We often encounter customers who want to purchase medications to eliminate phlegm-damp. What products would you recommend to them? Most pharmacy staff would first think of recommending herbs like Fu Ling (Poria), Yi Yi Ren (Job’s Tears), and Chi Xiao Dou (Adzuki Bean) as herbal teas for dampness removal. But are these herbal teas really effective? To understand what products to recommend to customers with a phlegm-damp constitution, we first need to understand what “phlegm-damp constitution” is.
Overview of Phlegm-Damp ConstitutionThe phlegm-damp constitution is a state characterized by the accumulation of phlegm and dampness due to the dysfunction of fluid metabolism, primarily marked by a sticky and turbid nature. In simple terms, it is a disorder of the spleen and stomach’s ability to transform and transport, leading to disturbances in the absorption, circulation, and excretion of fluids in the body, resulting in abnormal fluid accumulation, which is a pathological product also known as phlegm fluid, where the thicker and stickier part is phlegm, and the clearer part is fluid.The phlegm-damp constitution often develops over many years, with a long course of illness, primarily exhibiting the following characteristics:
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① Obesity, especially with fullness in the abdomen;
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② Preference for rich and fatty foods, oily skin, pale yellow and dull complexion, slightly swollen eyelids, easy fatigue, heavy body feeling, excessive sticky sweating, accompanied by chest tightness and excessive phlegm;
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③ Loose stools, either watery or sticky, cloudy urine, and frequent urination;
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④ Presence of lumps or nodules on the skin, soft or firm upon palpation, and painless.
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⑤ Generally, a large tongue body, white and greasy tongue coating, sticky mouth, and slippery pulse.
Long-term phlegm-damp in the body can lead to various diseases such as obesity, hyperlipidemia, hypertension, diabetes, sleep apnea syndrome, and polycystic ovary syndrome. Therefore, when signs of phlegm-damp constitution appear, it is advisable to regulate it early.The key issue with phlegm-damp lies in the damage to the spleen and stomach and the dysfunction of their transformation and transportation. Merely promoting diuresis and eliminating dampness will only exacerbate the deficiency of body fluids, leading to spleen deficiency and fluid depletion. Therefore, to eliminate phlegm-damp, it is essential to first strengthen the spleen and stomach, using methods to tonify the spleen and eliminate dampness, transform phlegm and drain turbidity, thereby enhancing the function of the spleen and stomach, normalizing fluid metabolism, and naturally eliminating phlegm fluid.Selection of Chinese Patent Medicines for Eliminating Phlegm-Damp1. Shen Ling Bai Zhu GranulesIndications:Strengthens the spleen and benefits qi. Used for fatigue, poor appetite, and loose stools.Overview: This formula addresses phlegm-damp due to spleen and lung qi deficiency. Shen Ling Bai Zhu Granules have a mild nature, tonifying without stagnation, and benefit both the lung and spleen, primarily tonifying the spleen while also eliminating phlegm and dampness, achieving a comprehensive treatment effect, making it a commonly used medicine for spleen deficiency and damp stagnation.2. Shen Ling Jian Pi GranulesIndications:Tonifies the spleen and strengthens the stomach, promotes dampness elimination and stops diarrhea. Used for spleen and stomach weakness, poor digestion, either diarrhea or vomiting, thin body, pale complexion, and fatigue.Overview: Shen Ling Jian Pi Granules are quite similar to Shen Ling Bai Zhu Granules, with slight differences in composition, mainly replacing ginseng with Bei Sha Shen (North American Ginseng), removing Jie Geng (Platycodon), and adding Chen Pi (Tangerine Peel), making the formula milder, with a weaker qi tonifying effect, and more suitable for a broader population, also nourishing stomach yin, making it more appropriate for those who cannot tolerate tonics, and also very suitable for those with spleen dysfunction and internal dampness.3. Jian Pi WanIndications:Strengthens the spleen and opens the appetite. Used for spleen and stomach weakness, abdominal distension, poor appetite, and loose stools.Overview:Jian Pi Wan has a simple composition, capable of tonifying qi and strengthening the spleen, promoting digestion and resolving food stagnation, and regulating qi and harmonizing the stomach. It is commonly used for treating spleen and stomach weakness and food stagnation with loose stools, but its dampness-eliminating effect is not as strong as the previous two medicines, so it can be combined with Er Chen Wan (Two Aged Pills) for treating phlegm-damp syndrome.4. Er Chen WanIndications:Dries dampness, transforms phlegm, regulates qi, and harmonizes the stomach. Used for cough with excessive phlegm, chest and abdominal distension, nausea, and vomiting due to phlegm-damp stagnation.Overview:Er Chen Wan consists of Chen Pi (Tangerine Peel), Ban Xia (Pinellia, processed), Fu Ling (Poria), and Gan Cao (Licorice), with ginger as an adjunct. It is a foundational formula for treating phlegm-damp, capable of transforming phlegm, regulating qi, and eliminating the source of phlegm by strengthening the spleen and draining dampness, addressing both symptoms and root causes, primarily treating symptoms, but with a slightly weaker spleen-strengthening effect, so it can also be paired with other spleen-strengthening patent medicines like Jian Pi Wan or Qi Pi Wan.5. Xiang Sha Ping Wei GranulesIndications:Strengthens the spleen, dries dampness, regulates qi, and harmonizes the middle. This product is mainly used for stomach pain caused by damp food obstruction in the middle jiao, with symptoms of gastric distension and pain, reduced appetite, exacerbation of distension after meals, acid regurgitation, and sticky stools.Overview:Xiang Sha Ping Wei Granules have a phlegm-damp eliminating effect and are characterized by “drying dampness,” which is mainly related to the warming herbs in the formula such as Cang Zhu (Atractylodes), Hou Po (Magnolia Bark), and Chen Pi (Tangerine Peel) that “dry dampness, eliminate phlegm, and strengthen the spleen,” while also containing Xiang Fu (Cyperus) for its pain-relieving properties, suitable for stomach pain caused by damp obstruction in the middle jiao. It is important to note that Xiang Sha Ping Wei Granules are warming and drying, so those with spleen and stomach yin deficiency should use it cautiously.In conclusion, when you notice that you have characteristics of phlegm-damp constitution, it is advisable to regulate it early to avoid the development of other issues over time. Additionally, when eliminating phlegm-damp, it is essential to strengthen the spleen and stomach; otherwise, it will only treat the symptoms without achieving the desired regulatory effect.
