1. Prescription Source & History

1. Prescription Origin

Shaofu Zhuyu Decoction (Drive Out Blood Stasis from the Lower Abdomen) originated from "Corrections of Medical", "In the era when Wang Qingren lived, although medical theories were rich, there were still limitations in the understanding and treatment methods of some diseases. Wang Qingren attached great importance to the role of qi and blood in the physiological and pathological processes of the human body. He believed that the occurrence of many diseases was closely related to qi and blood stasis. The creation of Shaofu Zhuyu Decoction was precisely based on his in-depth understanding of the theory of blood stasis causing diseases and the summary of practical experience, aiming to specifically treat various diseases caused by blood stasis obstruction in the lower abdomen.", "Since the publication of "Corrections of Medical implications of the theory of blood stasis causing diseases and the summary of practical experience, aiming to specifically treat various diseases caused by blood stasis obstruction in the lower abdomen.", "Since the publication of "Corrections of Medical", "In the era when Wang Qingren lived, although medical theories were rich, there were still limitations in the understanding and treatment methods of some diseases. Wang Qingren attached great importance to the role of qi and blood in the physiological and pathological processes of the human body. He believed that the occurrence of many diseases was closely related to qi and blood stasis. The creation of Shaofu Zhuyu Decoction was precisely based on his in-depth understanding of the theory of blood stasis causing diseases and the summary of practical experience, aiming to specifically treat various diseases caused by blood stasis obstruction in the lower abdomen.", "Since the publication of "Corrections of Medical Developments" (Yilin Gaicuo) written by the famous medical scientist Wang Qingren in the Qing Dynasty. Wang Qingren dedicated his life to the actual observation and research of the human viscera. Through years of practice and dissection, he corrected some errors in the records of the viscera in ancient medical books, making important contributions to the development of traditional Chinese medicine theory. Shaofu Zhuyu Decoction is one of the representatives of his many classic prescriptions.

2. Historical Background

In the era when Wang Qingren lived, although medical theories were rich, there were still limitations in the understanding and treatment methods of some diseases. Wang Qingren attached great importance to the role of qi and blood in the physiological and pathological processes of the human body. He believed that the occurrence of many diseases was closely related to qi and blood stasis. The creation of Shaofu Zhuyu Decoction was precisely based on his in-depth understanding of the theory of blood stasis causing diseases and the summary of practical experience, aiming to specifically treat various diseases caused by blood stasis obstruction in the lower abdomen.

3. Inheritance & Influence

Since the publication of "Yilin Gaicuo", Shaofu Zhuyu Decoction has been widely applied and inherited in the clinical practice of traditional Chinese medicine. Later generations of medical practitioners have continuously accumulated experience, supplemented and improved it in the process of using this prescription, making it a commonly used prescription for treating diseases caused by blood stasis obstruction, and playing an important role in the treatment of diseases in multiple fields such as traditional Chinese medicine gynecology, andrology, and internal medicine.

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

1. King Drugs - Fennel, Dry Ginger

- Fennel

- Nature, flavor, and meridian tropism: Pungent in flavor, warm in nature. It belongs to the liver, kidney, spleen, and stomach meridians.

- Efficacy and function: It has the effects of dispersing cold and relieving pain, regulating qi and harmonizing the stomach. In Shaofu Zhuyu Decoction, fennel can warm the lower jiao, disperse cold and promote qi movement, playing a key role in warming and dredging the cold pathogen stagnation in the lower abdomen. It can promote the qi and blood circulation in the lower jiao and relieve discomfort symptoms such as cold pain and distension in the lower abdomen caused by cold coagulation.

- Dry Ginger

- Nature, flavor, and meridian tropism: Pungent in flavor, hot in nature. It belongs to the spleen, stomach, kidney, heart, and lung meridians.

- Efficacy and function: Dry ginger can warm the middle-jiao and dispel cold, restore yang and promote blood circulation, dry dampness and eliminate phlegm. When combined with fennel, it enhances the power of the prescription to warm yang and dispel cold, further dispelling the cold pathogen in the lower abdomen and improving the symptoms of cold coagulation and blood stasis. At the same time, dry ginger can also assist other drugs to play their roles better and promote the circulation of qi and blood.

2. Minister Drugs - Corydalis, Myrrh, Angelica, Chuanxiong

- Corydalis yanhusuo

- Flavor, nature and meridian tropism: Pungent, bitter in taste, warm in nature. It belongs to the liver and spleen meridians.

