小陷胸汤有哪些主要功效？

小陷胸汤具有清热化痰、宽胸散结作用，常用于痰热互结所致的胸闷、反酸、胃脘不适及胸部压迫感问题。

现代医学常用于哪些问题？

常见于胃食管反流、慢性胃炎、消化不良、胸闷胸痛、咽喉异物感、反酸烧心及上腹胀满患者的辅助调理。

小陷胸汤适合长期服用吗？

需根据痰热程度及症状变化决定。若症状持续反复发作，应接受专业评估并调整治疗方案。

哪些人不适合服用？

脾胃虚寒、寒痰内盛、胃寒呕吐及气虚明显者应慎用。若胸痛剧烈、呼吸困难或伴心血管疾病风险因素，应及时就医检查。

Phlegm-Resolving Formulas

小陷胸湯 · Xiǎo Xiàn Xiōng Tāng

Xiao Xian Xiong Tang

A classical Shang Han formula for phlegm-heat clumping in the chest with focal distension and pain on pressure.

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Last reviewed August 2026

Formula CategoryPhlegm-Resolving Formulas

Primary PatternPhlegm-Heat

Primary FunctionClear heat, resolve phlegm, open the chest

Primary Therapeutic PrincipleClear phlegm-heat clumping in the chest

Main HerbsCoptis Rhizome · Pinellia Rhizome · Trichosanthes Fruit

Classical SourceShang Han Lun (Zhang Zhongjing, Eastern Han)

Why This Formula?

Traditionally selected for phlegm-heat clumping in the chest with focal pain on pressure, rather than mixed cold-heat glomus or diffuse Lung phlegm-heat.

Overview

What Is Xiao Xian Xiong Tang?

1. Classical Literary Records

Xiao Xian Xiong Tang (小陷胸汤), or Minor Sinking-into-the-Chest Decoction, is a classical formula from Zhang Zhongjing’s Shang Han Lun (Treatise on Cold Damage). It belongs to the category of formulas that clear Heat, transform Phlegm, and open the chest.

This formula addresses Phlegm-Heat binding in the chest (minor chest bind), in which Heat and Phlegm clump together and obstruct the flow of Qi through the chest and epigastrium. Typical signs include focal distention and pain in the chest or epigastrium that is worse with pressure, cough with yellow sticky phlegm, a greasy yellow tongue coating, and a slippery floating or rapid pulse.

Combining Gua Lou as the chief herb to clear Heat, transform Phlegm, and loosen the chest, Huang Lian to drain Heat from the chest and Middle Burner, and Ban Xia to transform Phlegm, dissipate clumps, and descend rebellious Qi, Xiao Xian Xiong Tang effectively clears Phlegm-Heat, opens the chest, and relieves the characteristic focal pain and oppression of minor chest bind.

2. Digestive System Disorders

Target Conditions: Often used to help manage issues like chronic gastritis and stomach ulcers.
Key Symptoms: It is especially helpful when a patient experiences a painful, full feeling in the stomach, heartburn, a bitter taste, nausea, and vomiting, along with a yellow, greasy tongue coating.
How It Helps: For people who eat irregularly or love rich, spicy foods (which creates internal damp-heat), Xiao Xian Xiong Tang can clear the stomach heat, dissolve the turbid phlegm, and regulate digestion to relieve stomach discomfort.

3. Respiratory System Disorders

Target Conditions: Used supportively for inflammatory respiratory conditions like pleurisy (inflammation of the lung lining).
Key Symptoms: Useful when there is chest pain, coughing up thick, yellow phlegm, fever, and a bitter taste in the mouth.
How It Helps: If an external sickness has moved deeper into the lungs and turned into a hot, phlegm-filled blockage, the formula's ability to clear heat, open the chest, and promote expectoration can significantly reduce chest pain and inflammation.

4. Cardiovascular System Disorders

Target Conditions: Sometimes applied as a complementary approach for certain patients with coronary artery disease.
Key Symptoms: Indicated when chest tightness or pain is accompanied by signs of phlegm-heat, such as irritability, a bitter taste, and a greasy tongue.
How It Helps: When sticky phlegm and heat block the blood vessels around the heart, it causes pain. By clearing this blockage and opening the chest, Xiao Xian Xiong Tang helps improve the circulation of Qi and blood. Note: For cardiovascular issues, this must always be combined with standard biomedical treatments and professional medical supervision.

