1. Prescription Source & History

1. Origin Background

Powder for Dispelling Swelling and Resolving Indurations It originated from 'Secret Treasury of the Orchid Chamber' written by Li Dongyuan, a famous medical scientist in the Jin and Yuan dynasties. During that era, medicine developed rapidly and various academic theories contended. Li Dongyuan emphasized the crucial role of the spleen and stomach in human health, and most of the formulas he created centered around regulating the spleen and stomach and treating diseases related to them. The emergence of the Powder for Dispelling Swelling and Resolving Indurations was aimed at the treatment needs of some local swelling and ulceration diseases at that time. Under the social environment at that time, people faced various life pressures and disease troubles, and swelling and ulceration diseases were relatively common. Traditional treatment methods were ineffective in some cases, which prompted Li Dongyuan to conduct in-depth research and create this formula.

For example, in medical practice at that time, for lumps and indurations that appeared in areas such as the neck and underarms, there were often lack of effective treatment means, and the patients' conditions dragged on without healing, bringing great pain to their lives. It was precisely based on the attention to these clinical problems that Li Dongyuan summarized the Powder for Dispelling Swelling and Resolving Indurations through long-term clinical practice and theoretical thinking.

2. Historical Inheritance & Development

Since the publication of 'Secret Treasury of the Orchid Chamber', the Powder for Dispelling Swelling and Resolving Indurations has spread in the field of traditional Chinese medicine. Later generations of medical scientists have continuously studied and applied it. During the Ming and Qing dynasties, many medical scientists further explained and developed the formula on the basis of inheriting Li Dongyuan's academic thoughts. Some medical scientists adjusted the dosage of the drugs according to the actual clinical situation to better adapt to the constitutions and conditions of different patients.

For example, when treating some swelling and ulceration diseases caused by emotional stagnation in the Ming Dynasty, it was found that appropriately increasing the dosage of drugs for soothing the liver and regulating qi and using them in combination with the Powder for Dispelling Swelling and Resolving Indurations had better effects. In modern and contemporary times, with the development of traditional Chinese medicine diagnostic techniques and pharmaceutical technologies, the application of the Powder for Dispelling Swelling and Resolving Indurations has become more extensive and in-depth. When modern traditional Chinese medicine clinicians use this formula, combined with modern medical examination means such as ultrasound and CT, they can more accurately judge the condition and use the formula reasonably. At the same time, pharmaceutical enterprises are also improving the dosage forms of the Powder for Dispelling Swelling and Resolving Indurations. In addition to the traditional decoction, granule and pill forms have also been developed to facilitate patients' taking.

2. Composition of Medicinal Flavors

1. Monarch Drug

柴胡 Bupleurum  : Bupleurum plays an important role in soothing the liver and regulating qi, and reconciling the constructive and defensive qi in the Powder for Dispelling Swelling and Resolving Indurations. It can regulate the liver qi, making the liver qi smooth and not stagnant. For swelling and ulceration diseases caused by emotional stagnation and liver qi depression, Bupleurum can fundamentally regulate qi movement. When a patient has a neck lump after getting angry, accompanied by symptoms such as chest and hypochondriac distending pain and depression, Bupleurum can effectively soothe the liver qi and relieve these discomforts. Moreover, Bupleurum also has the function of guiding the meridian and serving as the messenger drug, which can lead other drugs directly to the diseased site. It belongs to the liver and gallbladder meridians and can bring the medicinal power to the areas where the liver and gallbladder meridians circulate. For swelling and ulceration in the areas where the liver and gallbladder meridians circulate such as the neck and underarms, it can better play the therapeutic role.

连翘 Forsythia  : Forsythia has the effects of clearing heat and detoxifying, dissipating swelling and resolving masses. It is a commonly used drug for treating swelling and ulceration, which can clear local heat-toxicity and disperse masses. When there are heat-toxicity symptoms such as redness, swelling, heat and pain in the swelling and ulceration site, Forsythia can quickly play its role. Its nature is cold and cool, which can inhibit the growth and spread of heat-toxicity. For example, for some carbuncles and ulcers caused by the accumulation of heat-toxicity, Forsythia can effectively reduce the inflammatory reaction and promote the dissipation of the mass. It can also enhance the heat-clearing power of the formula and work synergistically with other drugs to jointly achieve the purpose of treating swelling and ulceration.

