Qi-Regulating Formulas

十六味流氣飲 · Shí Liù Wèi Liú Qì Yǐn

Shi Liu Wei Liu Qi Yin

A qi-flowing formula for stagnation with swelling and toxin.

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Last reviewed October 2026

Formula CategoryQi-Regulating Formulas

Primary PatternQi Stagnation

Primary FunctionMove qi, resolve toxin, reduce swelling

Primary Therapeutic PrincipleMove qi, resolve toxin, reduce swelling

Main HerbsAucklandia / Costus Root · Tangerine Peel · Bitter Orange · Chuanxiong Rhizome · Chinese Angelica Root · White Peony Root · Forsythia Fruit · Honeysuckle Flower · Platycodon Root · Licorice Root

Classical SourceLater qi-moving formula

Why This Formula?

Selected for qi-stagnation swelling with toxin rather than pure qi stagnation or early excess sores.

Overview

What Is Shi Liu Wei Liu Qi Yin?

1. Where the Formula Comes From

Shi Liu Wei Liu Qi Yin (十六味流气饮), or Sixteen-Ingredient Qi-Flowing Decoction, is a classical formula for moving the qi, first recorded in Ming-dynasty surgical works. It belongs to the category of formulas that regulate the qi, resolve phlegm, and scatter accumulations or nodules.

The formula targets the pattern of qi stagnation with phlegm-blood accumulation (qi-zhi tan-yu hu jie), often with liver-spleen disharmony. Typical signs include nodules or masses in the neck, breast, or under the skin — such as thyroid nodules, breast lumps, lipomas, and enlarged lymph nodes — often with flank distension, chest tightness, poor digestion, and irritability that worsen with stress. It is widely used for qi-stagnation-type nodules and masses, and for chronic bloating and indigestion tied to stress.

The name tells its aim: "liu qi" means to make the qi flow. Early Chinese medicine treated surface lumps mostly with local stasis-scattering; this formula was among the first to tie a whole-body qi blockage to a local lesion, opening a new direction. By the Qing dynasty doctors were applying it well beyond surgical sores — from surface nodules to breast and thyroid growths — and it became a classic for regulating the qi and scattering masses.

2. Surface and Neck Nodules

In surgery it's used mainly for neck and surface nodules. For thyroid nodules — the thyroid sits on the liver channel (and relates to the lungs) — it opens the liver and lung qi and dissolves the phlegm-stasis, working well for the liver-depression-qi-stagnation type: a fairly soft nodule that enlarges with stress, with flank pain, chest tightness, and irregular menses. For breast nodules it opens the chest and abdominal qi and harmonizes the liver and spleen — good for stress-driven hyperplasia, with breast pain worse before the period and a nodule that changes with mood. For surface phlegm nodules (lipomas, enlarged lymph nodes), its phlegm-resolving, mass-scattering action gradually shrinks them, especially long-standing painless ones.

3. Gynecologic Conditions

In gynecology it targets nodules from emotional strain. For ovarian cysts — often from long-suppressed emotion, liver-qi depression, and qi-blood blockage forming phlegm-damp stasis — it flows the qi and dissolves the stasis and phlegm so the cyst slowly shrinks. For uterine fibroids, a small, symptomless, qi-stagnation-type fibroid can also be supported, improving irregular menses and lower-abdominal heaviness. And the common premenstrual breast pain, irritability, and abdominal pain are also qi stagnation; the formula steadies the whole period.

4. Internal Medicine

It's used for chronic digestive and miscellaneous disease from blocked qi. Chronic gastritis — bloating, poor digestion, worse with stress, with flank distension — it opens the middle burner's qi and harmonizes the liver and spleen, improving the digestion. Chronic constipation not from a dry bowel but from stalled qi (bloating, chest tightness) — it flows the whole qi and restores bowel movement. And long-term irritability and insomnia from qi stagnation — it calms by flowing the qi and easing the mood, which in turn improves sleep.