How It Works

Herb Composition (Sovereign / Minister / Assistant / Envoy)

1. Chief Herb — Huang Lian (Coptis Root)

Nature and Flavor: Huang Lian is intensely bitter and cold, entering the Heart, Spleen, Stomach, Liver, Gallbladder, and Large Intestine channels.
Key Actions: Because it is so bitter and cold, it has a powerful ability to clear heat and dry dampness, especially in the middle burner (the digestive center).
Role in the Formula: In Xiao Xian Xiong Tang, Huang Lian goes straight to the root of the problem by clearing internal heat. It drains "heart fire" to stop heat from moving downward, and it dries up dampness to prevent it from combining with heat. This effectively cuts off the source of phlegm-heat generation.

2. Deputy Herb — Ban Xia (Pinellia)

Nature and Flavor: Ban Xia is acrid (spicy), warm, and slightly toxic. It enters the Spleen, Stomach, and Lung channels.
Key Actions: It is well-known for drying dampness, transforming phlegm, and directing energy downward to stop nausea and vomiting. It also helps break up lumps and relieve fullness.
Role in the Formula: Its main job here is to handle the dampness and phlegm. When paired with Huang Lian, they create a perfect cold and warm balance. The cold herb (Huang Lian) keeps the warm herb (Ban Xia) from creating too much heat, while the warm herb prevents the cold one from causing stagnation. Together, they effectively clear out phlegm-heat and relieve feelings of painful fullness.

Xiao Xian Xiong Tang: Clearing Heat, Transforming Phlegm, Widening the Chest and Dispersing Binds, Improving Gastroesophageal Reflux, Chest Oppression and Phlegm-Heat Constraint | HJMEDICAL

3. Assistant Herb — Gua Lou Shi (Trichosanthes Fruit)

Nature and Flavor: Gua Lou Shi (the whole Trichosanthes fruit) is sweet, slightly bitter, and cold. It targets the Lung, Stomach, and Large Intestine channels.
Key Actions: It excels at clearing heat, washing away phlegm, opening up the chest, and moisturizing the bowels.
Role in the Formula: As a crucial assistant, it clears heat and breaks up phlegm-heat knots. The physical shape of the large, roomy fruit mirrors its ability to open the chest and relieve tightness. Adding Gua Lou Shi makes the entire formula much more focused and powerful at clearing out stubborn phlegm-heat blockages.

Symptoms Traditionally Associated

Clinical Presentation in TCM

1. Pathomechanism Analysis

The Root Cause: Xiao Xian Xiong Tang is designed for a condition where phlegm and heat get tangled up together just below the heart (the upper stomach area).
How It Happens: This usually occurs when outside pathogens enter the body and turn into heat, or when internal organs aren't working properly, creating internal "turbid phlegm."
Symptoms: When this phlegm and heat clash, they block the flow of energy (Qi) between the chest and stomach. This leads to:
- A feeling of painful fullness or blockage right below the heart.
- Irritability or a bitter taste in the mouth (if the phlegm-heat rises).
- Digestive issues like nausea, vomiting, and a poor appetite (if it blocks the spleen and stomach's normal functions).

2. Actions

The main goal of Xiao Xian Xiong Tang is to clear heat, transform phlegm, open the chest, and break up knots.
How They Work Together: Huang Lian cools heat and drains fire; Ban Xia dries up dampness and transforms phlegm; and Gua Lou Shi washes away the phlegm while opening the chest. Working as a team, these three herbs clear out the phlegm-heat, get the body's energy flowing smoothly again, and melt away blockages and tightness.

3. Indications

Primary Use: It is the primary formula for patterns where phlegm and heat are mutually binding.
Common Signs: Practitioners look for fullness and pain below the heart that is tender when pressed, chest tightness, coughing up thick yellow phlegm, a bitter taste, a yellow and greasy tongue coating, and a fast, slippery pulse.
Modern Applications: Today, this formula is often used as supportive care for modern medical conditions that fit this "phlegm-heat" pattern, such as chronic gastritis, stomach ulcers, gallbladder inflammation (cholecystitis), and pleurisy.