2. Ministerial Drug

 Scutellaria baicalensis clears heat and dries dampness, purges fire and detoxifies. It can assist the monarch drug to enhance the heat-clearing power and has a good effect on clearing the heat-toxicity in the local area of swelling and ulceration. In the Powder for Dispelling Swelling and Resolving Indurations, Scutellaria baicalensis and Forsythia cooperate to more comprehensively clear heat-toxicity. When the swelling and ulceration are accompanied by symptoms of internal heat-toxicity excess such as fever, bitter taste in the mouth and dryness, Scutellaria baicalensis can effectively relieve these symptoms. It can also dry dampness and prevent the damp pathogen from combining with heat-toxicity and aggravating the condition.

 Coptis chinensis is extremely bitter and cold in nature, with a stronger ability to clear heat and dry dampness, purge fire and detoxify. It can directly counteract the fire, showing excellent therapeutic effects on the condition of exuberant heat-toxicity. In the Scattered Swelling and Resolving Firmness Decoction, Coptis chinensis echoes with Scutellaria baicalensis, further enhancing the effect of clearing heat and purging fire of the formula. For patients with obvious local redness, swelling, heat and pain in the abscess and severe heat-toxicity, Coptis chinensis can quickly relieve the symptoms of heat-toxicity.

3. Assistant Drug

 Phellodendron amurense clears heat and dries dampness, purges fire and detoxifies, and can strengthen yin. It acts synergistically with Scutellaria baicalensis and Coptis chinensis to enhance the efficacy of clearing heat and drying dampness. In the Scattered Swelling and Resolving Firmness Decoction, Phellodendron amurense can prevent heat-toxicity from consuming yin fluid, playing the role of strengthening yin. For some patients with abscesses with a relatively long course and heat-toxicity injuring yin, Phellodendron amurense can protect yin fluid while clearing heat.

 Anemarrhena asphodeloides clears heat and purges fire, nourishes yin and moistens dryness. It can assist the monarch and ministerial drugs in clearing heat and at the same time nourish yin. During the treatment of abscesses, especially in the case of heat-toxicity injuring yin, Anemarrhena asphodeloides can play a good role in nourishing yin and preventing excessive depletion of yin fluid. When combined with Phellodendron amurense, it can better regulate yin and yang in the body.

 Platycodon grandiflorum has the effects of dispersing the lung qi, resolving phlegm, and promoting the discharge of pus. In the Scattered Swelling and Resolving Firmness Decoction, it can carry the drugs upward, enabling the medicinal power to act better on the abscesses in the head, face, neck and other upper parts. At the same time, Platycodon grandiflorum can disperse the lung qi, help regulate qi mechanism, promote local qi and blood circulation, and is beneficial to the dissipation of abscesses.

 Ecklonia kurome softens hardness and dissipates nodules. It can disperse the hard nodules in the abscess site, showing a good softening effect on some relatively hard masses. In the Scattered Swelling and Resolving Firmness Decoction, Ecklonia kurome acts synergistically with other drugs to enhance the power of dissipating nodules of the formula.

 Sparganium stoloniferum breaks blood and promotes qi movement, eliminates accumulation and relieves pain. It can break and disperse stasis of blood, eliminating the stasis obstruction in the abscess site. For some abscesses with local stasis of blood manifestations, such as the mass being dark red in color and the pain being fixed and不移, Sparganium stoloniferum can play the role of promoting blood circulation to remove stasis.

 Curcuma zedoaria breaks blood and promotes qi movement, eliminates accumulation and relieves pain, with similar effects to Sparganium stoloniferum. In the Scattered Swelling and Resolving Firmness Decoction, Curcuma zedoaria and Sparganium stoloniferum are combined to enhance the effects of breaking blood and promoting qi movement, eliminating accumulation and dissipating nodules. When the qi and blood stasis in the abscess site is severe, the mass is large and relatively hard, Curcuma zedoaria and Sparganium stoloniferum can work together.

