qi and blood in the human body, and thus eliminating various diseases caused by qi and blood disorders.

2. Treat Both Symptoms and Root Causes

From the perspective of pathogenesis, the blockage of stasis of blood is the branch symptom, while various factors leading to the formation of stasis of blood such as emotions, cold pathogens, and qi deficiency are the root causes. While Guizhi Fuling Pills promote blood circulation and remove stasis to eliminate the branch symptom of stasis of blood, they also take into account the conditioning of the root causes. For example, the warming and dredging effect of Ramulus Cinnamomi can target the root cause of cold pathogen stagnation; the spleen-strengthening effect of Poria cocos can improve the insufficient production of qi and blood and abnormal water metabolism caused by spleen deficiency, fundamentally reducing the possibility of the formation of stasis of blood. By treating both the branch and root symptoms, it can not only relieve the current symptoms of stasis of blood but also adjust the overall state of the human body and prevent the recurrence of diseases.

3. Compatibility of Medicinal Properties

The compatibility of the medicinal properties of the drugs in the formula is exquisite. Ramulus Cinnamomi is warm in nature. When combined with drugs that promote blood circulation and remove stasis such as Semen Persicae and Cortex Moutan, the combination of warming and dredging enhances the power of promoting blood circulation and removing stasis, and the warm drugs can prevent the blood-activating and stasis-removing drugs from being too cold and damaging yang. Paeoniae Radix Alba is slightly cold in nature. When combined with Ramulus Cinnamomi, one cold and one hot, they restrict each other, making the medicinal properties of the formula mild, neither being too warm to consume yin and stir up fire nor being too cold to damage yang. Poria cocos is neutral in nature. When combined with other drugs, it plays a role in harmonizing the medicinal properties, enabling the whole formula to exert its therapeutic effect more smoothly.

V. Comparison with Other Similar Formulas

1. Comparison with失笑散

- Composition and efficacy

Shaoxing Powder It is composed of two herbs, Pollen Typhae and Faeces Trogopterori. Its efficacy is to activate blood circulation to remove stasis and disperse stagnation to relieve pain. It is mainly used for blood stasis stagnation syndromes, such as stabbing pain in the heart and abdomen, retention of lochia after childbirth, etc. Compared with Guizhi Fuling Pills, the composition of Shaoxing Powder is simpler. Its power of promoting blood circulation to remove stasis is relatively concentrated in Pollen Typhae and Faeces Trogopterori, and the analgesic effect is more prominent, focusing on treating pain symptoms caused by blood stasis.

- Differences in applicable diseases

Guizhi Fuling Pills In addition to activating blood circulation to remove stasis and relieve pain, it can also regulate the qi and blood and the metabolism of body fluids in the human body. It is applicable to various gynecological diseases caused by blood stasis blockage and other diseases related to blood stasis, such as masses, chronic pelvic inflammatory disease, etc. While Shaoxing Powder mainly targets pain caused by blood stasis, especially stabbing pain in the heart and abdomen, and is more applicable to simple pain symptoms caused by blood stasis.

2. Comparison with Sheng Hua Tang

- Composition and efficacy

Sheng Hua Tang It is composed of Radix Angelicae Sinensis, Rhizoma Chuanxiong, Semen Persicae, Rhizoma Zingiberis, and Radix Glycyrrhizae. Its efficacy is to nourish blood and remove stasis, warm the meridians and relieve pain. It is mainly used for symptoms such as deficiency of blood and cold in the postpartum period, retention of lochia, and cold pain in the lower abdomen. Sheng Hua Tang focuses on nourishing blood, promoting the discharge of blood stasis through nourishing blood, and at the same time warming the meridians and dispelling cold to relieve pain.

- Differences in applicable diseases

Guizhi Fuling Pills It focuses on promoting blood circulation and removing blood stasis, and has good curative effects on various diseases caused by blood stasis blockage, not limited to postpartum. While Sheng Hua Tang mainly targets the problems of lochia and cold pain in the lower abdomen caused by blood deficiency and cold after childbirth, and its effect of nourishing blood and warming the meridian is more prominent. It is a prescription specifically used for postpartum conditioning.

