I. Prescription Source & History

1. Origin Background

 Xiang Sha Liu Jun Decoction  (commonly known as 'Xiang Sha Liu Jun Zi Decoction') It is cited from the formula by Ke Yunbo in the medical work 'Discussions on Prescriptions of Renowned Physicians Past and Present' compiled by Luo Mei in the Qing Dynasty and annotated by Ke Yunbo in the Qing Dynasty. 。 It is composed by adding Aucklandia lappa and Amomum villosum to the 'Sijunzi Decoction' in 'Formulary of the Bureau of People's Welfare Pharmacy' in the Song Dynasty and the 'Liujunzi Decoction' in 'Orthodox Manual of Medicine' in the Ming Dynasty, and has the effects of replenishing qi and strengthening the spleen, promoting qi circulation and resolving phlegm. Its emergence is closely related to the understanding and treatment needs of traditional Chinese medicine for spleen and stomach diseases. The spleen and stomach are regarded as the foundation of acquired constitution and the source of qi and blood production in traditional Chinese medicine theory, playing a crucial role in human health. When there are problems with the functions of the spleen and stomach, a series of discomfort symptoms will occur. Therefore, medical experts throughout history have been committed to finding effective formulas for regulating the spleen and stomach, and Xiangsha Liujun Decoction is one of the outstanding ones.

2. Historical Evolution

Its history can be traced back to the Song Dynasty. Based on the summary of previous experience and their own clinical practice, medical experts at that time gradually explored some combinations of herbs for spleen and stomach weakness and qi stagnation. Through continuous improvement and perfection, by the Ming Dynasty, the structure and herb usage of the formula became more mature, and the prototype of Xiangsha Liujun Decoction was basically formed. After that, through the clinical verification and further optimization by many medical experts in the Ming and Qing dynasties, it finally became the classic formula we know today and has been used until now, playing an important role in traditional Chinese medicine clinical practice.

II. Composition Introduction (Monarch, Minister, Assistant, Guide)

1. Monarch Drug

- Ginseng

Ginseng tastes sweet and slightly bitter, is slightly warm in nature, and enters the spleen, lung, heart, and kidney meridians. It has the effects of greatly tonifying primordial qi, restoring pulse and arresting collapse, tonifying the spleen and benefiting the lung, promoting fluid production and nourishing blood, calming the mind and improving intelligence. In Xiangsha Liujun Decoction, as the monarch herb, ginseng mainly plays the role of greatly tonifying the qi of the spleen and stomach. When the spleen and stomach are weak and the transportation and transformation are weak, ginseng can supplement the consumed qi of the spleen and stomach, enhance the transportation and transformation function of the spleen and stomach, and lay a foundation for the restoration of the foundation of acquired constitution.

- Atractylodes macrocephala

Atractylodes macrocephala is bitter, sweet, and warm in nature, and enters the spleen and stomach meridians. It has the effects of strengthening the spleen and replenishing qi, drying dampness and promoting diuresis, stopping sweating, and preventing miscarriage. Atractylodes macrocephala is good at strengthening the spleen and drying dampness, and has a good conditioning effect on the condition of spleen weakness accompanied by internal obstruction of damp pathogen. It can enhance the transportation and transformation function of the spleen and stomach, remove dampness in the body, restore the normal function of the spleen and stomach, and thus improve various symptoms caused by spleen weakness and damp obstruction.

2. Minister Drug

- Poria cocos

Poria cocos is sweet, bland, and neutral in nature, and enters the heart, lung, spleen, and kidney meridians. It has the effects of promoting diuresis and percolating dampness, strengthening the spleen, and calming the mind. Poria cocos can both strengthen the spleen and replenish the middle, and promote diuresis and percolate dampness, assisting ginseng and Atractylodes macrocephala to enhance the power of strengthening the spleen and removing dampness. By promoting urine excretion, it clears the excess water in the body, reduces the harassment of damp pathogen on the spleen and stomach, and at the same time helps to enhance the transportation and absorption of the spleen and stomach for diet and food essence.

- Pinellia ternata

Pinellia ternata is pungent, warm in nature, and poisonous, and enters the spleen, stomach, and lung meridians. It can dry dampness and resolve phlegm, lower adverse qi and stop vomiting, and dissipate masses and nodules. Pinellia ternata mainly plays the roles of drying dampness and resolving phlegm and lowering adverse qi and stopping vomiting in the prescription. Spleen weakness is likely to lead to endogenous phlegm-dampness, and Pinellia ternata can dry dampness and resolve phlegm to eliminate the phlegm-damp pathogen. At the same time, for the symptoms of adverse rising of stomach qi, nausea and vomiting caused by spleen weakness, Pinellia ternata can harmonize the stomach and lower adverse qi to relieve discomfort.

