Traditional Chinese Medicine Case Studies / Medical Discussions / Reference Articles for Clinical TCM Studies
The Yiqi Jiedu Decoction (益气解毒汤) was formulated by Shi Yushu, the first president of Guizhou University of Traditional Chinese Medicine (formerly Guiyang College of Traditional Chinese Medicine). Due to the prevalence of damp-heat in central Guizhou, this formula was created to treat gynecological damp-heat discharge diseases and has been widely used as a fundamental formula for treating Qi deficiency with damp-heat syndrome, showing significant efficacy.
Yiqi Jiedu Decoction Ingredients
Ingredients: Huang Qi (Astragalus) 12g, Chao Bai Zhu (Fried Atractylodes) 12g, Huang Lian (Coptis) 3g, Huang Bo (Phellodendron) 10g, Yin Hua (Honeysuckle) 15g, Hou Po (Magnolia Bark) 10g, Huo Xiang (Agastache) 6g, Tu Fu Ling (Smilax) 15g.
In this formula, Huang Qi and Chao Bai Zhu tonify the spleen and stomach Qi, Huang Lian and Huang Bo clear damp-heat from the lower jiao, Yin Hua clears heat and toxins from the blood, Tu Fu Ling promotes the resolution of damp toxins from the lower jiao, and Huo Xiang and Hou Po regulate the spleen to treat water retention and toxins in the middle and lower jiao.
Although Huang Lian and Huang Bo are bitter and cold, when used in small amounts, they can strengthen the spleen and awaken the stomach. Huo Xiang and Hou Po combined with Huang Qi and Chao Bai Zhu can enhance the spleen and stomach function.
Huang Qi and Chao Bai Zhu promote urination and assist Tu Fu Ling in draining dampness, while also aiding Huang Lian, Huang Bo, and Yin Hua in detoxification. This formula supports the righteous Qi while expelling pathogens, draining dampness, and detoxifying, making it an excellent formula for tonifying Qi and detoxifying.
Pharmacological analysis shows that this formula enhances the body’s resistance to disease and has anti-inflammatory and antibacterial effects, particularly effective against certain viral or bacterial infections with prolonged inflammation.
Clinical Modifications and Applications:
For severe Qi deficiency, add Pao Shen (泡参); for severe damp toxins, add Yi Yi Ren (薏苡仁), Bai Hua She She Cao (白花蛇舌草), Ban Zhi Lian (半枝莲); for heavy heat toxins, add Zi Hua Di Ding (紫花地丁), Pu Gong Ying (蒲公英), Bai Jiang Cao (败酱草); for edema, remove Huang Lian and add Fu Ling (茯苓); for low back pain, remove Huo Xiang and add Xu Duan (续断), Su Geng (苏梗); for kidney deficiency, add Du Zhong (杜仲), Sang Ji Sheng (桑寄生);
for blood deficiency, add Dang Gui (当归), Xian He Cao (仙鹤草); for cold limbs and weak pulse, add Fu Zi (附子); for chest oppression, add Ban Xia (法半夏), Zhi Shi (枳实), Shi Chang Pu (石菖蒲); for blood stasis, add Dang Gui, San Leng (三棱), E Zhu (莪术); for excessive dampness with dry mouth and tongue, slightly add Shi Hu (石斛), Tai Zi Shen (太子参), etc.
Damp-heat infiltration and organ disharmony can be flexibly treated with damp-resolving and detoxifying herbs. For jaundice and hypochondriac pain due to damp-heat in the liver and gallbladder, use Jin Qian Cao (金钱草), Yin Chen (茵陈); for painful and difficult urination due to damp-heat in the bladder, use Shi Wei (石韦), Bian Xu (萹蓄); for diarrhea with urgency due to damp-heat in the large intestine, use Ma Chi Xian (马齿苋), Di Yu (地榆); for excessive and foul-smelling leukorrhea or prolonged menstruation due to damp-heat in the uterus, use Zao Jiao (皂角), Dan Cao (胆草);
for joint swelling and pain due to damp-heat in the meridians, use Shi Jian Chuan (石见穿), Bai Bu (百部); for sores and ulcers due to damp-heat in the blood vessels, use Qing Hao (青蒿), Qian Li Guang (千里光); for high fever and lethargy due to damp-heat pervading the three jiaos, remove Chao Bai Zhu and add Lian Zi (莲子), Hua Shi (滑石), Di Yu.
Case Study: Influenza (Viral Cold)
Patient Xu, female, 24 years old, first diagnosed on July 13, 1989. The patient caught a chill, experiencing aversion to wind, fever, nasal congestion, runny nose, slight abdominal distension, and had taken Yin Qiao Pian (银翘片), Niu Huang Jie Du Wan (牛黄解毒丸), and penicillin injections for over a month without improvement. Upon examination, although the fever had subsided, the aversion to wind was more pronounced, with persistent clear nasal discharge, nasal congestion, headache, abdominal bloating, loose stools, poor appetite, chest tightness, shortness of breath, fatigue, and sticky sweating without thirst but with irritability, and scanty yellow urine. The tongue was swollen with a white greasy coating and slightly yellow at the root, and the pulse was weak and deep.