3. Comparison with Xuefu Zhuyu Decoction

- Composition and efficacy

Xuefu Zhuyu Decoction It is composed of peach kernel, safflower, angelica sinensis, raw rehmannia root, chuanxiong rhizome, red peony root, achyranthes bidentata root, platycodon grandiflorum, bupleurum chinense, fructus aurantii, and licorice root. Its efficacy is to promote blood circulation and remove blood stasis, and promote qi circulation to relieve pain. It is mainly used to treat the syndrome of blood stasis in the chest, such as chest pain, headache, and those that do not heal for a long time. Based on promoting blood circulation and removing blood stasis, Xuefu Zhuyu Decoction pays more attention to promoting qi circulation to promote the dissipation of blood stasis, and its medicinal power is relatively strong.

- Differences in applicable diseases

Guizhi Fuling Pills are mainly used for diseases of blood stasis in the lower jiao, such as irregular menstruation and masses in gynecology. Xuefu Zhuyu Decoction focuses on treating blood stasis in the upper jiao, such as chest pain caused by blood stasis in the chest. The parts and pathogenesis of the applicable diseases are different from those of Guizhi Fuling Pills. The qi-promoting effect of Xuefu Zhuyu Decoction makes it more effective in treating blood stasis accompanied by qi stagnation symptoms, while Guizhi Fuling Pills relatively focus on simple blood stasis blockage diseases.

VI. Clinical Applications and Indications

1. Clinical Applications in Gynecology: Promote Blood Circulation and Remove Blood Stasis

Irregular menstruation

- Scanty menstrual flow with dark color and clots: This type of irregular menstruation is mostly caused by blood stasis blocking the uterus. In addition to scanty menstrual flow, patients may also experience abdominal pain during menstruation and the pain will be relieved after the clots are排出. Guizhi Fuling Pills can promote blood circulation to remove blood stasis, make the menstrual blood unobstructed, increase the menstrual flow, and improve the color and texture of the menstruation. Generally, after taking it for a period of time, the menstrual cycle and menstrual volume will gradually return to normal.

- Amenorrhea: For amenorrhea caused by blood stasis blocking, Guizhi Fuling Pills can be reasonably used based on syndrome differentiation and treatment according to the specific situation of the patient. Some patients have a short amenorrhea period and good physical constitution, and can simply take Guizhi Fuling Pills to promote blood circulation to remove blood stasis and promote menstruation. If the amenorrhea period is long and the physical constitution is weak, drugs for supplementing qi and nourishing blood can be appropriately added to the prescription to enhance the curative effect.

痛经

- Primary dysmenorrhea: It mostly occurs within 1 - 2 years after the first menstruation. The pain usually occurs several hours before menstruation, and the pain location is mostly in the lower abdomen, presenting as spasmodic pain, which can radiate to the lumbosacral region and the inner side of the thigh. Guizhi Fuling Pills have a good curative effect on primary dysmenorrhea of the cold coagulation and blood stasis type. Patients are mostly accompanied by symptoms such as fear of cold and cold limbs, and the pain is relieved by warmth. After taking Guizhi Fuling Pills, it can warm and dredge the blood vessels, disperse the cold pathogen, and relieve the pain.

- Secondary dysmenorrhea: It is commonly seen in diseases such as endometriosis and adenomyosis. In addition to dysmenorrhea symptoms, patients may also be accompanied by progressively aggravated dysmenorrhea, increased menstrual volume, infertility and other symptoms. Guizhi Fuling Pills can promote blood circulation to remove blood stasis, improve the blood circulation in the pelvic cavity, reduce the local blood stasis state, and thus relieve the dysmenorrhea symptoms. However, for secondary dysmenorrhea, comprehensive treatment needs to be combined with specific diseases.

Retention of lochia after childbirth

The lochia generally stops discharging about 3 weeks after childbirth. If the duration of lochia is prolonged, the amount is sometimes more and sometimes less, the color is purplish dark with clots, and accompanied by abdominal pain, it is mostly retention of lochia. Guizhi Fuling Pills can promote the discharge of blood stasis and make the lochia be discharged as soon as possible. For patients with relatively weak bodies after childbirth, while taking Guizhi Fuling Pills, appropriate nutrition can be increased and rest can be paid attention to to promote the recovery of the body.

癥瘕

- Uterine fibroids: Guizhi Fuling Pills can be used to treat relatively small uterine fibroids. For patients with a fibroid diameter of less than 3 cm and mild symptoms, after taking Guizhi Fuling Pills, the fibroids of some patients may shrink and the symptoms will also be relieved. However, for patients with larger fibroids or rapid growth, other treatment methods such as surgical treatment may be needed.

