1. Prescription Source & History

1. Ancient Classics Inheritance

The Xiangsha Yangwei Decoction is derived from the classic formula theory of traditional Chinese medicine and has gradually taken shape in long-term clinical practice. It embodies the wisdom and experience of ancient physicians in treating spleen and stomach diseases. In the development process of traditional medicine, the spleen and stomach are regarded as the foundation of acquired constitution and the source of qi and blood production, which is crucial for human health. Many physicians have been committed to researching formulas for regulating the spleen and stomach, and the Xiangsha Yangwei Decoction is one of the outstanding ones.

2. Historical Evolution

It has a long history and has been passed down and developed through multiple dynasties. With the changes of the times and the accumulation of clinical practice, the composition and application of the formula have been continuously optimized. From its initial prototype to the mature formula widely used today, the Xiangsha Yangwei Decoction has played an important role in treating spleen and stomach diseases and witnessed the continuous progress of traditional Chinese medicine formula science.

2. Composition of Medicinal Flavors

1. Monarch Drug

- Aucklandiae Radix

Aucklandiae Radix has the effects of promoting qi circulation to relieve pain and strengthening the spleen to promote digestion. It can promote qi circulation in the gastrointestinal tract and is a key herb for promoting qi circulation to relieve pain. In the Xiangsha Yangwei Decoction, Aucklandiae Radix can enhance the transportation and transformation function of the spleen and stomach, and eliminate discomfort symptoms such as distension and pain caused by qi stagnation. Its pungent and fragrant nature can guide all herbs to reach the disease location and make the qi of the spleen and stomach flow smoothly.

- Amomi Fructus

Amomi Fructus can promote digestion by resolving dampness, warm the spleen to stop diarrhea, and regulate qi to prevent miscarriage. It is good at awakening the spleen and harmonizing the stomach, promoting qi circulation and resolving dampness, and has a good conditioning effect on symptoms such as loss of appetite, nausea and vomiting caused by deficiency-cold of the spleen and stomach and dampness obstruction with qi stagnation. The strong aroma of Amomi Fructus can enhance the power of aromatic dampness resolution of the formula and restore the transportation and transformation function of the spleen and stomach.

2. Ministerial Drug

- Atractylodes macrocephala

Atractylodes macrocephala invigorates the spleen and replenishes qi, dries dampness and promotes diuresis. It is a commonly used herb for invigorating the spleen, enhancing the transportation and transformation functions of the spleen and stomach, and promoting the transportation and transformation of water-dampness. For the retention of water-dampness caused by spleen-stomach weakness and abnormal transportation and transformation, Atractylodes macrocephala can play a key regulatory role, gradually restoring the normal function of the spleen and stomach and expelling water-dampness.

- Tangerine peel

Tangerine peel regulates qi and invigorates the spleen, dries dampness and resolves phlegm. It can promote the qi movement of the spleen and stomach, relieve distension, and has a good relieving effect on symptoms such as abdominal distension and belching caused by qi stagnation in the spleen and stomach. At the same time, the effect of drying dampness and resolving phlegm of tangerine peel also helps to improve the endogenous phlegm-dampness caused by abnormal transportation and transformation of the spleen and stomach.

3. Assistant Drug

- Poria cocos

Poria cocos promotes diuresis and percolates dampness, invigorates the spleen, and calms the mind. It can percolate and expel water-dampness, allowing the pathogenic dampness to be excreted through urine and reducing the burden on the spleen and stomach. Poria cocos can also invigorate the spleen and assist Atractylodes macrocephala in enhancing the effect of invigorating the spleen. For those with spleen-stomach weakness accompanied by retention of water-dampness, Poria cocos plays an important synergistic therapeutic role.

- Pinellia ternata

Pinellia ternata dries dampness and resolves phlegm, suppresses vomiting and counteracts adverse qi, dissipates masses and relieves stagnation. In Xiangsha Yangwei Decoction, Pinellia ternata can dry dampness and resolve phlegm, relieving the symptoms of phlegm-dampness blockage caused by abnormal transportation and transformation of the spleen and stomach. Its effect of suppressing vomiting and counteracting adverse qi can improve manifestations such as nausea and vomiting due to adverse rising of stomach qi, and helps to restore the normal ascending and descending functions of the spleen and stomach.