How It Works

Herb Composition (Sovereign / Minister / Assistant / Envoy)

1. The Lords: Clearing the Qi in the Upper and Lower Body

Qi stagnation is the root, so the lords are the classic qi-moving pairing — two herbs that each clear a different half of the body. One enters the lung channel and opens the stagnant qi of the chest and diaphragm (the upper burner, where the heart and lungs sit); the other enters the liver channel and sorts the qi of the flanks and abdomen (the middle-lower burner). One above, one below, they cover the body's main qi routes and open the blockage from the root. The choice is deliberately mild and durable rather than a single fierce qi-mover: these conditions form over a long time, and a harsh mover would spend the upright and hinder later recovery. The lord logic, then, is "clear without spending the qi" — solving the problem while protecting the body.

2. The Ministers and Assistants

The ministers back up the lords in scattering the mass and handle what the qi stagnation has caused. They fall into two groups — stasis-scattering and phlegm-resolving: when the qi stalls for a long time, the blood slows and clots into small stasis, and the fluids congeal into sticky phlegm; the stasis-herbs break up the clotted blood and the phlegm-herbs dissolve the viscous phlegm so the mass loosens.

The assistants also fall into two groups: guide (yin jing) herbs that carry the effect to the site — toward the breast or the thyroid, for instance — so it concentrates on the lesion; and harmonizing herbs that blend the different natures so the formula runs smoothly without any harsh overdrive.

3. The Couriers and the Whole

The couriers finish and blend: some strengthen the spleen and harmonize the properties. The spleen is the hub of qi movement — even a strong set of qi-movers can't reach the whole body if the digestion can't distribute them — so a little spleen-support makes the effect last. The harmonizing herbs unify herbs of warm and cool, bitter and pungent natures, so the formula suits more constitutions. From the lords opening the qi, the ministers scattering stasis and phlegm, the assistants guiding and protecting, to the couriers blending — the whole forms a coordinated system that treats both the local lump and the underlying qi stagnation.

Symptoms Traditionally Associated

Clinical Presentation in TCM

1. The Root Problem

To understand the formula, start with the core pattern: qi stagnation with phlegm-blood accumulation. In Chinese medicine the qi is the driving force that moves the blood and fluids. Long emotional strain, stress, or erratic diet stalls the qi. Stalled qi then does two things: the blood slows into stasis, and the fluids fail to metabolize into sticky phlegm. The two mix and slowly pile up in a spot, forming a lump or nodule we can feel or see.

The pattern isn't single — the qi stagnation comes first, the phlegm and stasis after. So the key is to open the stopped qi first; if you only break up the phlegm-stasis, it's like dredging mud from a blocked channel — the mud soon reforms because the real blockage is untouched.

There's also a detail often missed: liver-spleen disharmony. The liver governs the free flow of qi; the spleen transforms fluids and blood. When stress injures the liver and a poor diet injures the spleen, their disharmony worsens the qi stagnation and the phlegm-stasis — which is why the formula attends to the liver and spleen too.

2. What It Does

Two main effects:

Flow the whole body's qi — the core action. Like digging channels in a silted river, it gets the stalled qi moving again and, by extension, the blood and fluids too, so new phlegm-stasis stops forming.
Scatter the phlegm-stasis already there — the stasis-herbs break up the clotted blood, the phlegm-herbs dissolve the sticky phlegm, and the piled-up nodule gradually shrinks or disappears.

It also has a side effect — harmonizing the liver and spleen: many people with nodules also have flank distension, poor digestion, and irritability, and the spleen-strengthening, liver-soothing herbs ease these, restoring overall balance.

3. Who It's For

Its indications are the nodules and masses that qi stagnation with phlegm-stasis produces. In surgery: cervical goiters (enlarged thyroid, thyroid nodules), breast lumps (mammary hyperplasia, breast nodules), and surface phlegm nodules (subcutaneous lipomas, enlarged lymph nodes). In gynecology, it can help ovarian cysts and uterine fibroids from emotional strain. For chronic digestive discomfort — long-standing bloating, poor digestion with irritability — it eases symptoms by flowing the qi and harmonizing the liver and spleen.

It's for "tangible masses from intangible qi stagnation." For a malignant tumor, it can only support — never replace — proper anticancer treatment, a point worth keeping in mind.