4. Guide Drug

 Glycyrrhiza uralensis has the effects of invigorating the spleen and replenishing qi, moistening the lungs and relieving cough, clearing heat and detoxifying, and harmonizing all the drugs. In the Scattered Swelling and Resolving Firmness Decoction, Glycyrrhiza uralensis mainly plays the role of harmonizing all the drugs. It can soothe the properties of each drug in the formula, making the drugs coordinate with each other and better play the therapeutic role. At the same time, Glycyrrhiza uralensis can also invigorate the spleen and replenish qi, enhance the function of the spleen and stomach, and contribute to the transportation and absorption of drugs.

III. Pathogenesis, Efficacy and Indications

1. Pathogenesis

Sanz Decoction for Resolving Swelling and Promoting Ulceration and Strengthening Resistance The pathogenesis it targets is mainly the accumulation of heat-toxin, qi and blood stasis, and phlegm-dampness condensation. The invasion of pathogenic heat-toxin into the human body can lead to poor local qi and blood circulation, and then form blood stasis. At the same time, heat-toxin decocts body fluids to produce phlegm-dampness. These pathological factors bind together and accumulate locally, resulting in the formation of swelling ulcers.

For example, emotional discomfort and liver depression transforming into fire can lead to the endogenous generation of heat-toxin. The heat-toxin disturbs upwards along the meridians and knots in areas such as the neck and underarms. The qi and blood circulation is blocked, forming masses. If the patient usually has improper diet, overeating fatty and sweet foods, damaging the spleen and stomach, the spleen and stomach transportation and transformation malfunction, endogenous dampness turbidity is generated, and dampness accumulates into phlegm. The phlegm combines with heat-toxin and blood stasis, aggravating the condition of swelling ulcers.

2. Efficacy

Sanz肿溃坚汤 has the comprehensive effects of clearing heat and detoxifying, dissipating swelling and resolving nodules, promoting blood circulation to remove blood stasis, and resolving phlegm and softening hardness. Clearing heat and detoxifying can remove pathogenic heat-toxin locally and relieve symptoms such as redness, swelling, heat, and pain. Dissipating swelling and resolving nodules can gradually disperse the swelling ulcers and reduce the size of the masses. Promoting blood circulation to remove blood stasis can improve local qi and blood stasis, promote blood circulation, enable the medicine to better reach the diseased site, and also contribute to the absorption of swelling ulcers. Resolving phlegm and softening hardness can eliminate phlegm-dampness condensation, soften the masses, make the hard masses gradually become soft and easy to disperse.

3. Indications

Sanz肿溃坚汤 is mainly used to treat Madao Jia猀, mostly caused by stagnation of the qi of the Foot-Shaoyang Gallbladder Meridian and accumulation of phlegm-dampness. Symptoms include masses appearing under the ear or in front of and behind the ear, as hard as a stone, immovable when pushed, unchanged skin color, no local heat or pain or slightly painful, no obvious systemic symptoms, but may be accompanied by bitter taste in the mouth, dryness, dizziness, fullness and discomfort in the chest and hypochondrium, and a taut and rapid pulse.

For diseases such as cervical tuberculosis, thyroid nodules, and breast hyperplasia nodules in modern medicine, if there are similar symptoms above and the syndrome differentiation belongs to the accumulation of heat-toxin, qi and blood stasis, and phlegm-dampness condensation, Sanz肿溃坚汤 can be used as a reference for treatment.

IV. Analysis of San Zhong Kui Jian Tang

1. Overall Compatibility Idea

Sanz Decoction for Resolving Swelling and Promoting Ulceration and Strengthening the Resistance The compatibility idea is to target the pathogenesis of swelling ulcers and comprehensively use various drugs for treatment. Based on heat-clearing and detoxifying drugs, pathogenic heat-toxin is removed to control the development of the disease. On this basis, drugs for promoting blood circulation to remove blood stasis are compatible to improve local qi and blood stasis and promote blood circulation. At the same time, drugs for resolving phlegm and softening hardness are added to eliminate phlegm-dampness condensation and soften the masses. Together with drugs for soothing the liver and regulating qi, the qi movement is regulated, so that qi movement promotes blood movement and qi smoothness eliminates phlegm, contributing to the dissipation of swelling ulcers.