Formula Analysis

The Mechanism in Classical Theory

1. Combining Heat-Clearing with Phlegm Transformation

The Cooling Foundation: Huang Lian (Coptis Root) is bitter and cold. It directly attacks internal heat, laying the groundwork for clearing out stubborn phlegm-heat.
The Drying Power: Ban Xia (Pinellia) steps in to dry up dampness and powerfully transform phlegm.
The Perfect Balance: Combining a cold herb (Huang Lian) with a warm one (Ban Xia) is a classic strategy. It eliminates damp-heat without letting the coldness hurt the stomach or the warmth create even more heat.
The Synergistic Boost: Gua Lou Shi (Trichosanthes Fruit) joins the team to clear heat, open the chest, and break up knots. This combination of clearing heat while actively resolving phlegm is the secret behind how Xiao Xian Xiong Tang successfully targets phlegm-heat blockages.

2. Pairing Qi Regulation with Bind Dispersal

Restoring Flow: When phlegm and heat bind together, they block the body's natural energy (Qi) flow, causing painful tightness.
Opening and Directing: Gua Lou Shi physically "opens" the chest to break up these knots, while Ban Xia helps push the rebellious Qi downward.
The Result: By regulating the Qi and dispersing the physical bindings, the formula gets energy flowing smoothly again. Once the Qi moves, the phlegm naturally disperses, and the painful fullness simply melts away.

3. Significance of Drug Dosage and Combination Proportions

The specific amounts of each herb in Xiao Xian Xiong Tang are intentionally balanced to maximize effectiveness while minimizing side effects:

Small Dose of Huang Lian: A little goes a long way. Using a small amount clears the heat without being so bitterly cold that it damages the stomach's digestion.
Moderate Dose of Ban Xia: This provides just enough power to dry dampness, transform phlegm, and regulate Qi effectively.
Large Dose of Gua Lou Shi: As the heavy lifter of the formula, a large dose ensures it can effectively wash away phlegm, open the chest, and relieve painful fullness, which is the primary goal of the treatment.

How This Formula Compares

Clinical Comparison Table

Compare	Xiao Xian Xiong Tang	Ban Xia Xie Xin Tang	Qing Qi Hua Tan Tang
Primary Function	Clear heat, resolve phlegm, open the chest	Harmonise cold and heat, disperse focal distension	Clear heat, resolve phlegm, regulate Qi
Formula Category	Phlegm-Resolving Formulas	Harmonising Formulas	Phlegm-Resolving Formulas
Typical TCM Pattern	Phlegm-Heat	Qi Stagnation	Phlegm-Heat
Main Conditions	Chest Tightness, Abdominal Pain	Bloating, Nausea, Diarrhea, Stomach Discomfort	Chest Tightness, Excessive Mucus
Main Herbs	Coptis Rhizome · Pinellia Rhizome · Trichosanthes Fruit	Pinellia Rhizome · Scutellaria / Baikal Skullcap · Coptis Rhizome · Dried Ginger · Ginseng Root · Jujube / Chinese Date · Honey-fried Licorice	Bile Arisaema · Trichosanthes Seed · Scutellaria / Baikal Skullcap · Immature Bitter Orange · Tangerine Peel · Poria / Hoelen · Bitter Apricot Kernel · Pinellia Rhizome
Classical Source	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Ming-Qing classical formulary

How to tell them apart

Xiao Xian Xiong Tang, Ban Xia Xie Xin Tang and Qing Qi Hua Tan Tang address focal chest or epigastric patterns. Ban Xia Xie Xin Tang harmonizes mixed cold-heat glomus; Qing Qi Hua Tan Tang clears diffuse Lung phlegm-heat. Xiao Xian Xiong Tang clears phlegm-heat clumping in the chest with focal distension and pain on pressure.

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

Clinical Modifications

Clinical Modifications for Xiao Xian Xiong Tang

1. For More Exuberant Phlegm-Heat

If the patient's phlegm-heat is particularly intense, practitioners often add herbs to boost the formula's cooling and clearing power:

Targeted Additions: Dan Nan Xing (Bile Arisaema) and Zhe Bei Mu (Zhejiang Fritillary Bulb) are commonly included.
How They Work: Dan Nan Xing is excellent at clearing heat and calming internal "wind," while Zhe Bei Mu is a powerful herb for breaking down stubborn phlegm and resolving toxicity. Adding them to Xiao Xian Xiong Tang makes the formula much more effective at tackling severe phlegm-heat patterns.

