Ji Sheng Shen Qi Wan: Warming Kidney Yang and Alleviating Fluid Retention

SERVICE HONGJI MEDICAL

I. Source and History of the Prescription

1. Inheritance of Ancient Prescriptions

Ji sheng Shen qi Wan originated from 'Jisheng Fang' written by the Southern Song Dynasty physician Yan Yonghe, with a history of hundreds of years. Yan Yonghe accumulated rich experience in his long-term clinical practice. He carefully developed this prescription, providing an effective good recipe for treating various diseases in later generations.

2. Historical Evolution

Over time, Jisheng Shenqi Pills have continuously developed in the process of inheritance. Later generations of physicians made some adjustments and improvements on this basis to make it adapt to the clinical needs of different eras. During the Ming and Qing dynasties, many physicians conducted in-depth research and application on this prescription, further enriching its connotation and application scope.

<span class= Detailed Explanation of Jisheng Shenqi Pills: A classic prescription for warming the kidney and promoting qi transformation, promoting diuresis and reducing swelling

II. Introduction to the Ingredients of Jisheng Shenqi Pills (King, Minister, Assistant, and Courier Drugs)

1. King Drug

Prepared Rehmannia Root: Sweet in taste, slightly warm in nature, attributing to the liver and kidney meridians. It has the effects of nourishing yin and tonifying blood, replenishing essence and marrow. It can greatly nourish the yin of the liver and kidney, being a key herb for nourishing the kidney and yin, laying the foundation for nourishing kidney yin in the prescription.

Asiatic Cornelian Cherry Fruit: Sour, astringent and slightly warm, attributing to the liver and kidney meridians. It can tonify the liver and kidney, astringe and secure. It can assist the prepared rehmannia root to enhance the effect of nourishing the liver and kidney, and at the same time prevent the nourishing substances from being too greasy.

Chinese Yam: Sweet in flavor, neutral in property, attributive to the spleen, lung and kidney meridians. It has the effects of invigorating the spleen and nourishing the stomach, promoting the production of fluid and benefiting the lung, tonifying the kidney and arresting seminal emission. It not only supplements the acquired spleen and stomach to nourish the congenital, but also helps the kidney to arrest seminal emission. It synergizes with Rehmannia glutinosa and Cornus officinalis to enhance the power of nourishing kidney yin.

2. Minister Drug

Poria cocos: Sweet and bland in flavor, neutral in property, attributive to the heart, lung, spleen and kidney meridians. Promoting diuresis to eliminate dampness, invigorating the spleen, calming the heart. It can percolate and drain water dampness, making the pathogenic factor of water dampness excreted through urine, and can also strengthen the spleen to promote digestion and transportation, preventing the endogenous production of water dampness. When combined with Dioscorea opposita, it enhances the effect of strengthening the spleen and promoting diuresis.

Alisma orientale: Sweet and bland in flavor, cold in property, attributive to the kidney and bladder meridians. Promoting diuresis, clearing away heat and dampness. It can directly reach the kidney and bladder, percolate and drain the dampness in the lower jiao, and drain the heat of the kidney and bladder. When combined with Poria cocos, it enhances the power of promoting diuresis and eliminating dampness, and can also prevent the greasy drugs such as Rehmannia glutinosa from hindering dampness.

Moutan cortex: Bitter and pungent in flavor, slightly cold in property, attributive to the heart, liver and kidney meridians. Clearing heat and cooling blood, promoting blood circulation to remove stasis. It can clear and drain the ministerial fire, cool the blood and disperse stasis, restricting the greasy property of drugs such as Rehmannia glutinosa, making the supplementation not stagnant.

Cinnamomum cassia: Pungent and sweet in flavor, extremely hot in nature, attributing to the kidney, spleen, heart and liver meridians. It supplements fire to boost yang, dispels cold and alleviates pain, and warms and dredges the meridians. It can warm and tonify the kidney yang, stimulate the kidney qi, lead back the floating fire, and warm and supplement the deficiency-cold in the lower jiao.

