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What is Liver Qi Stagnation?

Some friends often sigh, feeling a blockage in their chest, their emotions are not very high, and they suspect they have liver Qi stagnation. Is it possible? It is indeed possible that it is liver Qi stagnation! Unlike the heat symptoms of liver fire, liver Qi stagnation is characterized by Qi depression, Qi stagnation, and emotional changes, also known as liver Qi depression syndrome. This condition arises from the liver’s failure to regulate and disperse Qi, leading to stagnation of Qi. Typical manifestations include depression, frequent sighing, fullness in the chest and flanks or lower abdomen, accompanied by wandering pain. Female patients may experience breast lumps, breast tenderness, irregular menstruation, and dysmenorrhea. Modern medical diagnoses often identify symptoms of liver Qi stagnation in conditions such as chronic hepatitis, depression, menopausal syndrome, and breast hyperplasia.

Why Does Liver Qi Stagnation Occur?

This is often related to emotional factors and pathogenic invasion. Emotional factors can include anger, depression, unfulfilled desires, or sudden psychological stimuli that disrupt the smooth flow of liver Qi, causing stagnation and blockage, which in turn impairs liver function and leads to symptoms. Pathogenic factors may include blood stasis and phlegm-dampness, which obstruct the flow of Qi in the liver meridian, causing blockage; or damage to the spleen and stomach, leading to poor Qi flow in the middle jiao, which also affects liver Qi.

5 Herbs for Soothe Liver and Regulate Qi to Treat Liver Qi Stagnation

Chuan Lian Zi (Melia Toosendan) — Soothe the liver, clear heat, move Qi, relieve pain, expel parasites, treat skin diseases.

Chuan Lian Zi is bitter and cold in nature; it enters the liver, stomach, small intestine, and bladder meridians. This herb not only soothes the liver and clears heat but also moves Qi and relieves pain, treating liver Qi stagnation or disharmony between the liver and stomach, especially for heat-induced chest pain and liver-stomach Qi stagnation, which manifests as pain in the chest and flanks. It is renowned as a “special medicine for hernias”; it also has the ability to expel parasites and relieve pain, suitable for abdominal pain caused by roundworms. Chuan Lian Zi is bitter and cold, effective for treating skin diseases, including tinea capitis.

Patients with spleen and stomach deficiency, anemia, liver dysfunction, or gastrointestinal ulcers should avoid Chuan Lian Zi. It should not be taken in excessive amounts or for prolonged periods; caution is advised regarding the variety used, as some places substitute it with bitter lianzi, which can lead to poisoning.

In clinical practice, it can be combined as follows to soothe the liver and move Qi:

Chuan Lian Zi combined with Yan Hu Suo (Corydalis Yanhusuo), such as in Jin Ling Zi San, can soothe the liver, clear heat, move Qi, and relieve pain, suitable for heat-induced chest pain and liver-stomach Qi stagnation;

Chuan Lian Zi combined with Sheng Di (Rehmannia), Dang Gui (Angelica Sinensis), and Gou Qi Zi (Goji Berries) can nourish Yin and blood, soften the liver, and relieve pain, suitable for long-standing pain in the chest and flanks, liver Qi stagnation transforming into heat, and Yin-blood deficiency;

Chuan Lian Zi combined with Huo Xiang (Agastache) and Wu Zhu Yu (Evodia), such as in Dao Qi Tang, can move Qi, soothe the liver, dispel cold, and relieve pain, suitable for hernia pain due to excess cold and dampness;

Chuan Lian Zi combined with Xiang Fu (Cyperus Rotundus) can treat chest tightness and flank distension caused by liver Qi stagnation, breast tenderness, or menstrual irregularities.

Qing Pi (Unripe Tangerine Peel) — Soothe the liver, break Qi stagnation, eliminate accumulation.

Qing Pi is bitter and pungent, warm in nature; it enters the liver, gallbladder, and stomach meridians. This herb is effective in soothing the liver and breaking Qi stagnation, treating liver Qi stagnation with flank pain, breast tenderness or lumps, breast abscess, and cold hernia abdominal pain. It also disperses masses and eliminates stagnation, treating abdominal masses, chronic malaria, and food accumulation-related abdominal pain. Vinegar-fried Qing Pi is particularly effective in soothing the liver and relieving pain. However, caution is advised for those with Qi deficiency.

In clinical practice, Qing Pi can be combined as follows:

Qing Pi combined with Chai Hu (Bupleurum), Yu Jin (Curcuma), and Xiang Fu can treat liver Qi stagnation with chest and flank distension;

Qing Pi combined with Chai Hu, Zhe Bei Mu (Fritillaria), and Ju Ye (Tangerine Leaf) can treat breast tenderness or lumps;

Qing Pi combined with Gua Lou Pi (Trichosanthes), Jin Yin Hua (Honeysuckle), and Pu Gong Ying (Dandelion) can clear heat and detoxify, treating breast abscess and swelling;

Qing Pi combined with Wu Yao (Lindera) and Xiao Hui Xiang (Fennel), such as in Tian Tai Wu Yao San, can treat cold hernia pain;

Qing Pi combined with Gui Zhi (Cinnamon Twig) and Chen Pi (Aged Tangerine Peel), such as in San Pi Tang, can treat cold pain in the abdomen;

Qing Pi combined with San Leng (Sparganium) and E Zhu (Curcuma Zedoaria) can treat Qi stagnation and blood stasis-related abdominal masses and chronic malaria.

Yu Jin (Curcuma) — Invigorate blood, relieve pain, move Qi, resolve depression, cool blood, benefit the gallbladder, and reduce jaundice.