- Ovarian Cysts: Ovarian cysts mostly fall into the category of static blood masses in TCM syndrome differentiation. Guizhi Fuling Pills can promote blood circulation and remove blood stasis, and may have a certain effect in dissipating some physiological cysts or smaller benign cysts. For patients with larger cysts or suspected of having a tendency to malignancy, surgical and other treatment measures should be taken in a timely manner, and Guizhi Fuling Pills can be used for adjuvant treatment to prevent cyst recurrence.

2. Other Clinical Applications

- Chronic Pelvic Inflammatory Disease

Patients with chronic pelvic inflammatory disease often present with symptoms such as a feeling of heaviness, pain in the lower abdomen, and soreness in the lumbosacral region, which are often aggravated after fatigue, sexual intercourse, and before and after menstruation, along with increased leucorrhea. TCM believes that it is mostly caused by factors such as damp-heat stasis and qi stagnation with blood stasis. The effect of promoting blood circulation and removing blood stasis of Guizhi Fuling Pills can improve pelvic blood circulation, relieve local blood stasis, and alleviate pain symptoms. At the same time, according to the specific situation of the patient, drugs for clearing heat and promoting diuresis can be combined for comprehensive treatment.

- Benign Prostatic Hyperplasia

Benign prostatic hyperplasia can cause symptoms such as frequent urination, urgency of urination, and difficulty in urination. TCM believes that it is related to blood stasis obstruction. Guizhi Fuling Pills can promote blood circulation and remove blood stasis, improve local blood circulation in the prostate, relieve the compression of the hyperplastic tissue on the urethra, and thus alleviate symptoms such as difficulty in urination. For patients with mild symptoms, Guizhi Fuling Pills can be taken alone for treatment; for patients with severe symptoms, other treatment methods such as drug sitz bath and acupuncture can be combined to improve the treatment effect.

VII. Modified Guizhi Fuling Pills

1. Qi Deficiency and Blood Stasis

If the patient is accompanied by qi deficiency symptoms such as shortness of breath, weakness, and pale complexion, qi-tonifying drugs such as Astragalus membranaceus and Codonopsis pilosula can be added to the basis of Guizhi Fuling Pills. Astragalus membranaceus can tonify qi and raise yang, secure the exterior and stop sweating, promote diuresis and alleviate edema, promote the production of body fluid and nourish blood, promote qi movement and relieve pain, expel pus by supporting healthy qi, and promote granulation and muscle growth. Codonopsis pilosula can invigorate the spleen and benefit the lung, nourish blood and promote the production of body fluid. After adding qi-tonifying drugs, it can enhance the healthy qi of the human body, make qi flourish and blood move, contribute to the dissipation of blood stasis, and at the same time can also improve the patient's qi deficiency symptoms.

2. Cold Coagulation and Blood Stasis

For patients with obvious cold coagulation and blood stasis, warm-natured drugs such as Fructus Foeniculi and Folium Artemisiae Argyi can be added. Fructus Foeniculi can disperse cold and relieve pain, regulate qi and harmonize the stomach. Folium Artemisiae Argyi can warm the channels and stop bleeding, disperse cold and regulate menstruation, and prevent miscarriage. These drugs can enhance the warming and dredging power of the prescription, more effectively dispel cold pathogens, and promote the dissipation of blood stasis, and are suitable for diseases such as irregular menstruation and dysmenorrhea caused by cold pathogen stagnation.

3. Damp-Heat and Blood Stasis

If the patient is accompanied by damp-heat symptoms such as profuse vaginal discharge, yellow and thick in color, and obvious odor, heat-clearing and dampness-promoting drugs such as Cortex Phellodendri and Semen Coicis can be added. Cortex Phellodendri can clear heat and dry dampness, purge fire and detoxify, and remove steaming bone. Semen Coicis can promote diuresis and percolate dampness, invigorate the spleen and stop diarrhea, relieve pain due to rheumatism, expel pus, and resolve toxin and dissipate nodules. After adding heat-clearing and dampness-promoting drugs, it can target the pathogenesis of damp-heat stasis, clear away damp-heat pathogens, and dissipate blood stasis, and is suitable for diseases such as chronic pelvic inflammatory disease belonging to the syndrome of damp-heat stasis.