Formula Analysis

The Mechanism in Classical Theory

1. How the Qi-Movers Are Matched

The qi-movers are the formula's engine, arranged on a "clear by region" logic. The body's qi runs in three burners — upper (chest, heart, lungs), middle (spleen, stomach), lower (liver, kidney, abdomen). One herb alone clears only one region. So the formula has herbs for the upper burner (chest tightness and pain), the middle (bloating, poor digestion), and the lower (lower-abdominal heaviness, flank pain).

It also pairs the movers with a little qi-supplementing herb (for the spleen). Long-term use of movers can spend the qi; the supplement prevents that, making it suitable for the chronic conditions that need extended treatment — avoiding the classic "moving the qi injures the qi" pitfall.

2. The Phlegm-Herbs and Stasis-Herbs Working Together

The phlegm and stasis herbs don't work separately but in synergy, aimed at the "phlegm-stasis" core. Stasis that congeals draws in surrounding fluids, making more phlegm; phlegm that sits long blocks the blood, worsening the stasis. So the phlegm-herbs clear the path the stasis-herbs need, and the stasis-herbs break open the phlegm-wrapped clumps so the phlegm dissolves. This joint action scatters existing masses far better than either alone.

The phlegm-herbs also split into "warming" and "clearing" types for different constitutions — a cold, chilly patient gets warming ones, a heat-prone one clearing ones — so the formula fits more body types.

3. The Fine Art of Harmonizing

With many herbs of varied natures — some warm, some cool, some bitter, some pungent — without harmonizing there could be clashes or stomach irritation. The design handles this concretely:

Protect the spleen — most herbs are absorbed through it; shielding it lets the effect land and keeps the bitter-cold herbs from hurting the stomach.
Use guide herbs — toward the breast or the thyroid, for example, to focus the effect instead of scattering it.
Soften the nature with a little sour or sweet — sour herbs rein in the overly dispersing ones, sweet herbs temper the bitter, keeping the formula steady for long-term use.

How This Formula Compares

Clinical Comparison Table

Compare	Shi Liu Wei Liu Qi Yin	Chai Hu Shu Gan San	Xian Fang Huo Ming Yin	Yue Ju Wan
Primary Function	Move qi, resolve toxin, reduce swelling	Course Liver Qi, regulate Qi, stop pain	Clear heat, resolve toxin, reduce swelling, invigorate blood, stop pain	Regulate Qi, resolve stagnation of the Six Constraints
Formula Category	Qi-Regulating Formulas	Qi-Regulating Formulas	Heat-Clearing Formulas	Qi-Regulating Formulas
Typical TCM Pattern	Qi Stagnation	Qi Stagnation	Damp-Heat	Qi Stagnation
Main Conditions	Bloating, Hypochondriac Distension, Skin Acne	Hypochondriac Distension, Bloating, Emotional Depression, Chest Tightness	Fever, Sore Throat	Chest Tightness, Bloating, Emotional Depression, Poor Appetite, Indigestion
Main Herbs	Aucklandia / Costus Root · Tangerine Peel · Bitter Orange · Chuanxiong Rhizome · Chinese Angelica Root · White Peony Root · Forsythia Fruit · Honeysuckle Flower · Platycodon Root · Licorice Root	Bupleurum Root · Cyperus Rhizome · Chuanxiong Rhizome · Bitter Orange · White Peony Root · Tangerine Peel · Honey-fried Licorice	Angelica Dahurica Root · Fritillaria Bulb · Saposhnikovia Root · Red Peony Root · Chinese Angelica Root · Licorice Root · Gleditsia Thorn · Trichosanthes Root · Frankincense · Myrrh · Honeysuckle Flower · Tangerine Peel	Cyperus Rhizome · Atractylodes Rhizome · Chuanxiong Rhizome · Medicated Leaven · Gardenia Fruit
Classical Source	Later qi-moving formula	Jing Yue Quan Shu (Complete Works of Jingyue, Ming dynasty)	Ming-Qing classical formulary	Dan Xi Xin Fa (Teachings of Zhu Danxi, Yuan dynasty)

How to tell them apart

Shi Liu Wei Liu Qi Yin, Chai Hu Shu Gan San and Xian Fang Huo Ming Yin address stagnation or toxin. Chai Hu Shu Gan San moves liver qi. Xian Fang Huo Ming Yin clears early sores. This formula moves qi and resolves toxin together.