For example, the monarch drug Bupleuri Radix soothes the liver and regulates qi, can regulate qi movement, and creates a good qi and blood circulation environment for other drugs to exert their effects. Heat-clearing and detoxifying drugs such as Forsythiae Fructus, Scutellariae Radix, and Coptidis Rhizoma directly clear away heat and toxins, which are the key to controlling the inflammatory reaction of swelling and ulceration. Promoting blood circulation and removing stasis drugs such as Sparganii Rhizoma and Curcumae Rhizoma synergistically act with heat-clearing and detoxifying drugs. On the one hand, they can promote the discharge of heat and toxins, and on the other hand, they can improve local blood circulation, enhance drug penetration and absorption. Phlegm-resolving and hard mass softening drugs and drugs that guide the drug upward such as Laminariae Thallus and Platycodonis Radix can assist other drugs to better act on the swelling and ulceration site. The whole formula is rigorously formulated, and each drug cooperates with each other to jointly achieve the purpose of treating swelling and ulceration.

2. Drug Synergistic Effect

Bupleuri Radix and Forsythiae Fructus act synergistically. Bupleuri Radix soothes the liver and regulates qi, making qi movement smooth, which is conducive to the better exertion of heat-clearing and detoxifying drugs such as Forsythiae Fructus. At the same time, the power of Forsythiae Fructus to clear away heat and toxins also helps to relieve the heat and toxin symptoms caused by liver depression transforming into fire. Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex, and Anemarrhenae Rhizoma cooperate with each other to enhance the effects of clearing heat and purging fire, nourishing yin and moistening dryness. Sparganii Rhizoma, Curcumae Rhizoma, and Laminariae Thallus act synergistically. Sparganii Rhizoma and Curcumae Rhizoma break blood and promote qi movement, dissipate stasis and relieve pain, and Laminariae Thallus softens hardness and dissipates nodules. The three act together to effectively eliminate blood stasis, qi stagnation, and lumps in the swelling and ulceration site. Platycodonis Radix guides the drug upward and synergistically acts with other drugs, making the drug power better act on the swelling and ulceration sites such as the head, face, and neck. Glycyrrhizae Radix regulates various drugs, can relieve the properties of other drugs, and makes the drug power of the whole formula more gentle.

V. Comparison with Other Similar Prescriptions

1. Comparison with Wuwei Xiaodu Yin

Wuweixiaodu Decoction is mainly composed of Flos Lonicerae, Flos Chrysanthemi Indici, Herba Taraxaci, Herba Violae, and Herba Semiaquilegiae Adoxoidis, and its main effect is to clear away heat and toxins. It focuses on treating carbuncles and ulcers with intense heat-toxin, and has a significant effect on the situation with obvious local redness, swelling, heat, and pain and prominent heat-toxin symptoms. Its drug power is relatively strong and mainly aims to quickly clear away heat and toxins.

Sanzhong Kuijian Decoction not only has the effect of clearing away heat and toxins, but also takes into account promoting blood circulation and removing stasis, resolving phlegm and softening hard masses, and soothing the liver and regulating qi. It is more applicable to the situation of swelling and ulceration accompanied by various pathological factors such as qi and blood stasis, phlegm-dampness aggregation, and liver qi stagnation. Wuweixiaodu Decoction has a relatively simple drug composition and mainly targets heat and toxins; while Sanzhong Kuijian Decoction has a complex drug composition and can comprehensively regulate various pathogenesis factors of swelling and ulceration.

2. Comparison with Xiaoyao San

Xiaoyao Powder's main effects are to soothe the liver and relieve depression, nourish blood and strengthen the spleen, and is composed of Bupleuri Radix, Angelicae Sinensis Radix, Paeoniae Radix Alba, Atractylodis Macrocephalae Rhizoma, Poria, Glycyrrhizae Radix Preparata, Menthae Haplocalycis Herba, and Zingiberis Rhizoma Recens. It focuses on regulating liver depression and spleen deficiency, and has a good therapeutic effect on symptoms such as chest and hypochondriac distending pain, irregular menstruation, and loss of appetite caused by emotional discomfort and liver qi stagnation.