- Cyperus rotundus

Cyperus rotundus soothes the liver and regulates qi, alleviates pain associated with menstruation. It can soothe the liver and regulate qi, and has a certain conditioning effect on the situation where stagnation of liver qi caused by emotional discomfort affects the transportation and transformation functions of the spleen and stomach. Cyperus rotundus can make the liver qi smooth, and the qi mechanism of the spleen and stomach also becomes smooth accordingly, playing an auxiliary role in assisting the monarch and ministerial herbs to regulate the spleen and stomach.

4. Messenger Drug

- Glycyrrhiza glabra

Glycyrrhiza glabra invigorates the spleen and replenishes qi, moistens the lungs and relieves cough, clears heat and detoxifies, and harmonizes all the herbs. It can harmonize the properties of various herbs in the formula, making the herbs synergistic with each other and exerting a better therapeutic effect. Glycyrrhiza glabra can also invigorate the spleen and replenish qi, enhancing the functions of the spleen and stomach, and playing a role in harmonizing and strengthening the healthy qi in the whole formula.

Pathogenesis, Efficacy & Indications

1. Pathogenesis

Xiangsha Yangwei Decoction The pathogenesis it targets is mainly deficiency-cold in the spleen and stomach, dampness obstruction and qi stagnation. The spleen and stomach are the foundation of acquired constitution. If the yang qi of the spleen and stomach is insufficient, endogenous cold pathogens will occur, and the transportation and transformation functions will be weakened, which easily leads to stagnation of water and dampness; factors such as emotional discomfort and improper diet can cause qi stagnation, further加重 the burden of the spleen and stomach. This pathological state of mutual influence between deficiency-cold in the spleen and stomach and dampness obstruction and qi stagnation is the root cause of various spleen and stomach diseases.

2. Efficacy

- Warming the middle-jiao and harmonizing the stomach

Through the synergistic effect of drugs such as Aucklandia lappa, Amomum villosum, Atractylodes macrocephala, and Citrus reticulata in the prescription, it warms the yang qi of the spleen and stomach, enhances the transportation and transformation function of the spleen and stomach, improves the deficiency-cold of the spleen and stomach, and restores the normal digestion and absorption ability.

- Promote qi circulation to relieve pain

For symptoms such as abdominal distension and pain caused by qi stagnation, qi-regulating drugs such as Aucklandia lappa and Cyperus rotundus in the prescription can promote qi circulation in the stomach and intestines, eliminate pain, and make the qi mechanism smooth.

- Resolve dampness and arouse the spleen

Drugs such as Poria cocos and Pinellia ternata can percolate and promote the excretion of dampness, dry dampness and resolve phlegm, improve the internal retention of dampness and the blockage of phlegm-dampness caused by abnormal transportation and transformation of the spleen and stomach, and thus play the role of resolving dampness and arousing the spleen, gradually restoring the function of the spleen and stomach.

3. Indications

Xiangsha Yangwei Decoction It is mainly used to treat symptoms such as epigastric distending pain, fullness and discomfort, vomiting sour water, and loss of appetite caused by deficiency-cold of the spleen and stomach and dampness obstruction with qi stagnation. Clinically, it is commonly seen in diseases such as chronic gastritis, gastric ulcer, and dyspepsia. As long as the syndrome differentiation belongs to the above pathogenesis, this prescription can be used for conditioning.

Analysis of Xiangsha Yangwei Decoction

1. Regulating Spleen Deficiency Cold

In the formula, drugs such as Aucklandiae Radix, Amomi Fructus Villosae, Atractylodis Macrocephalae Rhizoma, and Citri Reticulatae Pericarpium act together to warm the yang qi of the spleen and stomach. Aucklandiae Radix and Amomi Fructus Villosae promote qi circulation and relieve pain, which can improve the pain symptoms caused by qi stagnation in the spleen and stomach and also contribute to the movement of yang qi. Atractylodis Macrocephalae Rhizoma invigorates the spleen and benefits qi, enhancing the transportation and transformation function of the spleen and stomach, providing a material basis for the restoration of yang qi in the spleen and stomach. Citri Reticulatae Pericarpium regulates qi and strengthens the spleen, assisting in enhancing the qi movement and transportation in the spleen and stomach, thus improving spleen and stomach yang deficiency and cold.

