Traditional Chinese Medicine Decoctions:
Refers to the liquid preparations obtained by boiling medicinal herbs or coarse granules in water or soaking them in boiling water, followed by straining to extract the juice. TCM decoctions are liquid composite dispersions and are the earliest and most widely used dosage form in China, still extensively utilized in clinical practice today. The reason TCM decoctions have been used for thousands of years is due to their flexible formulation, which meets the needs of TCM syndrome differentiation and treatment; at the same time, the preparation method is simple, using water as a solvent.
Correct Medication Administration (Timing, Temperature, Dosage, and Frequency):
TCM decoctions are one of the oldest dosage forms in traditional Chinese medicine and are the most widely used in clinical applications. Decoctions can fully adapt to the needs of TCM syndrome differentiation and treatment, and have several major characteristics such as rapid efficacy, easy absorption, and strong action. Correctly taking TCM decoctions can accelerate the improvement of the condition, while incorrect methods of administration can worsen the condition.
Timing:
The timing of medication should be determined based on the condition.
If the disease is in the upper jiao (heart, lungs), to allow the medicinal properties to linger longer, it is advisable to take the medicine after meals;
If the disease is in the lower jiao (bladder, intestines), to allow the medicinal properties to act quickly, it is advisable to take the medicine before meals;
Heat-clearing and detoxifying herbs, laxatives, and tonics should be taken on an empty stomach, as the stomach is empty and absorption is easier.
Taking on an empty stomach means taking the medicine one hour before breakfast or one hour after dinner.
Special medications should be taken in special ways, such as digestive aids should be taken after a small amount of food to enhance efficacy;
Antiparasitic medications should be taken on an empty stomach in the morning, and a little sugar water should be consumed before taking the medicine to enhance the effect;
For purgative medications, they should be stopped immediately after a bowel movement;
Calming herbs, tonics, and anti-aging medications should be taken before sleep;
Sleeping pills should be taken two hours before sleep;
Emergency medications do not have strict timing requirements;
Chronic patients who often take pills, powders, pastes, or tinctures should take them at regular intervals.
Temperature:
Decoctions should generally be taken warm for treating common diseases, while special treatment needs should follow specific methods of administration.
For qi-regulating herbs, heat facilitates relaxation, while coolness increases stagnation;
For blood-activating, blood-tonifying, cooling blood, and hemostatic herbs, cold can lead to stasis, while heat can cause overflow.
For detoxifying agents, they should be taken cold to facilitate the expulsion of toxins; taking them hot can increase the toxicity.
For heat-related diseases, cold administration is advisable (e.g., Si Hu Tang), while cold-related diseases should be taken hot to disperse and promote medicinal efficacy.
For herbs that promote blood circulation and unblock meridians, they should be taken hot, while astringent and hemostatic agents should be taken cold.
Wind-dispersing herbs are mostly pungent and dispersive, and should be taken hot;
Heat-clearing and summer-heat relieving herbs should be taken cold.
For severe heat diseases, cold medications should be taken warm; for severe cold diseases, hot medications should be taken cold.
Decoctions that should not be taken cold can cause gastrointestinal irritation, leading to abdominal pain or vomiting; ginger can be used to rub the tongue to stop this.
Dosage and Frequency:
TCM decoctions are typically a combined liquid obtained after boiling 2-3 times, and should be taken in doses according to clinical needs. Generally, each dose should be about 150 milliliters, but there are exceptions for certain conditions.
For patients with fever taking heat-clearing and detoxifying agents, the liquid can be slightly increased to enhance efficacy;
For thirst-quenching herbs, the liquid amount should also be increased and can be taken frequently instead of tea.
Stronger individuals can take more medicine, while weaker individuals, such as children and severely ill patients, should take less.
Generally, children under 1 year should take one-fifth of the adult dosage, ages 1-3 should take one-fourth; ages 4-7 should take one-third; ages 8-10 should take half; and those over 10 can take the adult dosage.
Generally, decoctions should be taken twice a day, morning and evening, while heat-clearing and detoxifying agents can be taken 3-4 times a day. Rehydrating herbs should be taken once in the morning and once in the evening, while diaphoretic herbs can be taken 2-3 additional times, and throat-soothing herbal juices can be taken in small amounts multiple times.
By mastering these methods, one can better utilize the medicinal properties to achieve optimal therapeutic effects.
—– Note
Avoid using hot water for decoction.
If medicinal herbs are boiled directly in hot water, the starch, proteins, and other components on the surface of the herbs will suddenly gelatinize or coagulate due to the heat, hindering the extraction of starch, proteins, and other effective components from the herbs.
The correct method is to soak the herbs in cool boiled water for a period (about 30 minutes) before boiling, which facilitates the infiltration, dissolution, and extraction of the effective components contained in the herbs. Nowadays, the water used by urban residents is mostly tap water, which is neither rainwater (from rain, mist, or snow) nor groundwater (from rivers or lakes), but chemically treated water. To ensure disinfection, tap water must contain a certain amount of residual chlorine, and in areas with poor water quality, the residual chlorine content is even higher. Chlorine is a strong oxidizing agent and can react with many organic substances. Since cool boiled water has already been boiled, the residual chlorine has evaporated, thus avoiding its destructive effect on the effective components. Additionally, during the heating process, the calcium and magnesium bicarbonates in the raw water decompose and precipitate, reducing the content of calcium and magnesium ions in the water, thereby decreasing the chances of effective components in the herbs combining and precipitating with calcium and magnesium ions, which increases the concentration of effective components in the decoction. Therefore, it is best to use cool boiled water for decocting Chinese medicine.
Be cautious of false boiling phenomena.
Boiling is a basic requirement for preparing TCM decoctions, and the standard for boiling is reaching a temperature of 100°C. However, some herbal liquids may start to “boil” at temperatures far below 100°C due to a physical-chemical phenomenon caused by certain chemical components in the herbs, such as saponins, which can produce a large amount of foam at lower temperatures. If the decoction contains herbs like Zi Wan (Aster tataricus), Kuan Dong Hua (Tussilago farfara), Yuan Zhi (Polygala tenuifolia), Sha Shen (Glehnia littoralis), Tian Qi (Notoginseng), Niu Xi (Achyranthes bidentata), Gan Cao (Glycyrrhiza uralensis), or Jie Geng (Platycodon grandiflorus), they may also exhibit this phenomenon during decoction. The true standard for determining whether the liquid is boiling is temperature, not the surface phenomenon of foam that people commonly recognize; if the liquid has not boiled, the effective components in the herbs have not been fully extracted, which may not achieve the expected clinical effects and could lead to other issues, so caution should be exercised during decoction preparation.
Storage:
Chinese herbs contain various components such as starch, sugars, proteins, vitamins, volatile oils, amino acids, and various enzymes and trace elements, most of which dissolve in the decoction during boiling. The general method of administration is to take half while warm, and the other half 4-6 hours later. If taken overnight or stored for too long, not only will the efficacy decrease, but factors such as air, temperature, time, and bacterial contamination can lead to enzyme decomposition, bacterial growth, and fermentation and hydrolysis of starch and sugar nutrients, resulting in spoilage and deterioration of the decoction, which is detrimental to human health.
— The above content is organized from online learning.