Although Sanzhong Kuijian Decoction also has Bupleuri Radix to soothe the liver and regulate qi, it mainly targets the swelling and ulceration diseases caused by liver depression transforming into fire and heat-toxin accumulation. Xiaoyao Powder mainly regulates liver depression and the functions of the spleen and stomach, while Sanzhong Kuijian Decoction, on the basis of soothing the liver and regulating qi, focuses on the effects of clearing away heat and toxins, detumescence and dissipating nodules, promoting blood circulation and removing stasis, and resolving phlegm and softening hard masses for treating swelling and ulceration.

VI. San Zhong Kui Jian Tang Clinical Applications & Indications

1. Neck Diseases

For scrofula in the neck, if the patient shows single or multiple masses in the neck, with a relatively hard texture, unchanged skin color, accompanied by yin deficiency symptoms such as low fever in the afternoon, night sweats, and fatigue, as well as liver depression symptoms such as bitter taste and dry mouth, chest and hypochondriac distending pain, Sanzhong Kuijian Decoction can be used for syndrome differentiation. Drugs such as Bupleuri Radix and Scutellariae Radix in the formula can soothe the liver and clear heat, heat-clearing and detoxifying drugs such as Forsythiae Fructus and Coptidis Rhizoma can control the inflammatory reaction of the tuberculosis focus, Sparganii Rhizoma and Curcumae Rhizoma promote blood circulation and remove stasis, and Laminariae Thallus softens hardness and dissipates nodules, which helps to dissipate the tuberculous nodules.

For patients with thyroid nodules, if the nodules have a relatively hard texture and are accompanied by symptoms such as emotional discomfort, irritability, bitter taste and dry mouth, Sanzhong Kuijian Decoction can also be applied. By regulating emotions, soothing the liver and regulating qi, combined with the effects of clearing away heat and toxins, softening hardness and dissipating nodules, the condition of thyroid nodules can be improved.

2. Breast Diseases

For patients with breast hyperplasia nodules, if there are symptoms such as breast distending pain, the mass being relatively hard in texture, changing with the menstrual cycle, accompanied by emotional depression, fullness and distension in the chest and hypochondrium, etc., the Sanzhong Kuijian Decoction has a certain therapeutic effect. Bupleurum in the formula can soothe the liver and regulate qi, relieve breast distending pain; Sparganium and Rhizoma Curcumae can promote blood circulation to remove blood stasis; Ecklonia kurome can soften hardness and dissipate nodules, which can improve the condition of breast hyperplasia nodules.

For patients with breast fibroids, if the tumor is small and hard in texture, accompanied by symptoms such as emotional discomfort and irregular menstruation, the Sanzhong Kuijian Decoction can also be considered. The formula can improve the local state of qi and blood stasis and phlegm-dampness aggregation through its comprehensive effects, and play a certain conditioning role on breast fibroids.

VII. San Zhong Kui Jian Tang Modifications

1. More Severe Heat Toxin

If the heat-toxin is relatively strong and there are obvious local redness, swelling, heat and pain, the dosage of heat-clearing and detoxifying drugs such as Forsythia suspensa, Coptis chinensis and Scutellaria baicalensis can be increased. The dosage of Forsythia suspensa can be increased to 15g, and the dosages of Coptis chinensis and Scutellaria baicalensis can each be increased to 12g. Lonicera japonica and Taraxacum mongolicum can also be added to enhance the effect of clearing heat and detoxifying, better control the symptoms of heat-toxin, and relieve local inflammatory reactions.

2. More Severe Blood Stasis

When the blood stasis is relatively heavy, the mass is dark red in color and the pain is severe, the dosages of Sparganium and Rhizoma Curcumae can be increased. The dosage of Sparganium can be increased to 10g, and the dosage of Rhizoma Curcumae can be increased to 10g. At the same time, drugs promoting blood circulation to remove blood stasis such as Salvia miltiorrhiza and Paeonia lactiflora are added to enhance the power of promoting blood circulation to remove blood stasis, improve the local blood stasis condition, and promote the dissipation of the mass.