3. Assistant Drug

- Tangerine peel

Tangerine peel is pungent, bitter, and warm in nature, and enters the spleen and lung meridians. It has the effects of regulating qi and strengthening the spleen, drying dampness and resolving phlegm. Tangerine peel is good at regulating qi, can move the qi stagnation in the spleen and stomach, and eliminate the feeling of fullness and distension. When combined with Pinellia ternata, it enhances the power of drying dampness and resolving phlegm; when combined with Atractylodes macrocephala and Poria cocos, it helps to regulate qi and strengthen the spleen, making the qi mechanism of the spleen and stomach smooth and the transportation and transformation function play normally.

- Aucklandia lappa

Costus root is pungent, bitter, and warm in nature, and it pertains to the spleen, stomach, large intestine, triple energizer, and gallbladder meridians. It can promote qi circulation to relieve pain and strengthen the spleen to promote digestion. Costus root can promote qi circulation in the gastrointestinal tract, enhance the transportation and transformation functions of the spleen and stomach, and relieve symptoms such as abdominal distension and pain, belching, and loss of appetite caused by qi stagnation. It plays a role in promoting qi circulation and removing stagnation in the formula, making the qi-regulating and spleen-strengthening effect of the whole formula stronger.

4. Guide Drug

- Amomum villosum

Amomum villosum is pungent in flavor and warm in nature, and it pertains to the spleen, stomach, and kidney meridians. It has the effects of promoting digestion by resolving dampness, warming the spleen to stop diarrhea, and regulating qi to prevent miscarriage. The aroma of Amomum villosum can awaken the spleen and harmonize the stomach, promote qi circulation and resolve dampness, and enhance the transportation and transformation functions of the spleen and stomach. It can also lead various herbs downward to reach the affected area, enabling the medicinal power to better act on the spleen and stomach and exert the regulating effect.

- Prepared Licorice Root

Prepared Licorice Root is sweet in flavor and neutral in nature, and it pertains to the heart, lung, spleen, and stomach meridians. It can invigorate the spleen and replenish qi, moisten the lungs and relieve cough, relieve spasm and pain, and harmonize various herbs. In the formula, Prepared Licorice Root on the one hand invigorates the spleen and replenishes qi, assisting ginseng and atractylodes macrocephala to enhance the effect of strengthening the spleen; on the other hand, it harmonizes various herbs, enabling the herbs in the formula to cooperate with each other to exert the best curative effect, and at the same time relieving the toxicity and potency of the drugs.

III. Pathogenesis, Efficacy & Indications of Xiangsha Liujunzi Decoction

1. Pathogenesis

The Xiangsha Liujun Decoction The pathogenesis it targets is mainly weakness of the spleen and stomach, failure of transportation and transformation, accompanied by qi stagnation and phlegm obstruction. The spleen and stomach are the foundation of acquired constitution and the source of qi and blood generation. If the spleen and stomach are weak and cannot normally transport and transform the essence of food and water, qi and blood generation will be insufficient, and the functions of zang-fu organs will lack nourishment. At the same time, weakness of the spleen and stomach easily leads to unsmooth qi movement, presenting symptoms of qi stagnation such as abdominal distension and belching. In addition, abnormal transportation and transformation of the spleen and stomach, obstruction of water metabolism, easily leads to the accumulation of dampness and the formation of phlegm, resulting in the syndrome of internal obstruction of phlegm-dampness, manifested as nausea, vomiting, loss of appetite, thick and greasy tongue coating, etc.

2. Efficacy

- Invigorating the spleen and replenishing qi

In the formula, ginseng, atractylodes macrocephala, poria cocos, and roasted licorice are combined with each other to greatly tonify the qi of the spleen and stomach, enhance the transportation and transformation functions of the spleen and stomach, enable the spleen and stomach to normally digest and absorb food and water, provide sufficient nutrients for the body, and thus improve symptoms such as sallow complexion and fatigue caused by weakness of the spleen and stomach.

- Regulating qi and resolving phlegm

Tangerine peel, costus root, and amomum villosum regulate qi and promote qi movement, and pinellia ternata dries dampness and resolves phlegm. When these herbs are used together, they can effectively eliminate qi stagnation in the spleen and stomach and internal obstruction of phlegm-dampness, relieve symptoms such as abdominal distension, nausea and vomiting, and profuse phlegm in cough, and make the qi movement of the spleen and stomach smooth, so that phlegm-dampness can be resolved.