- Efficacy and function: Corydalis yanhusuo has the effects of promoting blood circulation, regulating qi and relieving pain. It is good at dispersing, can regulate qi stagnation in blood and blood stagnation in qi, and is a good medicine for promoting blood circulation to remove blood stasis and regulating qi to relieve pain. In Shaofu Zhuyu Decoction, it can effectively relieve the stasis pain in the lower abdomen. Whether it is stabbing pain, distending pain or dull pain, it can achieve a good analgesic effect and enhance the core effect of the prescription in treating pain caused by blood stasis blockage.

- Myrrh

- Flavor, nature and meridian tropism: Pungent, bitter in taste, neutral in nature. It belongs to the heart, liver and spleen meridians.

- Efficacy and function: Myrrh can disperse stasis and relieve pain, reduce swelling and promote granulation. Its synergistic effect with Corydalis yanhusuo enhances the effects of promoting blood circulation to remove blood stasis, relieving pain and reducing swelling. For the pain caused by lower abdominal blood stasis and the possible accompanying local swelling and other symptoms, myrrh can play its unique role in removing stasis and reducing swelling, dissipating blood stasis, relieving pain and restoring the muscles to normal.

- Angelica sinensis

- Nature, flavor, meridian tropism: Sweet and pungent in flavor, warm in nature. It acts on the liver, heart and spleen meridians.

- Functions and effects: Angelica sinensis has the effects of enriching blood and promoting blood circulation, regulating menstruation and relieving pain, and moistening the intestines and relaxing bowel movements. It is an important herb for nourishing and activating blood circulation. It can both enrich blood to nourish Chong and Ren meridians and promote blood circulation to unblock blood vessels. In Shaofu Zhuyu Decoction, Angelica sinensis helps to improve qi and blood stagnation caused by blood stasis, and at the same time provides the effect of nourishing blood for the formula, so that the stasis is removed and new blood is generated, achieving the purpose of strengthening healthy qi and eliminating pathogenic factors. It is especially suitable for menstrual disorders, dysmenorrhea and other diseases caused by blood stasis in women.

- Ligusticum wallichii

- Nature, flavor, meridian tropism: Pungent in flavor, warm in nature. It acts on the liver, gallbladder and pericardium meridians.

- Functions and effects: Ligusticum wallichii can promote blood circulation and regulate qi, dispel wind and relieve pain. It ascends to the head, descends to the blood sea, and spreads to the limbs. It is a qi drug in blood. In Shaofu Zhuyu Decoction, Ligusticum wallichii can enhance the power of promoting blood circulation and regulating qi, guide all herbs to reach the diseased site, make the medicinal power better act on the blood stasis in the lower abdomen, and at the same time its effect of dispelling wind and relieving pain also helps to relieve the pain symptoms that may be caused by blood stasis blockage, playing an important role in improving the condition of qi and blood stasis in the lower abdomen.

3. Assistant Drugs - Cinnamon, Red Peony Root

- Cinnamomum cassia

- Nature, flavor, meridian tropism: Pungent and sweet in flavor, very hot in nature. It acts on the kidney, spleen, heart and liver meridians.

- Functions and effects: Cinnamomum cassia can reinforce yang by supplementing fire, dispel cold and relieve pain, and warm and dredge the meridians. It further strengthens the effects of warming yang and dispelling cold, and dredging blood vessels in the formula. Synergistic with Foeniculum vulgare, Zingiber officinale and other herbs, it enhances the power of warming and dredging qi and blood in the lower abdomen, so that pathogenic cold is dispelled and blood stasis is unblocked.

- Red Peony Root

- Nature, flavor, meridian tropism: Bitter in taste, slightly cold in nature. It belongs to the Liver Meridian.

- Efficacy and function: Red Peony Root has the effects of clearing heat and cooling blood, dissipating stasis and relieving pain. In Shaofu Zhuyu Decoction, on the one hand, Red Peony Root can prevent the warm drugs in the formula from being overly warm and dry and injuring yin. On the other hand, its function of dissipating stasis and relieving pain can assist other blood-activating and stasis-dispelling drugs to better play their roles, enabling the stasis to be dissipated and the pain to be relieved, playing a dual role of assisting and harmonizing.