2. Resolving Dampness & Qi Stagnation

Poria, Pinelliae Rhizoma recens percolate and drain dampness, dry dampness and resolve phlegm, eliminating the dampness and phlegm generated by abnormal transportation and transformation in the spleen and stomach. Cyperi Rotundi Rhizoma soothes the liver and regulates qi, relieving the impact of liver qi stagnation caused by emotional factors on the spleen and stomach, making the qi movement smooth. These drugs cooperate with each other to jointly resolve the pathological state of dampness obstruction and qi stagnation and restore the normal functions of the spleen and stomach.

3. Drug Synergistic Effect

Glycyrrhizae Radix et Rhizoma harmonizes all the drugs in the formula, making the medicinal properties of each drug in the formula coordinate with each other and exert a better therapeutic effect. It also invigorates the spleen and benefits qi, assisting Atractylodis Macrocephalae Rhizoma to enhance the function of strengthening the spleen. While regulating spleen and stomach yang deficiency and dampness obstruction and qi stagnation, the whole formula takes into account strengthening the healthy qi and promotes the overall restoration of spleen and stomach functions.

V. Comparison with Other Similar Formulas

1. Similarities and Differences with Xiangsha Liujunzi Decoction

- Similarities

The Xiangsha Liujunzi Decoction also has the effects of strengthening the spleen and harmonizing the stomach, regulating qi and resolving phlegm, and has certain similarities with the Xiangsha Yangwei Decoction in the treatment of spleen and stomach diseases. Both formulas contain drugs such as Aucklandiae Radix, Amomi Fructus Villosae, Atractylodis Macrocephalae Rhizoma, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma, and both focus on regulating spleen and stomach functions.

- Differences

The Xiangsha Liujunzi Decoction Is more prominent in strengthening the spleen and benefiting qi, focusing on treating spleen qi deficiency complicated with internal obstruction of phlegm-dampness. While the Xiangsha Yangwei Decoction emphasizes warming the middle-jiao and harmonizing the stomach, regulating qi and relieving pain, and promoting the spleen to resolve dampness and awaken the spleen, and is more targeted at the symptoms of spleen and stomach yang deficiency and dampness obstruction and qi stagnation. The Xiangsha Yangwei Decoction contains drugs such as Pinelliae Rhizoma recens and Poria, and its effects of drying dampness and resolving phlegm, promoting diuresis and draining dampness are more obvious to cope with the pathogenesis of dampness obstruction and qi stagnation.

2. Differences from Lizhong Decoction

- Lizhong Decoction

The main effects of Lizhong Decoction are warming the middle-jiao to dispel cold and tonifying qi to strengthen the spleen, and it is used to treat the syndrome of deficiency-cold of the spleen and stomach.

- Differences

Compared with Lizhong Decoction, Xiangsha Yangwei Decoction pays more attention to regulating qi and resolving dampness on the basis of warming the middle-jiao and strengthening the spleen of Lizhong Decoction. In Xiangsha Yangwei Decoction, drugs for regulating qi such as Aucklandia lappa, Amomum villosum, Citrus reticulata, and Cyperus rotundus are added, which can better relieve the symptoms of qi stagnation. At the same time, the presence of drugs for resolving dampness such as Poria cocos and Pinellia ternata enables the formula to effectively deal with the situation of damp obstruction while regulating the deficiency-cold of the spleen and stomach, while Lizhong Decoction relatively focuses on the simple regulation of the deficiency-cold of the spleen and stomach.