4. Severe Blood Stasis

When the symptoms of blood stasis are relatively severe, such as a large mass in the abdomen and severe pain, the dosage of peach kernels and safflower can be appropriately increased, or drugs with stronger effects of promoting blood circulation to remove blood stasis such as sparganium and zedoary can be added. Sparganium can promote blood circulation to remove blood stasis, activate qi to relieve pain, and eliminate stagnation. Zedoary can promote blood circulation to remove blood stasis, activate qi to relieve pain, and eliminate stagnation. However, when using drugs for promoting blood circulation to remove blood stasis, attention should be paid to controlling the dosage and treatment course to avoid excessive attack resulting in damage to healthy qi.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional Method

The traditional dosage form of Cinnamon Twig and Poria Pill is pills, generally honey pills or water pills. The method of making honey pills is to mix the fine powder of the drug evenly with the refined honey and make it into pills. Water pills are made by rolling the fine powder of the drug with an appropriate amount of water or yellow rice wine.

- Dosage

Generally, it is 6 - 9 grams each time, twice a day. The specific dosage can be adjusted according to factors such as the patient's condition and constitution. For example, those with a milder condition can appropriately reduce the dosage, and those with a more severe condition can increase the dosage according to the doctor's advice.

- Administration method

Take it with warm boiled water. When taking honey pills, the pills can be divided into small portions and taken separately; when taking water pills, they can be directly taken with warm boiled water.

2. Modern Concentrated Granules

Modern concentrated granules are granule preparations made from traditional Chinese medicine through processes such as extraction and concentration, with advantages such as convenient administration and definite curative effect.

- Dosage

The dosage of modern concentrated granules of Guizhi Fuling Pills generally varies according to the product instructions of different manufacturers. The common dosage is 1 packet once and 2 times a day. However, the specific dosage also needs to be adjusted individually by a doctor in combination with the specific situation of the patient.

- Administration method

Take it by pouring boiling water. Pour the granules into a cup, add an appropriate amount of boiling water, stir well and then take it. Compared with traditional pills, modern concentrated granules are easier to dissolve and absorb, and have a relatively better taste, which is more suitable for the modern fast-paced lifestyle.

IX. Precautions and Taboos

1. Contraindicated for Pregnant Women

Guizhi Fuling Pills have the effect of promoting blood circulation and removing blood stasis. Taking it during pregnancy may lead to adverse consequences such as fetal restlessness and miscarriage. During pregnancy, the physiological state of women is special, and the qi and blood circulation is relatively slow, mainly for nourishing the fetus. Drugs for promoting blood circulation and removing blood stasis may disrupt this physiological balance and affect the normal development of the fetus. Therefore, pregnant women should strictly avoid using Guizhi Fuling Pills.

2. Use with Caution during Menstruation

During menstruation, the qi and blood of women are in an excreted state and the body is relatively weak. The effect of promoting blood circulation and removing blood stasis of Guizhi Fuling Pills may lead to excessive menstrual flow and prolonged menstrual period. For women with normal or less menstrual flow and symptoms of blood stasis obstruction, under the guidance of a doctor, Guizhi Fuling Pills can be appropriately taken during non-menstrual periods according to the specific situation for conditioning. However, during menstruation, especially for women with heavy menstrual flow, it should be used with caution or discontinued.

3. Use with Caution for the Weak Physique

Those with weak constitutions, such as those with qi and blood deficiency and spleen and stomach weakness, have relatively weak vital qi in the body. The effect of promoting blood circulation and removing blood stasis of Guizhi Fuling Pills may consume vital qi to a certain extent. When using Guizhi Fuling Pills, such people should first consult a doctor's opinion. If it is really necessary to use it, drugs for tonifying qi and nourishing blood or strengthening the spleen and benefiting the stomach can be appropriately added to the prescription to enhance the constitution and reduce the damage of the drug to vital qi.