2. For Pronounced Qi Stagnation

When the energy flow (Qi) is heavily blocked, causing uncomfortable bloating and tightness:

Targeted Additions: Herbs like Zhi Ke (Bitter Orange Fruit) and Hou Po (Magnolia Bark) are introduced.
How They Work: Zhi Ke gently regulates energy and relieves bloating, while Hou Po dries dampness and pushes energy downward to eliminate fullness. Together, they enhance the formula's ability to get Qi moving and relieve that tight, full feeling below the heart.

3. For Concurrent Blood Stasis

If the phlegm-heat is accompanied by signs of poor blood circulation (blood stasis), such as sharp chest pain or a dark purple tongue:

Targeted Additions: Blood-activating herbs like Dan Shen (Salvia Root) and Chi Shao (Red Peony Root) are used.
How They Work: Dan Shen is famous for promoting blood flow, unblocking channels, and relieving pain, while Chi Shao clears heat and disperses stagnant blood. Adding these ensures Xiao Xian Xiong Tang can address both the phlegm-heat and the painful blood stasis effectively.

Modern Research

What the Science Suggests

Xiao Xian Xiong Tang is a classical formula that clears lung heat, descends qi, and dissipates nodules while supporting digestive health and qi and blood.

It addresses patterns addressed involving the target organs and channels entered, and is applied for shortness of breath, yellow sputum, dry mouth and throat, dry mouth, nosebleeds, palpitations, gastritis with acid reflux, gastrointestinal disorders, loose stools, chronic weakness, and even supportive use in coronary heart disease. The formula can help regulate overall temperature, and in certain modifications assists with warming the middle when a cold pattern is also present.

1. Pharmacological Research

Modern scientific studies have provided insights into how the individual herbs in Xiao Xian Xiong Tang work on a pharmacological level:

Huang Lian (Coptis Root): Contains compounds like berberine, which have shown strong antibacterial, anti-inflammatory, and blood-glucose-lowering effects.
Ban Xia (Pinellia): Exhibits properties that help suppress coughs, clear phlegm, and stop nausea.
Gua Lou Shi (Trichosanthes Fruit): Research indicates it can help dilate coronary arteries, increase blood flow to the heart, and lower blood lipids, supporting cardiovascular health.

2. Clinical Research

Recent clinical observations have highlighted the practical benefits of Xiao Xian Xiong Tang in modern healthcare:

Digestive Health: Studies show it can be a highly effective complementary treatment for issues like chronic gastritis, stomach ulcers, and cholecystitis (gallbladder inflammation). It helps relieve stomach pain, nausea, and bloating while promoting the repair of the stomach lining.
Broader Applications: It is also showing promising supportive benefits in managing certain respiratory and cardiovascular conditions that fit the "phlegm-heat" pattern.

3. Dosage Form Improvement Research

Thanks to modern pharmaceutical technology, taking this traditional formula is becoming much easier:

Modern Formats: Researchers have developed capsules and tablets in addition to traditional decoctions and concentrated granules.
Better Patient Experience: These new formats significantly improve drug stability, make dosages more precise, and—perhaps most importantly—mask the intensely bitter taste of herbs like Huang Lian, making it much easier for patients to stick to their health regimen.

Safety

Safety Considerations

1. Spleen–Stomach Deficiency-Cold and Pregnancy

Use Xiao Xian Xiong Tang cautiously in people with spleen–stomach deficiency-cold, as its bitter, cold nature may worsen stomach pain, diarrhea, or poor appetite. If treatment is necessary, it should be adjusted by a qualified practitioner. Pregnant women should use it only after a physician has carefully assessed the potential benefits and risks.

2. Dietary Restrictions

Avoid spicy, greasy, raw, and cold foods, such as chili peppers, fried foods, and ice cream, as they may aggravate phlegm-heat and reduce treatment effectiveness. Maintain a light diet with vegetables and fruits, such as bitter melon, winter melon, and pears, as appropriate.

Available Products

Where to Get It

Nong's Xiao Xian Xiong Tang Concentrated Granules

HJMEDICAL Nong's Xiao Xian Xiong Tang (Minor Chest-Focal-Distention) 5:1 Concentrated Granules $56.60

Hoi Tin Ban Xia Xie Xin Tang Extract Granules

HJMEDICAL Hoi Tin Ban Xia Xie Xin Tang (Pinellia Heart-Draining Decoction) 5:1 Concentrated Granules $26.32

Nong's Ban Xia Xie Xin Tang Extract Granules

HJMEDICAL Nong's Ban Xia Xie Xin Tang (Pinellia Heart-Draining) 5:1 Concentrated Granules $59.81

Hoi Tin Qing Qi Hua Tan Tang Extract Granules

HJMEDICAL Hoi Tin Qing Qi Hua Tan Tang (Clear Qi and Transform Phlegm Decoction) 5:1 Concentrated Granules $30.50

FAQ

Questions About Xiao Xian Xiong Tang

Q1: What are the actions of Xiao Xian Xiong Tang?