4. Messenger Herbs - Pollen Typhae, Faeces Trogopterori

- Pollen Typhae

- Nature, flavor, meridian tropism: Sweet in taste, neutral in nature. It belongs to the Liver and Pericardium Meridians.

- Efficacy and function: Pollen Typhae can stop bleeding, dissipate stasis and promote diuresis. It can both activate blood circulation and remove stasis and stop bleeding without leaving stasis, and has a good conditioning effect on the syndrome of stasis in the lower abdomen accompanied by a tendency to bleed or the intermingling of stasis and bleeding. In Shaofu Zhuyu Decoction, Pollen Typhae guides all the drugs into the blood aspect, enhances the effect of activating blood circulation and removing stasis, and at the same time regulates the flow of qi and blood, enabling the stasis to be removed and the qi and blood to flow smoothly.

- Trogopterus Dung

- Nature, flavor, meridian tropism: Sweet, bitter and salty in taste, warm in nature. It belongs to the Liver Meridian.

- Efficacy and function: Wulingzhi can activate blood circulation to disperse stasis and stop bleeding when stir-fried into charcoal. It is used in combination with Puhuang, enhancing the effect of promoting blood circulation to remove stasis and relieve pain. At the same time, its hemostatic effect also helps prevent the aggravation of bleeding symptoms caused by stasis. Wulingzhi can also guide the medicine into the Liver Meridian, making the prescription act more effectively on the stasis diseases in the lower abdomen of the Liver Meridian.

III. Pathogenesis, Efficacy and Indications

1. Pathogenesis

The pathogenesis targeted by Shaofu Zhuyu Decoction is mainly cold coagulation and blood stasis. The cold pathogen invades the lower Jiao, resulting in poor qi and blood circulation in the lower abdomen, and the blood stagnates into stasis. Cold is a yin pathogen and is likely to damage yang qi. Once yang qi is damaged, the warming and promoting functions are weakened, further aggravating the formation of stasis. The stasis blocks the lower abdomen, leading to local qi and blood obstruction. If there is obstruction, there will be pain, presenting symptoms such as lower abdominal pain and distension. At the same time, stasis can also affect the qi and blood circulation of the Chong and Ren Meridians, thus triggering gynecological diseases such as irregular menstruation, dysmenorrhea, amenorrhea in women, and andrological diseases such as lower abdominal pain and testicular distension in men.

2. Efficacy

Shaofu Zhuyu Decoction has the effects of warming the meridian to dispel cold and promoting blood circulation to remove stasis. The warm herbs in the prescription such as Fennel Fruit, Dry Ginger, and Cinnamon Twig disperse the cold pathogen in the lower Jiao, warming and transforming the cold pathogen. At the same time, promoting blood circulation to remove stasis herbs such as Corydalis Rhizome, Myrrh, Chinese Angelica, Szechuan Lovage Rhizome, Red Peony Root, Puhuang, and Wulingzhi are used to disperse the stasis in the lower abdomen. The two work synergistically to achieve the purpose of warming and dredging the meridians and promoting blood circulation to remove stasis, making the qi and blood in the lower abdomen unobstructed and restoring normal physiological functions.

3. Indications

- Mass in the lower abdomen due to blood stasis

It is manifested as a mass that can be felt in the lower abdomen, with a relatively hard texture, fixed and immovable, accompanied by pain. The nature of the pain is mostly stabbing or distending pain, and it is resistant to pressure. This situation is commonly seen in diseases caused by long-term accumulation of stasis, such as gynecological diseases like uterine fibroids and ovarian cysts, and andrological diseases like benign prostatic hyperplasia in men.

- Pain

- Cold pain in the lower abdomen: The pain is aggravated by cold and relieved by warmth, mostly caused by the cold pathogen stagnating the qi and blood in the lower abdomen. It is commonly seen in women with cold uterus and dysmenorrhea, postpartum abdominal pain, etc., and in men with lower abdominal pain caused by the cold pathogen invading the lower Jiao.

- Dysmenorrhea: The lower abdominal pain is severe before or during menstruation, presenting as stabbing or colicky pain, accompanied by dark purple menstrual blood with clots. The pain is relieved after the clots are discharged. It is mostly due to stasis blocking the Chong and Ren Meridians, resulting in poor qi and blood circulation. During menstruation, the qi and blood descend不畅, and the stasis obstruction is even more severe, thus triggering pain.