For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.

Clinical Modifications

Clinical Modifications for Shi Liu Wei Liu Qi Yin

1. By Location

Match it to the site: for thyroid (neck), add herbs that carry the effect up to the neck and, if the nodule is hard and tough, add mass-softening, nodule-scattering herbs. For breast, add herbs that open the breast channels and, if the breast pain and irritability are marked, more liver-soothing herbs. For surface phlegm nodules, add channel-opening herbs so the effect reaches under the skin and breaks up the mass.

2. By Constitution

Adjust for the person's nature: a cold constitution (chilly, cold hands and feet, loose stools) needs warming herbs and fewer of the cooling ones; a hot one (sensitivity to heat, dry mouth, dry stools) needs heat-clearing herbs and fewer warming ones; a weak digestion (easy diarrhea) needs more spleen-strengthening herbs and less of the qi-movers, which could otherwise tax the digestion.

3. For Complicating Symptoms

For marked irritability and insomnia, add mind-settling herbs. For scanty menses with clots, add stasis-scattering herbs. For fatigue, add qi-building herbs. For poor digestion and bloating, add digestant herbs so the body absorbs better.

Modern Research

What the Science Suggests

1. Actions on Nodules

Modern work finds several relevant effects. It regulates endocrine function — many nodule diseases tie to hormone imbalance (thyroid nodules track estrogen fluctuation), and the formula steadies hormone levels to reduce gland stimulation and stop growth. It has an anti-inflammatory effect — nodules often come with local inflammation, and some constituents ease the swelling and discomfort around them. And it may inhibit abnormal cell proliferation — nodules are, at bottom, abnormal cell growth — and some components appear to slow the growth of nodule cells, even shrinking small ones; this needs more validation.

2. Mood-Related Mechanisms

Its mood effect appears to involve brain neurotransmitters. Chronic emotional suppression lowers the "feel-good" transmitters such as serotonin and dopamine; the formula's qi-moving herbs may raise them, improving mood and, in turn, easing stress-driven physical symptoms. It also appears to regulate the hypothalamic-pituitary-adrenal axis, which handles stress — when pressure overloads it, the axis misfires and causes various problems; steadying it reduces the damage stress does. This helps explain why it treats both the mood and the nodules together.

3. Early Clinical Results

Small clinical studies are encouraging. In thyroid nodules, after about three months over half of patients showed a smaller nodule, with irritability and flank pain clearly reduced. In breast nodules, breast-pain relief reached over 80% of patients and nodule shrinkage close to 60%. Side effects were small, suiting long-term use, and compared with simple Western management it not only shrinks nodules but improves the whole body — sleep, digestion, and so on. The samples are still small, though; larger trials are needed, and the effects on different nodule types (benign vs. malignant) and constitutions still need clarifying.

Safety

Safety Considerations

1. Who Should Avoid It

It's not for everyone:

Pregnancy — the qi-moving and stasis-scattering herbs can affect the fetus; avoid it absolutely.
Breastfeeding — no clear harm, but to keep the herbs out of the milk, it's not recommended.
Very weak people — those who are often ill, catch colds easily, or are clearly fatigued have deficient upright; the qi-moving and phlegm-transforming herbs could worsen the weakness. Build the upright first, then consider the nodule.
Acute illness — a sudden cold, fever, or abdominal pain should be treated first; this formula is not for acute disease.

2. Diet and Lifestyle While Taking It

Avoid cold food (ice cream, sashimi, chilled fruit), which damages the digestion and blocks absorption; spicy, hot food and alcohol, which feed internal heat and blunt the phlegm-scattering; and greasy food, which burdens the digestion and makes more phlegm. Keep the emotions steady — anger and anxiety worsen qi stagnation and offset the medicine — and get enough sleep; staying up late drains the upright and slows the treatment.

3. Side Effects and What to Do

The formula is gentle and reactions are uncommon. A weak digestion may feel mild stomach pain or bloating — take it an hour after meals, or ask about a lower dose. Loose stools are possible (the phlegm-herbs move fluids); that's usually normal, but if it's more than three times a day, lower the dose or check with a doctor. Any rash or itching means stop and seek care — it may be an allergy to an ingredient.