VI. Clinical Applications and Indications

1. Chronic Gastritis

For patients with chronic gastritis, if they present with symptoms such as distending pain in the epigastrium, fullness and discomfort, loss of appetite, and tastelessness in the mouth, and the syndrome differentiation belongs to deficiency-cold of the spleen and stomach, damp obstruction and qi stagnation, Xiangsha Yangwei Decoction is a commonly used treatment formula. Through the functions of warming the middle-jiao and harmonizing the stomach, regulating qi to stop pain, and resolving dampness to arouse the spleen, it can relieve the discomfort symptoms of patients, promote the repair of gastric mucosa, and improve the digestive function of the stomach.

2. Gastric Ulcer

Patients with gastric ulcer often have symptoms such as epigastric pain, acid regurgitation, and belching. During the remission period of the disease, if there is a pathogenesis of deficiency-cold of the spleen and stomach, damp obstruction and qi stagnation, Xiangsha Yangwei Decoction can be used as a conditioning formula. It can regulate the functions of the spleen and stomach, enhance the resistance of the spleen and stomach, reduce the stimulation of gastric acid on the gastric mucosa, and promote the healing of the ulcer surface.

3. Dyspepsia

Patients with dyspepsia often present with symptoms such as abdominal distension, loss of appetite, nausea, and vomiting. Xiangsha Yangwei Decoction can warm the middle-jiao and harmonize the stomach, regulate qi and promote digestion, improve the transportation and transformation functions of the spleen and stomach, promote the digestion and absorption of food, and relieve the symptoms of dyspepsia.

VII. Modifications

1. Severe stomach pain

Rhizoma Corydalis and Fructus Toosendan can be added to enhance the effect of regulating qi and relieving pain. Rhizoma Corydalis can promote blood circulation, activate qi and relieve pain, and Fructus Toosendan can disperse the stagnated liver qi, clear heat and relieve pain. The combination of the two can effectively relieve the symptoms of epigastric pain.

2. Obvious acid regurgitation

Os Sepiae and Concha Arcae can be added to relieve pain by regulating acidity. Both Os Sepiae and Concha Arcae have the effect of regulating acidity, can neutralize gastric acid, reduce the stimulation of gastric acid on the gastric mucosa, and relieve the symptom of acid regurgitation.

3. Heavier dampness

Herba Pogostemonis and Herba Eupatorii can be added to enhance the power of resolving dampness. Both Herba Pogostemonis and Herba Eupatorii have the efficacy of aromatic dampness resolution, can effectively remove damp pathogens in the body, and improve the condition of damp obstruction in the spleen and stomach.

4. Obvious spleen - stomach qi deficiency

Radix Codonopsis and Radix Astragali can be added to enhance the effect of strengthening the spleen and replenishing qi. Radix Codonopsis and Radix Astragali are commonly used qi-tonifying drugs, can enhance the transport and transformation functions of the spleen and stomach, improve the resistance of the body, and have a good conditioning effect on patients with qi deficiency of the spleen and stomach.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional method

- Preparation of medicinal materials

Prepare medicinal materials such as Aucklandiae Radix, Amomi Fructus Villosi, Atractylodis Macrocephalae Rhizoma, Citri Reticulatae Pericarpium, Poria, Pinelliae Rhizoma, Cyperi Rhizoma, Glycyrrhizae Radix et Rhizoma, and accurately weigh them according to the composition ratio of the prescription.

- Decoction and administration method

After washing the medicinal materials, soak them in water for about 30 minutes, then bring to a boil over high heat, and then change to low heat and simmer for 30 - 40 minutes. Generally, one dose of medicine is taken twice, once in the morning and once in the evening. Pay attention to the moderate temperature when taking it to avoid overheating or overcooling from stimulating the gastrointestinal tract.

2. Modern concentrated granule Chinese patent medicine

- Administration method

Modern concentrated granules are relatively convenient to take. Generally, according to the dosage in the instruction manual, just take it with an appropriate amount of boiling water. Usually, it is also one dose per day, taken twice.

- Advantages

Modern concentrated granules maintain the efficacy of traditional prescriptions and have the advantages of being easy to carry and convenient to take. For modern people with a fast-paced life, it is more suitable for daily conditioning of spleen and stomach diseases.