Aconite Root: Pungent and sweet in flavor, extremely hot in nature, toxic, attributing to the heart, kidney and spleen meridians. It restores yang and reverses collapse, supplements fire to boost yang, dispels cold and alleviates pain. Being extremely pungent and hot, it can assist the heart yang upward, warm the spleen yang in the middle, and supplement the kidney yang downward. It is the key herb for warming the interior and restoring yang. When combined with Cinnamon Twig, it enhances the power of warming and tonifying the kidney yang.

3. Assistant Drug

Achyranthes Bidentata Root: Bitter, sweet and sour in flavor, neutral in nature, attributing to the liver and kidney meridians. It removes blood stasis and dredges the meridians, supplements the liver and kidney, strengthens the bones and muscles, promotes diuresis and relieves stranguria, and leads fire (blood) downward. It can both supplement the liver and kidney, strengthen the bones and muscles, and lead the herbs downward, enabling the medicinal power to directly reach the lower jiao. Moreover, it can promote urination and assist diuretic herbs to enhance the diuretic effect.

Plantain Seed: Sweet in flavor, cold in nature, attributing to the liver, kidney, lung and small intestine meridians. It clears heat, induces diuresis and relieves stranguria, percolates dampness and stops diarrhea, improves eyesight, and reduces phlegm. It can promote diuresis, distinguish the clear from the turbid and stop diarrhea, enabling the dampness to be excreted through urine. When combined with Poria, it enhances the effect of promoting diuresis and percolating dampness together.

4. Courier Drug

The guiding herb in this formula aims to harmonize all the herbs, making the compatibility of the whole formula coordinated and the medicinal power gentle. The herbs in the formula cooperate with each other to jointly achieve the effects of warming the kidney and activating qi transformation, promoting diuresis and reducing swelling.

<span class= Detailed Explanation of Jisheng Shenqi Pills: A Classic Prescribed Formula for Warming the Kidney and Promoting Qi Transformation, Resolving Edema and Promoting Diuresis

III. Pathogenesis, Efficacy, and Indications of Jisheng Shenqi Pills

1. Pathogenesis

Jisheng Shenqi Pills The diseases treated by Jisheng Shenqi Pills are mostly caused by insufficient kidney yang and impaired qi transformation. The kidney governs water. When kidney yang is deficient, it cannot warm and promote the metabolism of water fluid, leading to the retention of water-dampness in the body, which overflows the skin and causes symptoms such as edema. At the same time, due to insufficient kidney yang, the bladder fails to open and close properly, resulting in difficult urination and other conditions.

2. Efficacy

Warm the kidney and promote qi transformation, resolve edema and promote diuresis. It can both warm and tonify the yang qi of the kidney, restore the qi transformation function of the kidney, and promote the metabolism of water fluid, eliminating the pathogenic factor of water-dampness in the body.

3. Indications

It is used for kidney deficiency edema, soreness and heaviness of the waist and knees, difficult urination, phlegm-fluid dyspnea and cough caused by insufficient kidney yang and retention of water-dampness. Clinically, it is commonly seen in chronic nephritis, renal insufficiency, cardiogenic edema and other diseases belonging to the syndrome of deficiency of kidney yang and internal accumulation of water-dampness.

<span class= Detailed Explanation of Jisheng Shenqi Pills: A Classic Prescribed Formula for Warming the Kidney and Promoting Qi Transformation, Resolving Edema and Promoting Diuresis

IV. Analysis of the Formula's Meaning

1. Combining Tonifying Kidney Yang and Nourishing Kidney Yin

In the formula, Rehmannia glutinosa, Cornus officinalis, and Dioscorea opposita nourish the kidney yin, replenish essence and marrow, and are the basis for nourishing kidney yin. Cinnamomum cassia and Aconitum carmichaeli are pungent and extremely hot, warming the kidney yang and boosting the kidney qi. Tonifying both yin and yang enables the balance of yin and yang in the kidney, embodying the theory that those who are good at tonifying yang must seek yang from yin, and those who are good at tonifying yin must seek yin from yang.