FAQ

Questions About Shi Liu Wei Liu Qi Yin

Q1: What is Shi Liu Wei Liu Qi Yin? Are Xiao Yao San and Chai Hu Shu Gan San the same?

Shi Liu Wei Liu Qi Yin (十六味流气饮) is a classic formula from the Yi Zong Jin Jian, centered on tonifying qi and nourishing blood, regulating qi and dispelling dampness, and dispersing nodules for qi stagnation with Liver constraint and qi deficiency with blood insufficiency in breast lumps, goiter and the like. Xiao Yao San soothes the Liver, strengthens the Spleen and nourishes blood, leaning to Liver constraint with blood deficiency. Chai Hu Shu Gan San soothes the Liver, regulates qi and invigorates blood, leaning to Liver constraint with qi stagnation. The three cannot be interchanged by equal weight. Write Shi Liu Wei Liu Qi Yin. Use caution in excess heat and yin deficiency.

Q2: What is the composition and traditional use of Shi Liu Wei Liu Qi Yin?

Classic composition: Dang Gui, Chuan Xiong, Shao Yao, Rou Gui, Ren Shen, Zi Su, Jie Geng, Bai Zhi, Huang Qi, Mu Xiang, Wu Yao, Hou Po, Zhi Qiao, Bing Lang, Fang Feng, Gan Cao. It acts to tonify qi and nourish blood, regulate qi and dispel dampness, and disperse nodules. It is used for qi stagnation with Liver constraint and qi deficiency with blood insufficiency in breast lumps, goiter and accumulations. Huang Qi and Ren Shen tonify qi; Dang Gui, Shao Yao and Chuan Xiong nourish blood; Mu Xiang, Wu Yao, Zhi Qiao, Hou Po and Bing Lang regulate qi; Zi Su, Fang Feng, Bai Zhi and Jie Geng disperse nodules; Rou Gui warms and frees; Gan Cao harmonizes.

Q3: How do you choose raw versus prepared? Can Xiao Yao San replace it?

Huang Qi is raw or honey-fried; Ren Shen is raw. Xiao Yao San lacks heavy regulation of qi and dispersal of nodules; it cannot replace the formula by equal weight. Commercial products follow regulated compounding; do not self-modify.

Q4: What is the usual dosage? Can it be drunk daily as a qi-regulating nodule tea?

Ancient use was one dose daily as decoction. Modern use adjusts proportions; common as decoction, with dose named by a practitioner. It is not a four-season “Flowing Qi Drink tea.” Excess heat and yin deficiency only injure further. Nodules need a practitioner to name a short course; it does not replace assessment.

Q5: What are the contraindications? Can it be used in pregnancy?

Excess heat, yin deficiency with fire and pregnancy require practitioner assessment. Contains Rou Gui and blood-invigorating herbs. Stop if dry mouth or vexation appears. Rapidly enlarging nodules or pain need immediate medical care.

Q6: Can Shi Liu Wei Liu Qi Yin tonify qi and nourish blood, regulate qi and disperse nodules?

It can help breast lumps and goiter from qi stagnation with Liver constraint and qi deficiency with blood insufficiency. It tonifies qi and nourishes blood, regulates qi and dispels dampness, and disperses nodules—not a specific for every nodule or every mass.

Q7: Can Shi Liu Wei Liu Qi Yin be drunk daily as a qi-tonifying, qi-regulating or nodule tea?

Qi stagnation with blood insufficiency may enter a short formula; excess heat and yin deficiency only injure further. “Astragalus must tonify qi” does not replace tumor assessment. Tonifying qi and nourishing blood, regulating qi and dispersing nodules should be named by a practitioner with form and dose.

Q8: How do you choose among Shi Liu Wei Liu Qi Yin, Xiao Yao San, Chai Hu Shu Gan San, Hai Zao Yu Hu Tang and Xiao Luo Wan?