3. Excessive Phlegm-Dampness

If the phlegm-dampness is relatively strong, the mass is relatively soft in texture, accompanied by symptoms such as chest distress and excessive phlegm, drugs resolving phlegm such as Pinellia ternata, Citrus reticulata and Fritillaria thunbergii can be added. The dosage of Pinellia ternata can be increased to 9g, the dosage of Citrus reticulata can be increased to 9g, and the dosage of Fritillaria thunbergii can be increased to 12g to enhance the effect of resolving phlegm and softening hardness, eliminate phlegm-dampness aggregation, and make the mass easier to dissipate.

4. Obvious Yin Deficiency

For obvious yin deficiency, with symptoms such as dry mouth, dry throat, red tongue with little coating, drugs nourishing yin such as Rehmannia glutinosa, Ophiopogon japonicus and Scrophularia ningpoensis can be added. The dosage of Rehmannia glutinosa can be increased to 15g, the dosage of Ophiopogon japonicus can be increased to 12g, and the dosage of Scrophularia ningpoensis can be increased to 12g to nourish yin fluid, prevent heat-toxin from injuring yin, and at the same time contribute to the recovery of the swelling.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional Method

The traditional usage of the Sanzhong Kuijian Decoction is to soak the medicinal slices in water, boil them with strong fire first, and then simmer them with slow fire. Generally, each dose of medicine is decocted twice. For the first time, add an appropriate amount of water, soak for about 30 minutes, decoct until 200 - 300 ml, and filter out the medicinal liquid; for the second time, add an appropriate amount of water, decoct until 150 - 200 ml, filter out the medicinal liquid, and the two medicinal liquids are mixed and taken in two doses, once in the morning and once in the evening.

For example, the formula composed of 12g of Bupleurum, 15g of Forsythia suspensa, 9g of Scutellaria baicalensis, 6g of Coptis chinensis, 9g of Phellodendron amurense, 12g of Anemarrhena asphodeloides, 6g of Platycodon grandiflorum, 12g of Ecklonia kurome, 6g of Sparganium, 6g of Rhizoma Curcumae and 6g of Glycyrrhiza uralensis is decocted and taken according to the above method.

2. Modern Concentrated Granules

Modern concentrated granules are granule preparations made from traditional Chinese medicines through processes such as extraction and concentration. When using, just take the appropriate amount of granules with boiling water according to the instructions. For the concentrated granules of Sanzhong Kuijian Decoction, generally each dose is equivalent to the dosage of traditional cut herbs, and it is taken twice, once in the morning and once in the evening. Modern concentrated granules retain the active ingredients of traditional Chinese medicines, with accurate dosages, which are convenient for patients to carry and take.

IX. Precautions and Taboos

1. Dietary Taboos

During the period of taking Sanzhong Kuijian Decoction, it is necessary to avoid eating spicy, greasy and stimulating foods. Spicy foods such as chili peppers and Chinese prickly ash are likely to help generate fire and heat, exacerbate the symptoms of heat-toxin, and are not conducive to the treatment of swelling ulcers. Greasy foods such as fried foods and fatty meats are not easy to digest, can increase the burden on the spleen and stomach, and affect the absorption and transportation of drugs. Stimulating foods such as strong tea and so on may interact with drugs and affect the drug efficacy.

2. Emotional Regulation

Patients should keep their mood comfortable and avoid excessive emotions. Because emotional discomfort can lead to stagnation of liver qi and exacerbate the condition. For example, long-term anxiety and depression can cause stagnation of liver qi, transformation of qi stagnation into fire, and endogenous heat-toxin, which is not conducive to the dissipation of swelling ulcers. Patients can regulate their emotions by listening to music, taking walks, reading, etc., maintain a peaceful mindset, and actively cooperate with the treatment.

3. Special Populations

Pregnant women should use Sanzhong Kuijian Decoction with caution. Because drugs such as Sparganium and Curcuma zedoaria in the formula have the effects of promoting blood circulation and activating qi, which may have adverse effects on the fetus. The elderly, the weak, and those with deficiency-cold of the spleen and stomach should appropriately adjust the dosage of drugs when using, appropriately reduce the dosage of heat-clearing and detoxifying drugs, such as Coptis chinensis and Scutellaria baicalensis can be appropriately reduced, and at the same time add some drugs for strengthening the spleen and replenishing qi, such as Codonopsis pilosula and Atractylodes macrocephala, to protect the function of the spleen and stomach.