Yu Jin is pungent and bitter, cold in nature; it enters the liver, gallbladder, and heart meridians. This herb invigorates blood and moves Qi, effectively relieving pain and treating chest, abdomen, and flank distension or stabbing pain, as well as pain due to Qi stagnation and blood stasis. It can also cool blood and stop bleeding, suitable for vomiting blood, nosebleeds, and menstrual irregularities due to Qi fire. It awakens the spirit, benefits the gallbladder, and reduces jaundice, effective for liver and gallbladder damp-heat jaundice and gallstones. It is a key herb for invigorating blood, moving Qi, and cooling blood.

Care should be taken regarding dosage, form, and combinations to prevent Yu Jin toxicity; it should not be used with cloves due to pharmacological antagonism; those with Yin deficiency or without Qi stagnation and blood stasis should avoid it, and pregnant women should use it cautiously.

In clinical practice, Yu Jin can be combined as follows:

Yu Jin combined with Chai Hu, Bai Shao (White Peony), and Xiang Fu can treat stabbing pain in the chest and flanks due to liver Qi stagnation;

Yu Jin combined with Gua Lou, Xie Bai (Garlic Chives), and Dan Shen (Salvia) can treat chest pain due to blood stasis;

Yu Jin combined with Chai Hu, Zhi Zi (Gardenia), Dang Gui, and Chuan Xiong (Ligusticum) can treat dysmenorrhea and breast distension due to liver Qi stagnation with heat and blood stasis;

Yu Jin combined with Bie Jia (Soft-shelled Turtle), E Zhu, Dan Shen, and Qing Pi can treat abdominal masses.

Fo Shou (Buddha’s Hand) — Soothe the liver, resolve depression, regulate Qi, harmonize the middle jiao, dry dampness, and transform phlegm.

Fo Shou is pungent, bitter, and sour, warm in nature; it enters the liver, spleen, stomach, and lung meridians. This herb is particularly suitable for conditions of disharmony between the liver and stomach or liver-spleen imbalance. It is effective for indigestion, chronic gastritis, early liver cirrhosis, infectious hepatitis in children, and dysmenorrhea, especially in cases of liver Qi stagnation or liver-stomach disharmony, as well as abdominal distension, nausea, reduced appetite, chronic cough with excessive phlegm, and chest pain. This herb is pungent and warming, and caution is advised for those with Yin deficiency and heat, or Qi deficiency without stagnation.

In clinical practice, Fo Shou can be combined as follows:

Fo Shou combined with Qing Pi and Chuan Lian Zi can treat liver Qi stagnation and liver Qi invading the stomach;

Fo Shou combined with Mu Xiang (Aucklandia) and Zhi Ke (Bitter Orange) can treat lung Qi stagnation with chest tightness and spleen-stomach Qi stagnation;

Fo Shou combined with Ju Luo (Tangerine Peel), Si Gua Luo (Luffa), and Pi Pa Ye (Loquat Leaf) is particularly suitable for chronic cough with excessive phlegm and chest and abdominal tightness;

Fo Shou combined with Chen Pi enhances the ability to regulate Qi, dry dampness, and transform phlegm, treating spleen-stomach or liver-stomach Qi stagnation with excessive phlegm and cough.

Xiang Fu (Cyperus Rotundus) — Soothe the liver, resolve depression, regulate menstruation, relieve pain, and regulate Qi.

This herb is pungent, slightly bitter, and slightly sweet, neutral in nature; it enters the liver, spleen, and San Jiao meridians. It is primarily used to treat liver Qi stagnation with flank pain, abdominal pain, as well as menstrual irregularities, dysmenorrhea, breast hyperplasia, chronic hepatitis, liver cirrhosis, gallstones, chronic gastritis, duodenal ulcers, and pelvic inflammatory disease, all of which are related to liver Qi stagnation. As a general remedy for Qi disorders and a key herb in gynecology, Xiang Fu is also an essential medicine for regulating menstruation and relieving pain. Similar to other Qi-regulating herbs, caution is advised for those with Qi deficiency without stagnation, Yin deficiency, or blood heat.

In clinical practice, Xiang Fu can be combined as follows to treat liver Qi stagnation:

Xiang Fu combined with Gao Liang Jiang (Galanga) can treat abdominal pain due to cold Qi stagnation and liver Qi invading the stomach;

Xiang Fu combined with Chai Hu, Chuan Xiong, and Zhi Ke can treat flank distension and pain due to liver Qi stagnation;

Xiang Fu combined with Zi Su (Perilla) can balance Qi and blood, enhancing the ability to regulate Qi, relieve depression, move Qi, and eliminate fullness, suitable for Qi and blood imbalance, chest and abdominal fullness, and pregnancy-related nausea and abdominal distension;

Xiang Fu combined with Dang Gui can complement each other, enhancing the effects of soothing the liver and nourishing blood, regulating menstruation, and relieving pain, suitable for stabbing pain in the chest, breast tenderness, menstrual irregularities, and lower abdominal distension.

Comparison of Xiang Fu and Chai Hu:

What Should Patients with Liver Qi Stagnation Pay Attention To?

Liver Qi stagnation is closely related to emotional stimuli and unfulfilled emotions. Therefore, patients should maintain an optimistic attitude, a relaxed mood, and focus on diverting their attention, avoiding fixation on any particular issue. Liver Qi stagnation or blockage can involve a wide range of conditions, particularly in gastrointestinal and gynecological diseases. It is generally not recommended for patients to self-medicate; instead, they should seek treatment under the guidance of a qualified physician to effectively improve and stabilize their condition. Through good daily management, patients should avoid rich, spicy, and cold foods, refrain from smoking and drinking, and actively cooperate with medication and follow-up examinations to facilitate recovery.

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