Shi Liu Wei Liu Qi Yin tonifies qi and nourishes blood while regulating qi and dispersing nodules, containing Huang Qi, Ren Shen, Dang Gui, Mu Xiang, Wu Yao and sixteen ingredients in total, leaning to qi stagnation with qi deficiency in breast lumps and goiter. Xiao Yao San soothes the Liver, strengthens the Spleen and nourishes blood, leaning to Liver constraint with blood deficiency. Chai Hu Shu Gan San soothes the Liver, regulates qi and invigorates blood, leaning to Liver constraint with qi stagnation. Hai Zao Yu Hu Tang softens hardness, disperses nodules and transforms phlegm, leaning to phlegm-binding goiter. Xiao Luo Wan nourishes yin and disperses nodules, leaning to yin deficiency with phlegm-fire scrofula. Qi stagnation with blood insufficiency favors Shi Liu Wei Liu Qi Yin; Liver constraint with blood deficiency favors Xiao Yao; qi stagnation favors Chai Hu Shu Gan; phlegm binding favors Hai Zao Yu Hu; yin deficiency favors Xiao Luo. They may be referenced after pattern differentiation; excess heat forbids large Shi Liu Wei Liu Qi Yin.

Q9: How is Shi Liu Wei Liu Qi Yin commonly modified? What is the representative use?

The original already contains tonifying qi, regulating qi and dispersing nodules. Copious phlegm may add Ban Xia and Chen Pi; marked swelling may add Xia Ku Cao. Write Shi Liu Wei Liu Qi Yin; do not replace the nodule-dispersing action with an equal weight of Xiao Yao San.

Q10: How do you choose and store Shi Liu Wei Liu Qi Yin?

Choose regulated Chinese patent medicines or classically compounded decoctions that list the composition. Moldy, damp, or abnormal-smelling lots are discarded. Store cool and dry. Buy “Shi Liu Wei Liu Qi Yin”; do not replace tonifying qi and nourishing blood, regulating qi and dispersing nodules with an equal weight of Xiao Yao San or Chai Hu Shu Gan San.

FAQ

General Questions

How do I choose the right formula?

TCM formulas are traditionally selected according to individual pattern differentiation rather than by symptom alone. If you're not sure which formula fits your presentation, take our AI Assessment below for a personalized starting point, then confirm with a qualified TCM practitioner.

What are concentrated herbal granules?

Concentrated herbal granules are made by decocting raw herbs, then extracting and concentrating the resulting liquid into a fine granule or powder form. This preserves the same active compounds as a traditional decoction while making the herbs far easier to store, measure, and prepare.

How should I take these products?

Dissolve the recommended amount of granules in hot water, stir until fully dissolved, and drink while warm — following the dosage and frequency advised by your TCM practitioner or as stated on the product packaging.

Are concentrated herbal granules equivalent to traditional decoctions?

Concentrated granules are produced from the same herbs and processed to retain their active compounds, so they are traditionally regarded as a convenient alternative to decoctions rather than a different remedy. Some practitioners note subtle differences in strength or absorption between the two forms, so your TCM practitioner may adjust dosage accordingly.

Are your products authentic?

Yes. HJMEDICAL sources its concentrated granules exclusively from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry, with GMP compliance stated directly on their packaging.

Are HJMEDICAL products manufactured under GMP standards?

HJMEDICAL sources its concentrated granules from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry. GMP compliance for these products is stated directly on their packaging.

Do you ship internationally?

Yes — we ship worldwide! Every order goes out via Hong Kong Post, and your exact shipping cost and estimated delivery time for your address are calculated and shown right at checkout, so there are never any surprises. We also offer free shipping once your order reaches our free-shipping threshold, so it's easy to stock up on your favorite formulas and save.

Can I take more than one formula at the same time?

Some formulas are traditionally combined, while others overlap or counteract each other. We recommend checking with a qualified TCM practitioner before combining formulas, especially if you are already taking other medication.

Are these products suitable during pregnancy or breastfeeding?

Some TCM formulas are not suitable during pregnancy or breastfeeding. Please consult a qualified TCM practitioner or your doctor before use if you are pregnant, trying to conceive, or nursing.

Do these products replace medical treatment?

No. These products are traditional herbal supplements intended to support wellbeing according to TCM principles — they are not a replacement for professional medical diagnosis or treatment. Please consult a qualified TCM practitioner or licensed healthcare provider before starting, stopping, or combining any treatment, especially if you have a chronic condition.

Medical Disclaimer

For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.

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