X. Modern Research Progress

1. Pharmacological Research

Modern pharmacological studies have shown that Bupleurum in Sanzhong Kuijian Decoction has anti-inflammatory effects and can reduce inflammatory reactions. Components such as saikosaponin contained in it can regulate the immune function of the body. Forsythia suspensa has antibacterial and antiviral effects and can inhibit the growth and reproduction of various bacteria and viruses. Components such as phillyrin contained in it have a certain inhibitory effect on the release of inflammatory mediators. Heat-drying and dampness-clearing drugs such as Scutellaria baicalensis, Coptis chinensis, and Phellodendron amurense have antibacterial, anti-inflammatory, antipyretic and other effects, can inhibit various pathogenic bacteria, and reduce symptoms such as swelling, redness, heat and pain caused by inflammation.

Blood-activating and stasis-dispelling drugs such as Sparganium and Curcuma zedoaria can improve hemorheological indexes, reduce blood viscosity, promote blood circulation, increase local blood flow, and are conducive to the penetration and absorption of drugs. Softening and resolving hard masses drugs such as Ecklonia kurome contain various minerals and amino acids and other components, which may have the effect of regulating local tissue metabolism and promoting the dissipation of masses. Licorice has the effects of regulating immunity, anti-inflammatory, anti-allergic, etc., can enhance the resistance of the body, and reduce the adverse reactions of drugs.

2. Clinical Research

In recent years, there have been many clinical research reports on the curative effects of Sanzhong Kuijian Decoction in the treatment of diseases such as scrofula of the neck and breast hyperplasia nodules. Some studies have shown that Sanzhong Kuijian Decoction combined with anti-tuberculosis drugs in the treatment of scrofula of the neck can improve the cure rate, shorten the course of treatment, and reduce the recurrence rate of tuberculosis lesions. In the treatment of breast hyperplasia nodules, Sanzhong Kuijian Decoction can significantly relieve the symptoms of breast distending pain, reduce the size of breast hyperplasia nodules, and improve the quality of life of patients.

For example, a clinical study on 50 patients with scrofula of the neck divided the patients into two groups. One group was treated with Sanzhong Kuijian Decoction combined with anti-tuberculosis drugs, and the other group was treated with anti-tuberculosis drugs alone. The results showed that the cure rate of the combined treatment group was significantly higher than that of the single drug treatment group, and the negative conversion rate of tuberculin test in patients after treatment was higher, indicating that Sanzhong Kuijian Decoction has a positive effect in the treatment of scrofula of the neck. These clinical studies provide a strong basis for the further application and promotion of Sanzhong Kuijian Decoction.

Summary of Modified Sanzhong Kuijian Decoction

The Scattering Swelling and Resolving Firmness Decoction (Modified Scattering Swelling and Resolving Firmness Decoction) is from 'Secret Collection of the Orchid Chamber' and 'Collection of Insights into Medicine', and is a classic formula for treating scrofula (including sabre-like carbuncles), applicable to disorders of the Hand-Shaoyang, Foot-Shaoyang, and Foot-Yangming meridians. For patients with scrofula all over the body, the nodules are hard as stones, joined together, purplish-red, hard as a board, and even discharging pus and fluid, and the pulse is mostly forceful and rapid. This formula has the functions of dissipating firmness and swelling, clearing heat and resolving nodules, softening hardness and dissipating nodules, purging fire and detoxifying, and detoxifying and ascending yang. The main herbs include Forsythia suspensa (3 qian of Forsythia suspensa), Cimicifuga foetida (3 qian of Cimicifuga foetida), Ecklonia kurome, Platycodon grandiflorum, Gleditsia sinensis spine, Paeonia lactiflora, Glycyrrhiza glabra, Bupleurum chinense, Gentiana scabra, Curcuma zedoaria, Pueraria lobata, Angelica sinensis tip, Trichosanthes kirilowii root, Coptis chinensis, Phellodendron amurense, Scutellaria baicalensis, Portulaca oleracea, etc. It is decocted with yuan wine or water, and has good curative effect on scrofula.