In Traditional Chinese Medicine (TCM), there are various forms of medicine such as pills, powders, ointments, and elixirs. With advancements in science and technology, the forms of Chinese herbal medicine are also evolving. In addition to decoctions, modern Chinese patent medicines, instant granules, and powdered herbs are increasingly accepted by many.
However, many patients may wonder which form of the same herbal prescription is the most effective. Which dosage form yields the best medicinal effect?
Below, I will clarify this confusion.
1. Decoctions (汤剂)
Decoctions are prepared by boiling various herbs, which undergo chemical reactions through the action of water and fire, maximizing their medicinal effects. For example, in our diet, the taste and nutrition of main dishes, side dishes, and meats are completely different when cooked compared to when they are simply mixed. Similarly, decoctions in TCM work in the same way.
Advantages: They are easily absorbed, maximizing the medicinal effects.
Disadvantages: Preparing decoctions can be inconvenient. Modern people are very busy, and the process of decocting Chinese herbs requires time and patience, typically taking about 2 hours. Some herbs have specific requirements for decocting, such as being wrapped or added later, which requires mastering some techniques, making the process relatively cumbersome.
As a result, some people find it troublesome and prefer to choose hospital-prepared decoctions or other forms.
2. Granules (冲剂)
Granules refer to the extract of herbs combined with appropriate excipients or powdered herbs to form dry granules or blocks for internal use. They are taken by dissolving in hot water.
Granules are a new form developed based on decoctions and syrups. According to incomplete statistics, there are about 200 types of granules available in the country, and nearly 100 types made from ancient formulas in Japan.
Granules retain the rapid action characteristic of decoctions while overcoming the inconvenience of decocting. They are also tasty, small in size, and convenient for taking, storing, and transporting, making them popular among patients. However, granules are prone to moisture absorption, requiring careful packaging and storage, and they often contain a high amount of sugar, leading to higher costs.
Advantages: They eliminate the decocting process, making them convenient to carry and take. This is especially beneficial for students living in dorms, business travelers, and busy office workers.
Disadvantages:
(1) Inability to control the quality of herbs
Compared to herbal slices, we cannot see the original herbs used in granules. Patients who regularly consume Chinese herbs should be aware that high-quality herbal slices are not cheap. It is still common for inferior herbs to be mixed with good ones, and this is even more pronounced with granules.
(2) High cost
The main drawback of granules is their generally high market price, and some granules can be difficult to dissolve. This is due to the multiple steps of extraction and concentration, which increase production costs, making them more expensive compared to traditional decoctions. Many patients with chronic diseases are unwilling to choose more expensive medications.
(3) Uncertain efficacy
The key to Chinese medicine lies in the compatibility of herbs, which, according to modern pharmacology, requires chemical reactions between different herbs. The compatibility of granules is fixed, and their targeted efficacy may be reduced after brewing.
3. Powders (散剂)
Powders are made by mixing and grinding various herbs, a practice that has existed since ancient times.
Advantages: They are simple to prepare and can save on herbs, making them convenient to carry and take.
Disadvantages: For internal treatment of diseases, the absorption of powders is not as effective as that of decoctions.
Moreover, not all herbs are suitable for powdering. For example, some herbs that release exterior pathogens, such as Mentha (薄荷, bohe) and Agastache (藿香, huoxiang), rely on their volatility for efficacy, and powdering them can easily dissipate their medicinal properties.
Therefore, powdered herbs should be tailored to the specific herb, and it is recommended to prepare them fresh to ensure efficacy and prevent spoilage.
Powders should be taken with hot water, rice soup, or yellow wine, as different powders have different optimal liquid combinations. It is best not to consume them dry.
4. Pills (中成丸剂)
Pills are a widely used form of medicine, made according to specific herbal formulas, such as Liu Wei Di Huang Wan (六味地黄丸, Six-Ingredient Rehmannia Pill), Xiao Yao San (逍遥散, Free and Easy Wanderer Powder), and Bu Zhong Yi Qi Wan (补中益气丸, Tonify the Middle and Augment the Qi Pill), which are all excellent examples of Chinese patent medicines.
Advantages: They are convenient to take, have a better taste than decoctions, have fewer side effects, and are easy to carry and store.
Disadvantages: Their efficacy is not as strong as that of decocted herbs, and Chinese patent medicines are generally made from established herbal formulas, which limits their treatment scope and does not allow for clinical adjustments.
Each form of Chinese medicine has its advantages and disadvantages, and the existence of each form is reasonable. When consulting TCM, individuals should choose based on their actual situation. If there is no time to decoct herbs, instant granules, powders, and patent medicines can be chosen. For those who can decoct herbs, I still recommend doing it yourself, as this method provides the best medicinal effect.
Recommended Previous Articles:
8 Essential Tips for Decocting Chinese Herbs!
The Benefit for Thin People: Dang Shen (党参, Codonopsis) Weight Gain Soup
Neiting Point (内庭穴): The “Fire Extinguisher” Hidden in Your Foot
The Past and Present of Liu Wei Di Huang Wan (六味地黄丸)
Special TCM Formulas for Treating Cervical Spondylosis