3. Indications

Xiangsha Liujun Decoction is mainly used to treat various diseases caused by weakness of the spleen and stomach and qi stagnation with phlegm obstruction. Common symptoms include abdominal distension and pain in the epigastrium, loss of appetite, nausea, vomiting with acid regurgitation, belching, loose stools, fatigue, sallow complexion, pale tongue with white greasy coating, and string-like and slippery pulse. Clinically, it is often used in the treatment of digestive system diseases such as chronic gastritis, gastric ulcer, dyspepsia, and gastrointestinal dysfunction, and has a good effect on improving the symptoms of patients and promoting the recovery of spleen and stomach functions.

VI. Analysis of the Formula of Xiangsha Liujun Decoction

1. Treating Spleen and Stomach Simultaneously (Invigorating the Spleen)

In the formula, ginseng, atractylodes macrocephala, poria cocos, and roasted licorice strengthen the spleen and boost qi, fundamentally enhancing the transportation and transformation functions of the spleen and stomach, and regulating the root deficiency of weakness of the spleen and stomach. At the same time, tangerine peel, costus root, amomum villosum regulate qi and promote qi movement, and pinellia ternata dries dampness and resolves phlegm, treating the superficial excess of qi stagnation and phlegm obstruction caused by abnormal transportation and transformation of the spleen and stomach. Treating both the root and the branch enables the comprehensive recovery of spleen and stomach functions.

2. Considering Qi and Blood Simultaneously (Resolving Phlegm)

The spleen and stomach are the source of qi and blood production. When the functions of the spleen and stomach are normal, qi and blood are sufficient. The herbs that strengthen the spleen and boost qi in the formula can promote the production of qi and blood, and the herbs that regulate qi and resolve phlegm help to inhibit bacteria and eliminate the influence of qi stagnation and phlegm obstruction on the transportation and transformation of the spleen and stomach, ensuring the smooth production of qi and blood. Only when qi and blood are sufficient can the functions of the zang-fu organs be normally exerted, thus maintaining the healthy state of the human body.

3. Interaction between Rising and Descending

In the formula, there are herbs for supplementing qi and lifting yang, such as ginseng, atractylodes macrocephala, and roasted licorice, and herbs for promoting qi movement and descending qi, such as tangerine peel, costus root, amomum villosum, and pinellia ternata. Supplementing qi and lifting yang can enhance the transportation and transformation functions of the spleen and stomach, and promoting qi movement and descending qi can eliminate qi stagnation and phlegm obstruction, aiming at restoring the ascending and descending balance of the qi movement of the spleen and stomach due to insufficient stomach yang. The ascending and descending are interdependent, making the functions of the spleen and stomach coordinated and the qi and blood circulation smooth.

V. Comparison with Other Similar Formulas

1. Comparison with Sijunzi Decoction

- Composition differences

Si Jun Zi Tang It is composed of ginseng, atractylodes macrocephala, poria cocos, and roasted licorice root. Its main efficacy is to replenish qi and strengthen the spleen, with the focus on tonifying the qi of the spleen and stomach. On the basis of Si Jun Zi Tang, Xiang Sha Liu Jun Tang adds four herbs, namely tangerine peel, costus root, amomum villosum, and pinellia ternata.

- Efficacy focus

On the basis of replenishing qi and strengthening the spleen, Xiang Sha Liu Jun Tang pays more attention to regulating qi and resolving phlegm. For patients with weakness of the spleen and stomach accompanied by symptoms of qi stagnation and phlegm obstruction, the curative effect of Xiang Sha Liu Jun Tang is more significant. While Si Jun Zi Tang mainly targets simple qi deficiency of the spleen and stomach, with a relatively narrow conditioning range.

2. Comparison with Xiangsha Yangwei Pills

- Dosage form and administration method

Xiang Sha Yang Wei Tang It is in pill form and is relatively convenient to take, but the onset of effect is relatively slow. Xiang Sha Liu Jun Tang is generally in decoction form and needs to be decocted before taking. It has a faster onset of effect and can exert its medicinal effects more rapidly.