- Amenorrhea: Absence of menstruation, accompanied by distending pain in the lower abdomen that is resistant to pressure, and manifestations of static blood such as a purplish-dark tongue or petechiae and ecchymoses. It is mostly caused by the obstruction of the uterus by static blood, the blockage of Chong and Ren channels, and the failure of menstrual blood to descend.

- Irregular menstruation

- The menstrual cycle is disordered, either earlier or postponed, the menstrual volume is more or less, the menstrual color is purplish-dark, with blood clots, accompanied by pain in the lower abdomen. It is mostly caused by the obstruction of Chong and Ren channels by static blood, resulting in disharmony of qi and blood and abnormal changes in the menstrual cycle and volume.

IV. Analysis of Recipe of Shaofu Zhuyu Decoction

1. Synergy of Warming Yang to Disperse Cold and Promoting Blood Circulation to Remove Blood Stasis

In the formula, fennel, dried ginger, and cinnamon are the main herbs for warming yang and dispelling cold. They can warm the lower jiao, disperse cold pathogens, and prevent cold pathogens from stagnating qi and blood. At the same time, combined with herbs for promoting blood circulation and removing blood stasis such as Corydalis yanhusuo, Myrrha, Angelica sinensis, Ligusticum chuanxiong, and Red peony root, warming yang and dispelling cold helps enhance the effect of herbs for promoting blood circulation and removing blood stasis, making it easier for static blood to disperse in a warm and unblocked environment; promoting blood circulation and removing blood stasis can improve the unsmooth flow of qi and blood, reducing the chance of endogenous cold pathogens. The two complement each other and jointly play a therapeutic role against the pathogenesis of cold coagulation and blood stasis.

2. Treating Qi and Blood Simultaneously

The herbs for nourishing blood and promoting blood circulation such as Angelica sinensis and Ligusticum chuanxiong are combined with herbs for promoting qi circulation and relieving pain such as Corydalis yanhusuo and Myrrha, embodying the idea of treating both qi and blood. Qi is the commander of blood, and blood is the mother of qi. Qi and blood depend on each other and influence each other. The obstruction of static blood can lead to qi stagnation, and qi stagnation can further aggravate blood stasis. Shaofu Zhuyu Decoction focuses on promoting blood circulation and removing blood stasis while paying attention to promoting qi circulation to assist blood circulation, so that qi moves and blood moves, and static blood can be dispersed; it also nourishes blood to supplement the possible deficiency of blood after the dissipation of static blood, making qi and blood harmonious and achieving the purpose of treating diseases.

3. Guiding Meridian Messenger

Pollen Typhae and Faeces Trogopterori belong to the Liver Meridian, which can guide all herbs into the Liver Meridian, enabling the medicinal power to better act on the static blood diseases in the lower abdomen of the Liver Meridian. At the same time, Ligusticum chuanxiong ascends to the head, descends to the blood sea, and spreads to the limbs, guiding all herbs directly to the diseased site, enhancing the therapeutic effect of the formula in the lower abdomen, enabling the medicine to accurately act on the diseased site and exert the best therapeutic effect.

V. Comparison with Other Similar Formulas

1. Comparison with Xuefu Zhuyu Decoction

- Composition differences

Xuefu Zhuyu Decoction is mainly composed of peach kernels, safflower, Angelica sinensis, raw Rehmannia glutinosa, Ligusticum chuanxiong, Red peony root, Achyranthes bidentata, Platycodon grandiflorum, Bupleurum chinense, Fructus Aurantii Immaturus, and Glycyrrhiza uralensis. Shaofu Zhuyu Decoction mainly uses fennel, dried ginger, Corydalis yanhusuo, Myrrha, Angelica sinensis, Ligusticum chuanxiong, cinnamon, Red peony root, Pollen Typhae, and Faeces Trogopterori as the main herbs. There are obvious differences in their drug compositions. Xuefu Zhuyu Decoction focuses on promoting blood circulation and removing blood stasis, taking into account promoting qi circulation and relieving pain, and the drugs are distributed in the upper, middle, and lower jiaos. Shaofu Zhuyu Decoction It focuses more on warming the meridians and dispelling cold, targeting the cold coagulation and blood stasis syndromes in the lower jiao of the lower abdomen.