Xiao Xian Xiong Tang has the actions of clearing Heat, transforming Phlegm, opening the chest, and dissipating clumps. It is the Shang Han Lun formula for minor chest-binding (xiao jie xiong), in which Phlegm and Heat lock together in the chest and epigastrium.

Q2: Which modern diseases is Xiao Xian Xiong Tang suited to?

Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within Phlegm-Heat binding in the chest, including acute or chronic bronchitis with yellow sticky phlegm and chest oppression, gastritis or reflux of Phlegm-Heat type with focal epigastric fullness that is tender to pressure, and some biliary or pleuritic discomfort of this pattern after emergency causes have been excluded.

Q3: Is Xiao Xian Xiong Tang suitable for improving chest-epigastric fullness that hurts when pressed?

For presentations of focal fullness or oppression in the chest or just below the heart, pain on pressure, cough with yellow sticky sputum, a yellow greasy tongue coating, and a slippery rapid pulse — in those whose pattern differentiation confirms Phlegm-Heat binding — TCM commonly applies Xiao Xian Xiong Tang as an adjunct. Sudden severe chest pain requires urgent medical evaluation and is not treated with this formula alone.

Q4: Who should not take Xiao Xian Xiong Tang?

Those with Cold-type chest fullness and white thin phlegm, Spleen-Stomach deficiency with loose stools, or Yin-deficiency dry cough without Phlegm-Heat are generally not suitable. Huang Lian and Gua Lou are cold and can loosen the stool. Use should be assessed by a qualified TCM physician.

Q5: Why are only three herbs used, and why is Gua Lou decocted first?

Gua Lou is the chief: it clears Heat, transforms Phlegm, and opens the chest, and its moistening nature also gives the bound Phlegm a downward path. Huang Lian drains the Heat that cooks the Phlegm. Ban Xia transforms Phlegm, dissipates clumps, and descends rebellious Qi. Decocting Gua Lou first is the classical method to draw out its chest-opening, Phlegm-transforming juice before the other herbs are added.

Q6: How does Xiao Xian Xiong Tang differ from Ban Xia Xie Xin Tang or Qing Qi Hua Tan Tang?

Ban Xia Xie Xin Tang treats mixed Cold-Heat epigastric pi that is full but not truly painful on pressure, with more emphasis on harmonizing the Stomach. Qing Qi Hua Tan Tang more broadly treats Phlegm-Heat cough in the Lung. Xiao Xian Xiong Tang is chosen when Phlegm-Heat is bound locally in the chest or xin xia and the hallmark is focal fullness that hurts when pressed.

Q7: What are the main ingredients of Xiao Xian Xiong Tang?

The classical three-ingredient formula consists of a large dose of Gua Lou (Gua Lou Shi) to clear Heat, transform Phlegm, and open the chest; Huang Lian to drain Heat; and Ban Xia to transform Phlegm, dissipate clumps, and descend Qi.

Q8: Is Xiao Xian Xiong Tang suitable for long-term use?

No. It is a short-course formula for bound Phlegm-Heat. Once the chest opens and the yellow sticky sputum lessens, the formula should be stopped. Prolonged use of Huang Lian and Gua Lou readily injures Spleen Yang and loosens the stool.

Q9: Can this formula help both the tender chest fullness and the yellow sticky cough?

Yes. The same Phlegm-Heat that binds under the heart and makes the area tender also lodges in the Lung and produces yellow sticky sputum. Opening the chest and transforming that Phlegm-Heat can improve both when they belong to one pattern. Isolated dry cough without binding fullness is a different formula.

Q10: What lifestyle advice supports the use of Xiao Xian Xiong Tang?

Avoiding alcohol, fried and greasy foods that generate Phlegm-Heat, eating lighter meals, and seeking immediate care for crushing chest pain, sweating, or breathlessness all support correct use. This formula treats a TCM pattern; it is not a substitute for cardiac or pulmonary emergency care.

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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