- Composition and efficacy of herbs

The Xiangsha Yangwei Pills are mainly composed of Aucklandia lappa, Amomum villosum, Atractylodes macrocephala, Citrus reticulata Blanco, Poria cocos, Pinellia ternata, Cyperus rotundus, Aurantii Fructus Immaturus, Amomum kravanh, Magnolia officinalis, Pogostemon cablin, Glycyrrhiza glabra, Zingiber officinale, and Ziziphus jujuba, and have the effect of warming the middle-jiao and regulating the stomach. The composition of the Xiangsha Liujun Decoction is relatively simple, mainly focusing on strengthening the spleen and replenishing qi, regulating qi and resolving phlegm, and is more suitable for patients with spleen and stomach weakness and relatively mild qi stagnation and phlegm obstruction.

VI. Clinical Applications and Indications

1. Chronic Gastritis

Patients with chronic gastritis often present symptoms such as fullness and distension in the epigastrium, pain, loss of appetite, nausea, and belching, which are mostly caused by spleen and stomach weakness, qi stagnation and phlegm obstruction. The Xiangsha Liujun Decoction can strengthen the spleen and replenish qi, regulate qi and resolve phlegm, improve the discomfort symptoms in the stomach, promote the repair of gastric mucosa, and regulate gastrointestinal function, and has a good effect on the treatment of chronic gastritis.

2. Gastric Ulcer

Patients with gastric ulcer often have manifestations such as epigastric pain, gastric burning, acid reflux, belching, and loss of appetite. According to traditional Chinese medicine syndrome differentiation, it is mostly spleen and stomach weakness, and the stomach fails to descend harmoniously. The Xiangsha Liujun Decoction can enhance the function of the spleen and stomach, harmonize the stomach and lower adverse qi, relieve epigastric pain, reduce gastric acid secretion, and promote ulcer healing.

3. Dyspepsia

Common symptoms of dyspepsia include abdominal distension, abdominal pain, nausea, vomiting, loss of appetite, etc., which are mostly related to spleen and stomach weakness and abnormal transportation and transformation. The Xiangsha Liujun Decoction can strengthen the spleen and promote digestion, regulate qi and resolve phlegm, improve digestive function, promote the digestion and absorption of food, and relieve the symptoms of dyspepsia.

4. Gastrointestinal Dysfunction

Patients with gastrointestinal dysfunction often present symptoms such as abdominal pain, diarrhea, constipation, and epigastric discomfort. Traditional Chinese medicine believes that it is related to spleen and stomach weakness, limb fatigue, and qi movement disorder. The Xiangsha Liujun Decoction can regulate the function of the spleen and stomach, balance the qi movement in the gastrointestinal tract, and improve the symptoms of gastrointestinal dysfunction.

The classic conditioning plan for strengthening the spleen, regulating the stomach and resolving phlegm

VII. Additive and Subtractive Changes

1. Severe epigastric pain

Rhizoma Corydalis and Fructus Toosendan can be added to enhance the effect of regulating qi and relieving pain. Rhizoma Corydalis can activate blood circulation, promote qi movement and relieve pain, and Fructus Toosendan can soothe the liver, clear heat and promote qi movement and relieve pain. The combination of the two has a good relieving effect on patients with obvious epigastric pain.

2. Obvious Pantothenic Acid

Os Sepiae and Concha Arcae can be added to relieve acid and stop pain. Os Sepiae can astringe to stop bleeding, relieve acid and stop pain, and Concha Arcae can eliminate phlegm, disperse stasis, soften hardness and dissipate nodules, relieve acid and stop pain, and can effectively reduce the stimulation of gastric acid on the gastric mucosa and relieve the symptom of acid reflux.

Severe abdominal distension cases

Adding Magnolia Officinalis and Immature Bitter Orange can enhance the power of promoting qi and relieving distension. Magnolia Officinalis can dry dampness, eliminate phlegm, descend qi and relieve fullness. Immature Bitter Orange can break qi to eliminate accumulation, resolve phlegm and relieve stuffiness. With their synergistic effect, they can quickly relieve the symptom of abdominal distension.

Those with loose stools and increased frequency

Adding Chinese Yam and Gorgon Fruit can invigorate the spleen and stop diarrhea. Chinese Yam can invigorate the spleen, nourish the stomach, promote fluid production and moisten the lung, replenish the kidney and astringe essence. Gorgon Fruit can astringe the kidney and consolidate essence, invigorate the spleen and stop diarrhea, eliminate dampness and arrest vaginal discharge, which helps to enhance the effect of invigorating the spleen and stopping diarrhea and improve the symptom of loose stools.