- The efficacy and treatment focus on

- Xuefu Zhuyu Decoction Its efficacy is mainly promoting blood circulation to remove blood stasis and regulating qi to relieve pain, treating the syndrome of blood stasis in the chest, manifested as chest pain, headache, not healed for a long time, pain like pricking with a fixed location, or hiccups that do not stop for a long time, or internal heat and restlessness, or palpitations, insomnia, irritability and anger, etc. Shaofu Zhuyu Decoction The main efficacy is to warm the meridians and dispel cold, promote blood circulation and remove blood stasis, treating the cold coagulation and blood stasis syndromes in the lower jiao of the lower abdomen such as blood stasis mass in the lower abdomen, cold pain in the lower abdomen, dysmenorrhea, amenorrhea, etc.

2. Comparison with Gexia Zhuyu Decoction

- The characteristics of the drug composition

- The Ge Xia Zhu Yu Decoction is composed of Trogopterus Dung, Angelica sinensis, Ligusticum wallichii, Persica, Cortex Moutan, Radix Paeoniae Rubra, Lindera aggregata, Corydalis yanhusuo, Glycyrrhiza uralensis, Cyperus rotundus, Flos Carthami, and Fructus Aurantii. Compared with it, the Shao Fu Zhu Yu Decoction adds drugs such as Fructus Foeniculi, Rhizoma Zingiberis, Cinnamomum cassia, and Pollen Typhae. The Shao Fu Zhu Yu Decoction emphasizes more on warming yang and dispelling cold. In view of the characteristics of pathogenic cold in the lower jiao causing diseases, warming drugs are added to dispel cold pathogens. While the Ge Xia Zhu Yu Decoction relatively focuses more on promoting blood circulation to remove blood stasis and regulating qi to relieve pain, and the warming property of the drugs is not as prominent as that of the Shao Fu Zhu Yu Decoction.

- Different applicable diseases and syndromes

- The Ge Xia Zhu Yu Decoction is mainly used to treat the syndrome of blood stasis under the diaphragm, such as abdominal mass, fixed pain, or abdominal sagging when lying down, there is a mass in the abdomen, hard and immovable, pain with resistance to pressure, relieved by warmth, in women, it may show delayed menstruation, amenorrhea, increased leucorrhea, or dysmenorrhea, etc. The Shao Fu Zhu Yu Decoction mainly targets the syndrome of cold coagulation and blood stasis in the lower abdomen, such as cold pain in the lower abdomen, dysmenorrhea, etc., and the disease location is more limited to the lower jiao of the lower abdomen.

VI. Clinical Applications and Indications

1. Gynecological Diseases

- Dysmenorrhea

- The cold coagulation and blood stasis type of dysmenorrhea is one of the main indications of the Shao Fu Zhu Yu Decoction. Patients have cold pain in the lower abdomen before or during menstruation, relieved by warmth, less menstrual volume, purple and dark color, with blood clots, purple and dark tongue, thin white coating, and taut and tight pulse. The Shao Fu Zhu Yu Decoction warms the meridians to dispel cold and promotes blood circulation to remove blood stasis, which can effectively relieve the symptoms of dysmenorrhea. Generally, it is taken 3 - 5 days before menstruation and continuously taken until the end of menstruation. By adjusting the menstrual cycle and improving the state of cold coagulation and blood stasis, the purpose of treating dysmenorrhea is achieved.

- Amenorrhea

- For amenorrhea caused by cold coagulation and blood stasis, the Shao Fu Zhu Yu Decoction also has good curative effects. Patients' menstruation stops for several months, with distending pain in the lower abdomen with resistance to pressure, sallow complexion, or having cold symptoms, purple and dark tongue, deep and unsmooth or taut and unsmooth pulse. The Shao Fu Zhu Yu Decoction can warm and dredge the qi and blood in the lower jiao, disperse blood stasis, make the thoroughfare and conception vessels unobstructed, and the menstruation comes down. In clinical application, the dosage and treatment course of the medicine can be appropriately adjusted according to the specific situation of the patient. Generally, it needs to be continuously taken for a period of time to observe the recovery of menstruation.