Diagnosis: Viral influenza (Qi deficiency with summer heat and dampness).
Prescription: Huang Qi 15g, Chao Bai Zhu 12g, Huo Xiang 9g, Huang Lian 3g, Tu Fu Ling 15g, Qing Hao 12g, Hou Po 9g, Huang Bo 9g, Yin Hua 12g.
After taking 2 doses, the patient experienced slight sweating, the sweat was no longer sticky, the aversion to wind had resolved, and her spirit improved slightly, with a slightly stronger pulse and increased urine output. The original formula was maintained with the addition of Yi Yi Ren 12g and Lian Qiao 9g. After 3 doses, the greasy coating receded, and the patient felt refreshed, with symptoms resolved.
Note: The root cause of the illness is the invasion of pathogens due to Qi deficiency, and the pathogens are able to invade due to the weakness of the righteous Qi. Prolonged influenza without resolution is due to weak resistance and instability of the exterior. Influenza in hot weather often carries dampness, which consumes Qi, leading to fatigue and weakness, and the symptoms of influenza persist. Therefore, Yiqi Jiedu Decoction is appropriate. Adding Qing Hao helps to expel residual pathogens from the exterior. In the summer of 1990, there were dozens of cases of viral influenza diagnosed as Qi deficiency with summer heat and dampness, all treated with this formula with effective results.
Case Study: Damp-Warmth (Typhoid Fever)
Patient Wang, male, 24 years old, first diagnosed on September 16, 1986. The patient had a high fever for a week, treated with antiviral drugs and ampicillin without effect, and also ineffective with Bai Hu Tang (白虎汤), Gan Lu Xiao Du Dan (甘露消毒丹), and San Ren Tang (三仁汤). The body temperature was 40℃, with persistent high fever, significant aversion to cold, abdominal distension, frequent urge to defecate, extreme fatigue, and inability to sit up. Hearing was diminished, expression was dull, skin was pale with cold sweat. The tongue was dark red and swollen, with a white greasy coating, and the pulse was thin and rapid. The Widal test showed O agglutination titer 1:160, H agglutination titer 1:320, white blood cell count 3000/mm³, neutrophils 58%, lymphocytes 42%, eosinophils 0.
Diagnosis: Typhoid fever (Qi stagnation with damp-heat pervading the three jiaos).
Prescription: Huang Qi 12g, Huang Lian 5g, Huang Bo 9g, Lian Mi (Lotus Seed) 12g, Hou Po 9g, Yin Hua 15g, Tu Fu Ling 15g, Huo Xiang 6g, Hua Shi (Talc) 18g, Di Yu 12g.
After taking the medicine, the patient experienced slight sweating, skin warmed, cold sweat subsided, and body temperature decreased to 38.5℃, with gradually increased urine output. After taking 7 doses, the spirit improved, and the high fever subsided, followed by treatment with Zhu Ye Shi Gao Tang (竹叶石膏汤) until recovery.
Note: The middle Qi is easily obstructed by damp-heat, and more easily harmed and consumed by damp-heat. Yiqi Jiedu Decoction, with its sweet warmth, bitter cold, and draining properties, can replenish the stagnant Qi, and disperse the damp-heat pervading the three jiaos. Huang Qi’s slightly warm nature does not hinder the pathogens at this time but rather benefits Qi transformation. In cases of damp-warmth, where the condition is prolonged and the turbid pathogens linger in the Qi level, the fatigue is prominent, Yiqi Jiedu Decoction is particularly useful, similar to Li Dongyuan’s Qing Shu Yi Qi Decoction. Di Yu drains dampness and clears the intestines, having a special therapeutic effect on typhoid fever, hence its inclusion.
Case Study: Lin Syndrome (Chronic Pyelonephritis)
Patient Wang, female, 42 years old, first diagnosed on November 3, 1989. Five years prior, she had an acute onset with frequent and painful urination, accompanied by chills and fever. After treatment, she improved, but since then, she frequently experienced urinary tract irritation symptoms, especially after exertion, and despite multiple treatments, could not be cured, with gradually weakening constitution.
Currently: Frequent and urgent urination, residual dribbling, fatigue in limbs, weakness, low back pain, and mild lower limb edema. The tongue was swollen and pale, with a yellow greasy coating, and the pulse was thin and wiry. Urinalysis showed a large number of pus cells and white blood cells.
Diagnosis: Chronic pyelonephritis (Qi deficiency with bladder damp-heat).
Prescription: Huang Qi 15g, Chao Bai Zhu 12g, Xu Duan 12g, Huang Lian 3g, Huang Bo 9g, Yin Hua 15g, Tu Fu Ling 18g, Huo Xiang 9g, Hou Po 9g, Sang Ji Sheng 15g.
After taking over 20 doses, urination became clear, microscopy was normal, appetite increased, and energy and spirit significantly improved. The patient was advised to prepare this formula as a powder and take it for over a month, feeling very well, with no recurrence of the illness.