The classic conditioning plan for invigorating the spleen, regulating the stomach and resolving phlegm

VIII. Dosage (Traditional & Modern)

1. Traditional Methods

Generally, it is decocted in water for oral administration. The common dosage is: 9 grams of Ginseng, 9 grams of Atractylodes Macrocephala, 9 grams of Poria, 6 grams of Prepared Licorice Root, 6 grams of Tangerine Peel, 9 grams of Pinellia Ternata, 6 grams of Aucklandia Root, 6 grams of Amomum Villosum. Add appropriate amount of water to the above medicines, soak for 30 minutes, then decoct with slow fire until 200 - 300 ml, take it in two doses, one dose per day.

Modern Chinese Patent Medicine Concentrate Granules

Modern concentrated granules are made by extracting and concentrating traditional Chinese medicines, which are more convenient to take. The dosage is generally determined according to the content of the medicine and the specific situation of the patient, usually equivalent to the dosage of traditional cut crude drugs. When taking, dissolve the granules with appropriate amount of boiling water, take it in two doses, one dose per day.

IX. Precautions and Taboos

1. Dietary Taboos

During the medication period, it is necessary to avoid eating raw, cold, greasy, spicy and other stimulating foods to avoid increasing the burden on the spleen and stomach. Raw and cold foods such as ice cream and cold drinks, greasy foods such as fried foods and fatty meat, and spicy foods such as chili peppers and Chinese prickly ash may all affect the curative effect of the medicine and are not conducive to the recovery of the disease.

2. Special Populations

Use with caution during pregnancy. Although most of the medicines in Xiangsha Liujun Decoction are relatively mild, pregnant women still need to be cautious about taking medicines and should use them under the guidance of a doctor. In addition, those with deficiency-cold of the spleen and stomach accompanied by symptoms of excess heat, such as burning sensation in the epigastrium, bitter taste in the mouth and dry throat, dry and hard stools, etc., should use it reasonably after syndrome differentiation by a doctor and avoid taking it blindly.

3. Drug Interactions

If taking other medicines, you should inform the doctor, because the medicines in Xiangsha Liujun Decoction may interact with certain medicines. For example, taking it together with medicines containing Veratrum may cause adverse reactions.

The classic conditioning plan for strengthening the spleen, harmonizing the stomach and resolving phlegm - HJMEDICAL

X. Modern Research Progress

1. Pharmacological Effect Research

Modern research shows that Xiangsha Liujun Decoction has the effects of regulating gastrointestinal motility, promoting the secretion of digestive juices, enhancing the protection of gastrointestinal mucosa, and regulating the secretion of gastrointestinal hormones. It can improve gastrointestinal function, increase the activity of digestive enzymes, promote the digestion and absorption of food, enhance the resistance of gastrointestinal mucosa, and prevent and treat gastrointestinal diseases.

2. Clinical Efficacy Observation

Multiple clinical studies have confirmed that Xiangsha Liujun Decoction has significant curative effects in the treatment of digestive system diseases such as chronic gastritis, gastric ulcer, and dyspepsia. Compared with western medicine, Xiangsha Liujun Decoction has fewer side effects, high safety, and can regulate the function of the spleen and stomach as a whole, improving the symptoms and quality of life of patients.

3. Mechanism Exploration

Through the research on Xiangsha Liujun Decoction, it is found that its mechanism of action may be related to regulating the gastrointestinal nerve - endocrine - immune network. It can regulate the release of gastrointestinal neurotransmitters, improve the level of gastrointestinal hormones, and enhance the body's immunity, so as to achieve the purpose of treating gastrointestinal diseases. With the continuous deepening of research, more potential mechanisms of action of Xiangsha Liujun Decoction will be revealed, providing a more solid theoretical basis for its clinical application.

Summary

Xiangsha Liujun Decoction is a commonly used prescription in traditional Chinese medicine for strengthening the spleen and resolving phlegm, warming the middle - jiao and harmonizing the stomach. It is applicable to such syndromes as dull pain in the stomach, fullness and discomfort in the epigastrium, dry mouth and throat, restlessness and discomfort, vomiting of sour water, loss of appetite, anorexia, dyspepsia, etc. caused by deficiency - cold of the spleen and stomach and stagnation of dampness and qi. Clinically, it is used for digestive system diseases such as gastric ulcer, acute and chronic gastritis, etc. The medicinal ingredients of this prescription include fructus amomi, costus root (Cyperus rotundus vinegar processed), Cyperus rotundus, dried tangerine peel, pinellia ternata (processed), poria cocos, licorice root, ginseng, etc. It can be taken orally in the form of pills or decoction, 2 times a day, 9 grams each time, and taken with warm boiled water. It has good curative effects on the syndrome of spleen deficiency and dampness obstruction, and can also assist in treating such syndromes as respiratory tract infection, etc.