- Uterine myoma

- Uterine myoma belongs to the category of "accumulation" in traditional Chinese medicine. If it is differentiated as the syndrome of cold coagulation and blood stasis, Shaofu Zhuyu Decoction can be used for treatment. Patients may present with a mass in the lower abdomen, which is firm and fixed in texture, heavy menstrual bleeding or prolonged menstrual period, purple and dark menstrual blood with blood clots, accompanied by pain in the lower abdomen and other symptoms. Shaofu Zhuyu Decoction helps improve the symptoms of uterine myoma and reduce the volume of the myoma through promoting blood circulation to remove blood stasis and softening hardness to disperse stasis. In clinical application, it is often used in combination with other drugs for softening hardness and dispelling stasis, and the changes of the myoma are observed regularly at the same time.

2. Andrological Diseases

- Varicocele

- Some patients with varicocele may experience symptoms such as scrotal distension, pain, and discomfort in the lower abdomen with traction. If differentiated as cold coagulation and blood stasis in traditional Chinese medicine, Shaofu Zhuyu Decoction can be used as one of the treatment prescriptions. Shaofu Zhuyu Decoction can warm and dredge the qi and blood in the lower jiao, improve local blood circulation, relieve blood stasis blockage, and alleviate the symptoms of scrotal distension and pain. During clinical treatment, the dosage and course of treatment can be adjusted according to the severity of the patient's condition, and appropriate rest and life conditioning can be combined to promote the recovery of the disease.

- Chronic prostatitis

- For patients with chronic prostatitis, if they present with distending pain in the lower abdomen, perineum, and testicles, which is aggravated by cold, accompanied by symptoms such as frequent urination, urgency of urination, and incomplete urination, and are differentiated as cold coagulation and blood stasis, Shaofu Zhuyu Decoction can play the roles of warming the meridians to dispel cold, promoting blood circulation to remove blood stasis, and dredging collaterals to relieve pain. By improving the local blood circulation of the prostate, reducing the inflammatory reaction, and alleviating the pain symptoms. While using Shaofu Zhuyu Decoction for treatment, physical therapy methods such as prostate massage can be combined to improve the treatment effect.

VII. Modification and Variation

1. Those with severe cold

The dosage of fennel, dried ginger, and cinnamon can be increased to enhance the power of warming yang and dispelling cold. For example, fennel can be increased to 15g, dried ginger to 10g, and cinnamon to 6g to better dispel the cold pathogen in the lower jiao and relieve the cold coagulation symptoms such as cold pain in the lower abdomen.

2. Those with severe blood stasis

The dosage of Corydalis yanhusuo, Myrrha, Ligusticum chuanxiong, Radix Paeoniae Rubra, Pollen Typhae, and Faeces Trogopterori can be increased, or drugs for breaking blood and removing blood stasis such as Sparganium stoloniferum and Rhizoma Curcumae can be added. For example, Corydalis yanhusuo can be increased to 20g, Myrrha to 12g, and at the same time, Sparganium stoloniferum 10g and Rhizoma Curcumae 10g can be added to enhance the effect of promoting blood circulation to remove blood stasis and disperse the accumulated blood stasis mass.

3. Those with severe pain

10g of prepared Myrrha and prepared Bdellium can be added respectively, or 3g of Asarum can be added to enhance the analgesic effect. Prepared Myrrha and prepared Bdellium can enhance the effect of promoting blood circulation to remove blood stasis and relieve pain. Asarum is warm in nature and pungent in taste, with the function of dispersing cold and relieving pain, which can effectively relieve the pain symptoms and significantly reduce the pain in the lower abdomen of the patient.

4. Those with qi stagnation

10g of Cyperus rotundus and 10g of Lindera aggregata can be added to promote qi circulation and relieve pain, enhancing the power of qi and blood circulation. Cyperus rotundus can soothe the liver, regulate qi and relieve menstruation pain, while Lindera aggregata can promote qi circulation, relieve pain, warm the kidney and dispel cold. The addition of the two can synergize with the qi-promoting drugs in Shaofu Zhuyu Decoction to improve the symptoms of qi stagnation and blood stasis.

5. Those with blood deficiency

15g of Rehmanniae Radix Praeparata and 15g of Paeoniae Radix Alba can be added to nourish blood. Rehmanniae Radix Praeparata nourishes yin and replenishes blood, while Paeoniae Radix Alba nourishes blood and regulates menstruation. Adding these two herbs can supplement the blood deficiency that may be caused by the dissipation of stasis, making qi and blood sufficient and enabling the body to restore balance.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional method

- Composition of the medicine: 7 roasted fennel seeds, 0.6 g of stir-fried dried ginger, 3 g of Corydalis yanhusuo, 6 g of comminuted Myrrha, 9 g of Angelica sinensis, 6 g of Ligusticum chuanxiong, 3 g of Cinnamomum cassia, 6 g of Paeonia lactiflora, 9 g of Typha angustifolia pollen, 6 g of stir-fried Trogopterus dung

- Usage: Decoct in water for oral administration. Generally, soak the above-mentioned herbs for about 30 minutes, then decoct them with slow fire for 30 - 40 minutes, obtain about 300 ml of the decoction, take it warm in two divided doses, one dose per day.