IX. Precautions and Taboos

1. Dietary Taboos

During the period of taking Xiangsha Yangwei Decoction, it is necessary to avoid eating stimulating foods such as raw and cold, greasy, and spicy foods. Raw and cold foods are likely to damage the yang qi of the spleen and stomach, greasy foods are not easy to digest and will increase the burden on the spleen and stomach, and spicy foods may stimulate the gastrointestinal tract and affect the efficacy of the medicine.

2. Emotional Regulation

Keep your mood comfortable and avoid emotional distress. Because emotional factors can lead to stagnation of liver qi, which in turn affects the transportation and transformation functions of the spleen and stomach and is not conducive to the recovery of diseases.

3. Special Populations

Pregnant women should use Xiangsha Yangwei Decoction with caution because the formula contains some qi-regulating drugs, which may have a certain impact on the fetus. When children, the elderly, and those with weak constitutions take it, the dosage should be adjusted under the guidance of a doctor.

Research Progress in Modern Times

1. Pharmacological Research

Modern research shows that the drugs in Xiangsha Yangwei Decoction have various pharmacological effects. Qi-regulating drugs such as Aucklandia lappa and Amomum villosum can promote gastrointestinal peristalsis, enhance gastrointestinal emptying ability, and improve gastrointestinal motility disorders; spleen-strengthening drugs such as Atractylodes macrocephala and Poria cocos can regulate the secretion of gastrointestinal digestive juices, enhance the activity of digestive enzymes, and improve digestive function; drugs for drying dampness and resolving phlegm such as Pinellia ternata have a certain inhibitory effect on gastrointestinal inflammation and can reduce inflammatory reactions.

2. Clinical Efficacy Verification

A large number of clinical studies have confirmed that Xiangsha Yangwei Decoction has significant curative effects in the treatment of diseases related to deficiency-cold of the spleen and stomach and stagnation of dampness and qi. It can effectively relieve symptoms such as epigastric distending pain, fullness and discomfort, nausea and vomiting, and improve the quality of life of patients. For diseases such as chronic gastritis and gastric ulcer, it has a positive effect on improving symptoms and promoting the repair of gastric mucosa, and has high safety.

3. Dosage Form Improvement

With the development of modern technology, the dosage form improvement of Xiangsha Yangwei Decoction is constantly carried out. In addition to the traditional decoction and modern concentrated granules, new dosage forms such as capsules and pills have also been developed. While maintaining the efficacy, these new dosage forms further improve the stability and convenience of taking the drug, providing more choices for patients.

Summary of Xiangsha Yangwei Pills

Xiangsha Yangwei Decoction (Xiangsha Yangwei Pills) is a commonly used formula in traditional Chinese medicine for warming the middle-jiao and harmonizing the stomach, strengthening the spleen and resolving phlegm. It is applicable to syndromes such as dull pain in the stomach, gastric burning, stuffiness and discomfort in the epigastrium, noisy discomfort, vomiting sour water, loss of appetite, anorexia, and indigestion caused by deficiency-cold of the spleen and stomach, insufficiency of stomach yang, and stagnation of dampness and qi. Clinically, it is used for digestive system diseases such as gastric ulcer, acute and chronic gastritis. The medicinal ingredients of this formula include Amomum villosum, Aucklandia lappa (Cyperus rotundus vinegar-processed), Cyperus rotundus, Citrus reticulata, Pinellia ternata (processed), Magnolia officinalis, Poria cocos, Pogostemon cablin, Amomum kravanh, Zingiber officinale, Glycyrrhiza glabra, Ziziphus jujuba, Panax ginseng, etc. The pills are taken orally, 2 times a day, 9 grams each time, and taken with warm boiled water. It has a good curative effect on the syndrome of stagnation of dampness and qi and deficiency-cold of the spleen and stomach. Clinically, Xiangsha Yangwei Decoction has a good curative effect on patients with deficiency-cold of the spleen and stomach accompanied by shortness of breath, limb fatigue, and dry mouth and tongue, and can assist in the treatment of respiratory infections and has a certain antibacterial effect.