2.协同利水渗湿与温阳化气Synergistically Promoting Diuresis and渗湿 Dampness Resolution and Warming Yang to Promote Qi Transformation

Poria cocos, Alisma orientale, and Plantago asiatica promote diuresis and percolate dampness, enabling the pathogenic factor of water-dampness to be excreted through urine. Cinnamomum cassia and Aconitum carmichaeli warm the kidney and promote qi transformation, enhance the bladder qi transformation function, and strengthen the ability of water fluid metabolism. The combination of promoting diuresis and warming yang treats both the symptoms and the root cause, enabling the removal of water-dampness, the restoration of yang qi, and normal qi transformation.

3.引火下行与补泻兼施Guiding Fire Downward and Combining Reinforcement and Reduction

Achyranthes bidentata can lead fire (blood) downward and prevent upward floating of deficient yang. Cortex Moutan clears heat and cools blood, restricting the dryness of warm-natured drugs. The whole formula has supplementation within purgation and purgation within supplementation, where supplementation does not hinder pathogenic factors and purgation does not damage healthy qi, making the supplementation and purgation appropriate to achieve the therapeutic purpose.

V. Comparison with Other Similar Prescriptions

1. Jinkui Shenqi Pills

Jinkui Shenqi Pills originated from Synopsis of the Golden Chamber and are a classic prescription for warming and tonifying the kidney yang. Compared with Jisheng Shenqi Pills, Jinkui Shenqi Pills focus more on simply warming the kidney yang and have relatively mild medicinal properties. On the basis of Jinkui Shenqi Pills, Jisheng Shenqi Pills add Achyranthes bidentata and Plantago asiatica, enhancing the effect of promoting diuresis and alleviating edema, and are more suitable for the syndrome of deficiency of kidney yang combined with internal retention of water-dampness.

2. Zhenwu Decoction

The main efficacy of Zhenwu Decoction is to warm yang and promote diuresis, and it is mainly used to treat the syndrome of yang deficiency with flooding of water. Compared with Jisheng Shenqi Pills, Zhenwu Decoction mainly uses Radix Aconiti Lateralis Preparata, Rhizoma Atractylodis Macrocephalae, Poria, Ginger, and Radix Paeoniae Alba, focusing on warming yang and promoting diuresis, with a stronger diuretic effect but a relatively weaker kidney-tonifying effect. Jisheng Shenqi Pills, while warming yang and promoting diuresis, pay more attention to tonifying kidney yin and yang, and the drug compatibility is more comprehensive.

VI. Clinical Applications and Indications

1. Chronic Nephritis

For patients with chronic nephritis who present symptoms of deficiency of kidney yang and internal accumulation of water-dampness, such as soreness and weakness of the waist and knees, fear of cold and cold limbs, edema, and difficult urination, Jisheng Shenqi Pills can be selected for treatment. By warming the kidney and promoting qi transformation, promoting diuresis and alleviating edema, it can improve kidney function and relieve the edema symptoms.

2. Renal Insufficiency

For patients with renal insufficiency, especially when there are manifestations of deficiency of kidney yang and retention of water-dampness, Jisheng Shenqi Pills can be used as adjuvant therapeutic drugs. It helps to regulate the balance of yin and yang in the kidneys, promote water metabolism, and relieve a series of symptoms caused by renal insufficiency.

3. Cardiac Edema

For edema caused by heart failure, if accompanied by symptoms of deficiency of kidney yang, such as palpitations, shortness of breath, fear of cold, edema, etc., Jisheng Shenqi Pills can be used in combination with western medicine for treatment. It warms the kidney and aids yang, promotes diuresis and reduces swelling, relieves the burden on the heart, and improves the condition of edema.

<span class= Detailed explanation of Jisheng Shenqi Pills: A classic formula for warming the kidney and transforming qi, promoting diuresis and reducing swelling

VII. Modifications and Variations

1. In cases of more severe edema

Polyporus umbellatus and Areca peel can be added to enhance the effect of promoting diuresis and reducing swelling. Polyporus umbellatus has a strong diuretic effect, and Areca peel can promote qi movement and diuresis, enabling the pathogenic factors of water-dampness to be excreted more quickly.