4. Dietary Taboos

During the period of taking Guizhi Fuling Pills, it is necessary to avoid eating stimulating foods such as raw and cold, greasy, and spicy foods. Raw and cold foods such as ice cream and cold drinks may damage the yang qi of the spleen and stomach, affect the transportation and transformation function of the spleen and stomach, and thus be unfavorable for the absorption of the drug and the exertion of the drug effect. Greasy foods such as fried foods and fatty meat are not easy to digest and will加重 the burden of the spleen and stomach. Spicy foods such as chili peppers and Chinese prickly ash are easy to stir up fire and generate heat, and may conflict with the medicinal properties of Guizhi Fuling Pills, resulting in disorder of qi and blood circulation in the body.

X. Modern Research Progress

1. Research on Pharmacological Effects

The effect of promoting blood circulation and removing blood stasis

Guizhi Fuling Decoction and Guizhi Fuling Pills are widely used in clinical practice for promoting blood circulation and removing blood stasis. They are mainly used to treat gynecological diseases such as dysmenorrhea, uterine fibroids, ovarian cysts, adnexitis, etc. They are applicable to chronic prostatitis, varicose veins, acne, thrombosis, chloasma, renal insufficiency, diabetic nephropathy, ovarian cancer, thyroid cysts, bronchial asthma and fetal protection caused by blood stasis, and have the effects of dilating blood vessels and promoting blood circulation and removing blood stasis.

Modern research shows that Guizhi Fuling Pills have obvious effects of promoting blood circulation and removing blood stasis. The drug components contained in it, such as cinnamon twig, peach kernel, and cortex moutan, can improve hemorheological indexes, reduce blood viscosity, increase the deformability of red blood cells, and promote blood circulation. By improving microcirculation, the blood supply to the stasis area is improved, which helps to disperse blood stasis. For example, in some animal experiments, after administering Guizhi Fuling Pills, it was observed that the blood vessel diameter of the animals widened, the blood flow velocity accelerated, and the blood flow volume in the stasis area increased significantly.

Regulatory effect on endocrine

Guizhi Fuling Pills have a certain regulatory effect on the female endocrine system. It can regulate the hormone levels in the female body and improve symptoms such as irregular menstruation caused by endocrine disorders. Research has found that Guizhi Fuling Pills can regulate the function of the hypothalamus-pituitary-ovarian axis, making hormone levels such as estrogen and progesterone tend to be balanced. For some gynecological diseases caused by hormone imbalance, such as polycystic ovary syndrome, Guizhi Fuling Pills may improve symptoms and enhance the fertility of patients by regulating the endocrine system.

Anti-inflammatory effect

This prescription also has a certain anti-inflammatory effect. It can reduce the inflammatory response and has an adjuvant therapeutic effect on some inflammatory diseases. In inflammatory model experiments, it was found that Guizhi Fuling Pills can inhibit the release of inflammatory mediators, reduce exudation and edema at the inflammatory site, and减轻组织损伤. For example, in the treatment research of chronic pelvic inflammatory disease, Guizhi Fuling Pills can improve the inflammatory state of pelvic tissues and relieve symptoms such as pain and distension through its anti-inflammatory effect.

Clinical Research Results

Application in the treatment of gynecological diseases

Clinical research has confirmed the effectiveness of Guizhi Fuling Pills in the treatment of gynecological diseases. For diseases such as irregular menstruation, dysmenorrhea, amenorrhea, and postpartum lochia not cleared, the total effective rate is relatively high. For example, in a clinical study on scanty menstruation, patients were divided into a treatment group and a control group. The treatment group took Guizhi Fuling Pills, and the control group adopted other conventional treatment methods. The results showed that the menstrual volume of the patients in the treatment group increased significantly, and the menstrual cycle returned to normal, and the curative effect was significantly better than that of the control group. In the treatment of dysmenorrhea, many studies have shown that Guizhi Fuling Pills can effectively relieve dysmenorrhea symptoms and improve the quality of life of patients.

Exploration in the treatment of other diseases

In addition to gynecological diseases, there are also relevant research reports on the treatment of some other diseases with Guizhi Fuling Pills. For example, in the treatment of benign prostatic hyperplasia, some clinical observations have found that after taking Guizhi Fuling Pills, the symptoms such as dysuria in patients have been improved, and the prostate volume has been reduced to a certain extent. In the treatment of chronic pelvic inflammatory disease, the combined use of Guizhi Fuling Pills and antibiotics and other drugs can improve the treatment effect, shorten the course of disease, and reduce the recurrence rate. These research results provide a basis for the further clinical application of Guizhi Fuling Pills and also broaden its application scope in the field of modern medicine.