Note: Chronic urinary tract infections are often due to damp-heat in the lower jiao, but in cases of prolonged illness, one should consider the failure of clear Qi to descend and the obstruction of bladder Qi transformation, leading to the retention of turbid pathogens. To eliminate the long-stagnant turbid pathogens in the lower jiao, one should elevate the insufficient clear Qi in the upper jiao. Observing hundreds of cases of chronic urinary tract infections, most are due to Qi deficiency and bladder damp-heat pathology, and Yiqi Jiedu Decoction has a gentle and stable therapeutic effect. Such conditions often involve kidney deficiency, thus it is advisable to add Sang Ji Sheng, Xu Duan, Tu Si Zi (菟丝子), Du Zhong to tonify kidney Qi.
Case Study: Leukorrhea Disease (Endometritis)
Patient Zhang, female, 32 years old, first diagnosed on March 16, 1989. The patient had experienced excessive leukorrhea for half a year, clear and thin like water, with gynecological examination results indicating endometritis. Western medicine anti-inflammatory treatment for 3 weeks was ineffective, and after using Bai Tang (带汤) and Bu Zhong Yi Qi Tang (补中益气汤) to tonify the spleen and drain dampness, over 20 doses were ineffective.
Currently: Dizziness, shortness of breath, poor sleep, fatigue, low back pain, prolonged menstruation for over 10 days. The tongue was pale with tooth marks, slightly greasy coating, and the pulse was thin and soft with no strength.
Diagnosis: Endometritis (Qi deficiency with damp-heat in the uterus).
Prescription: Huang Qi 12g, Chao Bai Zhu 12g, Dang Gui (Angelica) 9g, Pao Shen 15g, Sang Ji Sheng 15g, Huang Lian 3g, Huang Bo 9g, Tu Fu Ling 15g, Hou Po 9g, Huo Xiang 6g, Dan Cao 9g.
After 5 doses, leukorrhea decreased, dizziness and shortness of breath improved, and lower limb edema gradually subsided. After taking 12 more doses, the endometritis was cured.
Note: Excessive leukorrhea that is clear and thin, with a weak constitution, is treated as insufficient spleen and kidney, and treatment for cold dampness descending is ineffective. Excessive leukorrhea secretion is often due to local damp-heat infiltration, and Yiqi Jiedu Decoction tonifies the middle jiao spleen and stomach righteous Qi, disperses the dampness in the middle jiao, and clears the damp toxins from the lower jiao, aligning with the pathogenesis. Simply tonifying or draining dampness and detoxifying is not suitable for this type of syndrome.
Case Study: Leukorrhea Disease (Cervical Cancer)
Patient Tu, female, 65 years old, first diagnosed on January 21, 1987. The patient had irregular vaginal bleeding for half a year, with foul-smelling blood mixed, persisting continuously. Gynecological examination showed cervical erosion and necrosis, with bleeding upon touch, and biopsy results indicated squamous cell carcinoma. Currently: Pale complexion, generalized edema, fatigue, aversion to cold, stabbing pain and heaviness in the lower abdomen, yellow and scanty urination, and dribbling. The tongue was dark and pale with tooth marks, and the pulse was deep, thin, and weak.
Diagnosis: Cervical cancer (Qi deficiency with damp-heat accumulation).
Prescription: Huang Qi 15g, Yi Yi Ren 15g, Zhi Fu Zi (Processed Aconite) 9g, Tu Fu Ling 15g, Sang Ji Sheng 15g, Hou Po 9g, Ban Zhi Lian (半枝莲) 18g, She She Cao (蛇舌草) 18g, Zi Hua Di Ding 15g.
After taking over 10 doses, the amount of leukorrhea increased while bleeding decreased, and the foul odor slightly diminished, with clearer urination and less aversion to cold. The original formula was adjusted and taken for over 60 doses, with symptoms basically eliminated, and gynecological examination results showed no erosion or necrosis, and no purulent or bloody discharge. Follow-up after 6 years showed the patient still healthy.
Note: This case shows significant Qi deficiency, and the necrotic part of the cervix should be viewed as a manifestation of damp-heat accumulation. The aversion to cold and deep pulse indicate the use of Fu Zi. Cancer is stubborn, and Huang Lian and Huang Bo often consume the already deficient Yang Qi, hence the selection of herbs with mild cold properties and detoxifying effects such as She She Cao, Ban Zhi Lian, and Zi Hua Di Ding. Yi Yi Ren tonifies the spleen, similar to Bai Zhu, and also drains dampness, detoxifies, and has anti-cancer properties.
Source: China Traditional Chinese Medicine NewsWritten by: He Qian, People’s Hospital of Jiangkou County, Tongren City, Guizhou Province; Shi Enjun, Second Affiliated Hospital of Guizhou University of Traditional Chinese MedicineRecommended Articles, click to read the original text:Folk Bone Setters Do Not Pass on Secret Recipes: The First Formula for Treating Fractures and Pain Relief!A Powerful Formula that Can Treat Cervical, Lumbar, Knee, and Heel Issues!//////////【 Read Previous Highlights 】