2. In cases of obvious weakness and soreness of the waist and knees

Eucommia ulmoides and Dipsacus asper can be added to enhance the effects of tonifying the liver and kidney and strengthening the bones and muscles. Both Eucommia ulmoides and Dipsacus asper are good herbs for tonifying the liver and kidney and strengthening the bones and muscles, and can effectively relieve the symptoms of soreness and weakness in the waist and knees.

3. In cases of more severe cough and dyspnea

Perilla frutescens and Lepidium apetalum can be added to lower qi and relieve asthma. Perilla frutescens can lower qi and resolve phlegm, and Lepidium apetalum can relieve asthma by purging the lung and promote diuresis and reduce swelling, which has a good effect on relieving the symptoms of wheezing and coughing.

<span class= Detailed explanation of Jisheng Shenqi Pills: A classic formula for warming the kidney and transforming qi, promoting diuresis and reducing swelling

VIII. Dosage and Administration

1. Traditional Method

The traditional dosage form is pills, usually taken orally, 6 - 9 grams each time, 2 - 3 times a day. Take it with warm water for easy absorption and exertion of the drug.

2. Modern Concentrated Granules

Modern concentrated granules are more convenient to take. Generally, they are taken by brewing according to the instructions or following the doctor's advice. The dosage varies according to different manufacturers and specifications, but overall, they can better maintain the efficacy of the prescription, and the dosage is relatively more accurate than traditional pills.

IX. Precautions and Contraindications

1. Dietary Taboos

During the medication period, raw and cold foods such as cold drinks and sashimi should be avoided. Raw and cold foods are likely to damage the yang qi of the spleen and stomach, affect the absorption and efficacy of the medicine, and are not conducive to the transportation and transformation of water dampness.

2. Constitution Taboos

Those with yin deficiency and excessive fire should use it with caution. Jisheng Shenqi Pills tend to be warming and tonifying. Those with the constitution of yin deficiency and excessive fire may aggravate the symptoms of yin deficiency in the body after taking it, resulting in discomfort such as dry mouth and throat, and fever with vexation of the five centers.

3. Special Situations

Pregnant women should use it with caution. Although most of the drugs in the prescription are commonly used traditional Chinese medicines, medication during pregnancy needs to be cautious and should be used under the guidance of a doctor to avoid adverse effects on the fetus.

X. Ji Sheng Shen Qi Wan Modern Research Progress

1. Research on Pharmacological Effects (Kidney Qi Pill)

Modern research shows that Jisheng Shenqi Pills have the effects of regulating kidney function (warms the kidneys and promotes urination), improving water metabolism, and enhancing the body's immunity. Its protective effect on the kidneys may be related to mechanisms such as regulating renal cell apoptosis and improving renal blood circulation.

2. Expansion of Clinical Applications

In addition to the traditional indications, Jisheng Shenqi Pills have also been tried in modern clinical practice to treat some other diseases, such as diabetic nephropathy and osteoporosis. Studies have found that it has a certain effect on improving the renal function of patients with diabetic nephropathy and a certain effect on increasing the bone density of patients with osteoporosis.

3. Research on Dosage Form Improvement

With the development of modern pharmaceutical technology, the research on the dosage form improvement of Jisheng Shenqi Pills is also continuously carried out. In addition to traditional pills and modern concentrated granules, new dosage forms such as capsules and tablets have also been developed to meet the needs of different patients and improve the stability and convenience of taking the medicine.

Ji Sheng Shen Qi Wan Conclusion

Ji Sheng Shen Qi Wan, a modified version of the classic Kidney Qi Pill or Shen Qi Wan, is a traditional formula used for kidney yang deficiency with water retention. It tonifies kidney yang and provides a warming kidney yang effect while promoting urination to resolve water retention, oedema, and regulate water metabolism.

The formula addresses kidney deficiency patterns (which may also involve kidney yin support) and relieves symptoms such as lower back pain, cold limbs, frequent urination, difficult urination, dysuria, and scanty urination. In modern practice, it is applied to chronic kidney disease and hypothyroidism, with noted anti-inflammatory benefits. Key herbs include shu di huang, shan yao, shan zhu yu, fu zi, fu ling, ze xie, che qian zi, and niu xi.

⚠️ This content is for reference only and does not provide medical advice. Consult a healthcare professional for any health concerns.

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