- Dosage: According to the condition of the disease and the individual differences of the patients, the dosage of the above-mentioned drugs can be appropriately adjusted. However, generally follow the compatibility principle of monarch, minister, assistant, and guide to achieve the best therapeutic effect. For example, for those with mild symptoms of cold coagulation and blood stasis, the drug dosage can be relatively reduced; for those with severe symptoms, the dosage can be appropriately increased.

2. Modern concentrated granules

- Composition of the medicine: Concentrated granules of the same medicines as in the traditional prescription, such as concentrated granules of fennel, concentrated granules of dried ginger, concentrated granules of Corydalis yanhusuo, etc.

- Usage: Take it by pouring boiling water over it. Mix the concentrated granules of each medicine according to the corresponding proportion, take it with appropriate boiling water, take it in two doses, one dose per day.

- Dosage: The dosage of modern concentrated granules is generally used according to the recommended dosage in the instruction manual. For example, the concentrated granules of fennel may be 1g per bag, and the dosage is 1 - 2 bags each time; the concentrated granules of dried ginger are 1g per bag, and the dosage is about 0.6g each time. The specific dosage can be adjusted according to the condition and the doctor's advice. Modern concentrated granules are convenient to take, save time, and can better retain the active ingredients of the medicine, and are becoming more and more popular in clinical applications.

IX. Precautions and Taboos

1. Precautions

- Contraindicated for pregnant women

Shaofu Zhuyu Decoction contains various drugs promoting blood circulation and removing blood stasis, such as Angelica sinensis, Ligusticum chuanxiong, Paeonia lactiflora, Typha angustifolia, Trogopterus dung, etc. These drugs may have adverse effects on the fetus, leading to restlessness of fetal movement, miscarriage and other situations. Therefore, it is absolutely contraindicated for pregnant women.

- Use with caution during menstruation

During menstruation, the female body is in a state of downward movement of qi and blood. If Shaofu Zhuyu Decoction with a strong effect of promoting blood circulation and removing blood stasis is used at this time, it may cause excessive menstrual flow, prolonged menstrual period and other situations. Therefore, if it needs to be used during menstruation, it should be used with caution under the guidance of a doctor, and the dosage should not be too large.

- Use with caution for those with weak spleen and stomach

Most of the drugs in the formula are warm-natured and drugs promoting blood circulation and removing blood stasis. Those with weak spleen and stomach may have an increased gastrointestinal burden after taking it, causing symptoms such as indigestion and discomfort in the epigastric region. If those with weak spleen and stomach need to use it, drugs for strengthening the spleen and regulating the stomach, such as Atractylodes macrocephala, Poria cocos, Citrus reticulata, etc., can be appropriately added to the formula to reduce the stimulation of the drugs on the spleen and stomach.

2. Taboos

- Avoid raw, cold and greasy foods

During the period of taking Shaofu Zhuyu Decoction, raw and cold foods such as ice cream, cold drinks, raw fish slices, etc., and greasy foods such as fried foods, fatty meat, etc., should be avoided. Raw and cold foods are likely to damage the yang qi of the spleen and stomach, and greasy foods are not easy to digest, which will affect the absorption and curative effect of the drugs and is not conducive to the treatment of diseases.

- Avoid anger and irritation.

During the medication period, patients should keep a happy mood and avoid negative emotions such as anger and depression. Because emotional fluctuations may lead to qi stagnation and blood stasis, aggravating the disease condition and also affecting the therapeutic effect of the medicine. Maintaining a good mental state is conducive to the smooth flow of qi and blood and promotes the recovery of the disease.

X. Modern Research Progress

1. Effects on Hemorheology

Shaofu Zhuyu Decoction originated from 'Corrections of Errors in Medical Writings'. It is a commonly used prescription for treating gynecological diseases such as irregular menstruation, dysmenorrhea, amenorrhea, infertility, uterine fibroids, chronic pelvic inflammatory disease, pelvic inflammatory disease. It has the functions of warming and expelling blood stasis in the lower abdomen, promoting blood circulation to remove blood stasis, activating blood circulation and removing stasis, promoting qi movement by activating blood circulation, regulating qi and activating blood circulation, warming the meridian to relieve pain, warming the meridian to dispel cold, warming and dredging blood vessels, and reaching the lower jiao. It is applicable to lower abdominal pain, metrorrhagia and metrostaxis accompanied by lower abdominal pain, blood clots, etc. caused by cold coagulation and blood stasis, blood stasis, and qi stagnation. The prescription is composed of Angelica sinensis, Ligusticum chuanxiong, Paeonia lactiflora, Cinnamomum cassia, Foeniculum vulgare, Drynaria fortunei, Typha angustifolia, Trogopterus dungaricanus, Myrrha, Epimedium, etc. Clinically, 1 dose is decocted with water daily for oral administration, and it has good curative effects on metrorrhagia and metrostaxis, dysmenorrhea, etc., and is often combined with Shixiao Powder.

Modern research shows that Shaofu Zhuyu Decoction can improve hemorheological indexes. It can reduce the blood viscosity, decrease the aggregation of red blood cells, and increase the deformability of red blood cells, thus improving blood circulation and enabling blood to flow more smoothly in blood vessels. This has important therapeutic significance for diseases with blood circulation disorders caused by blood stasis blockage, helps relieve the blood stasis symptoms in the lower abdomen, and improves the blood supply of local tissues.

2. Effects on Uterus

In the research of gynecology, Shaofu Zhuyu Decoction has a certain regulatory effect on the uterus. It can promote uterine contraction and enhance uterine blood circulation. For patients with dysmenorrhea of cold coagulation and blood stasis type, it can relieve the spasm of uterine smooth muscle and reduce pain symptoms. At the same time, for diseases such as irregular menstruation and amenorrhea caused by uterine blood stasis, Shaofu Zhuyu Decoction can improve the functional state of the uterus, regulate the menstrual cycle, and make the menstrual blood discharge smoothly.

3. Anti-inflammatory and Analgesic Effects

Shaofu Zhuyu Decoction has certain anti-inflammatory and analgesic effects. The synergistic effect of various blood-activating and stasis-removing drugs and yang-warming and cold-dispelling drugs in its drug components can inhibit the release of inflammatory mediators, reduce the inflammatory reaction, and thus relieve local pain and swelling. For inflammatory pain in the lower abdomen caused by blood stasis blockage, such as chronic prostatitis, inflammatory pain associated with varicocele of spermatic cord, etc., Shaofu Zhuyu Decoction can improve the symptoms of patients and improve the quality of life through anti-inflammatory and analgesic effects.

4. Effects on Endocrine System

Research has found that Shaofu Zhuyu Decoction may have a certain regulatory effect on the endocrine system. It can affect the hormone levels in the body, especially the hormones related to female reproductive endocrinology. For diseases such as irregular menstruation and amenorrhea caused by endocrine disorders, Shaofu Zhuyu Decoction regulates the endocrine system and improves the hormone imbalance state, thus achieving the purpose of treating diseases. This provides a new theoretical basis for the treatment of gynecological endocrine diseases with Shaofu Zhuyu Decoction.

Clinical efficacy observation

Shao Fu Zhu Yu Tang (少腹逐瘀汤), known in English as Drive Out Blood Stasis from the Lower Abdomen Decoction, is one of the most important classical formulas in Traditional Chinese Medicine for treating Blood stasis in the lower jiao. Created by the famous Qing dynasty physician Wang Qing-ren, this warming and strongly moving formula is specifically indicated for fixed lower abdominal pain, severe dysmenorrhea with dark clotted blood, infertility, uterine fibroids or masses, and chronic pelvic inflammatory conditions when Blood stasis and cold congealing are the root pattern. In modern clinical practice, Shao Fu Zhu Yu Tang is widely used in gynecology for endometriosis-like symptoms, adenomyosis, fallopian tube blockage, and infertility due to Blood stasis. By combining strong Blood-moving, stasis-breaking, and warming herbs, it effectively breaks up fixed masses, relieves pain, and restores normal circulation in the lower abdomen — making it one of the most frequently prescribed formulas for gynecological Blood stasis patterns.