（This article is for learning and reference only. The formulas mentioned should be used under the guidance of a qualified TCM practitioner, and should not be attempted blindly by non-professionals.）The theoretical basis of this article: “Treatise on the Golden Chamber” and “Chinese Herbal Medicine”.Hello, I am a TCM practitioner, Wen Junran.Today, I would like to discuss TCM’s treatment experience for Spleen and Stomach Yang Deficiency.In fact, there is a classic formula for Spleen and Stomach Yang Deficiency in TCM. This is the Huang Qi Jian Zhong Tang (Astragalus Jian Zhong Decoction). It comes from the “Treatise on the Golden Chamber” and consists of the following ingredients: Gui Zhi (Cinnamon Twig) 9g, Zhi Gan Cao (Honey-Fried Licorice) 6g, Da Zao (Jujube) 6 pieces, Bai Shao (White Peony) 18g, Sheng Jiang (Fresh Ginger) 9g, Yi Tang (Maltose) 30g, Huang Qi (Astragalus) 5g.This formula is based on Xiao Jian Zhong Tang (Minor Jian Zhong Decoction) with the addition of Huang Qi. Its efficacy is to warm and tonify the middle Qi and harmonize the interior.Dear readers, remember that when it comes to regulating Spleen and Stomach Yang Deficiency, TCM practitioners must think of Huang Qi Jian Zhong Tang. It is also knowledge that ordinary TCM enthusiasts and the general public should be aware of.Now, let me share a clinical case story with you.
There was a man, 34 years old, who worked as a laborer.He was diagnosed with duodenal bulb ulcer in his early years, and after treatment, the results were mediocre, with his condition fluctuating between good and bad. Later, his problems developed to a more serious level. In addition to pain in the epigastric region, he also experienced spasmodic sensations throughout his abdomen, similar to cramping. When did this happen? It occurred during cold and damp weather. What did he do when the symptoms flared up? He had to eat something. Eating a little would provide some relief.However, he could not eat much, had a small appetite, and was increasingly fatigued, almost unable to maintain his work. His stools were soft and rarely formed.In desperation, he later sought TCM treatment.Upon examination, the patient’s tongue was pale with a moist coating, and his pulse was weak and wiry.After understanding these conditions, the physician prescribed a formula. The prescription was as follows:Gui Zhi 6g, Bai Shao 12g, Sheng Huang Qi 15g, Sheng Jiang 3 slices, Da Zao 5 pieces, Zhi Gan Cao 6g, Yi Tang 30g, Guang Mu Xiang 6g, Sha Ren 6g, totaling 5 doses.What was the result? After taking the medicine, the patient’s gastric pain significantly decreased, and the spasmodic sensations in the abdomen disappeared. Only during hunger did he still feel some pain in the stomach. However, this pain was tolerable.At this point, the original prescription remained unchanged, and another 5 doses were given.After completing a total of 10 doses, the patient’s discomfort symptoms had basically disappeared. He felt strong and invigorated. At this time, the physician adjusted the formula to Xiang Sha Liu Jun Zi Tang (Aromatic Sand Six Gentlemen Decoction) for follow-up treatment.This is the basic course of the clinical case I have narrated.Now, let’s briefly discuss its theoretical implications.You see, this patient’s issue is a classic case of Spleen and Stomach Yang Deficiency.Setting aside the so-called duodenal bulb ulcer, let’s focus on his symptoms. This patient experienced increased gastric pain during cold and damp conditions, indicating that there is cold in the middle jiao (digestive system). The external cold pathogen exacerbates the internal cold; cold leads to stagnation and pain, hence the patient experiences pain.
Secondly, the patient was mentally fatigued, and eating alleviated the pain, yet his appetite was small, his pulse was weak, and his tongue was pale. This fully indicates that he has Spleen and Stomach Qi Deficiency, which is the “deficiency” aspect. Mental fatigue is due to Qi deficiency failing to invigorate and nourish the head and face. Eating alleviates the pain because it slightly improves the deficiency of middle Qi. A weak pulse indicates that Qi deficiency cannot propel the pulse.The patient’s stools were soft and unformed, which is a manifestation of Spleen deficiency and insufficient transformation.In summary, we can conclude that this is a case of Spleen and Stomach Yang Deficiency.Next, there is an important piece of information: the patient experienced spasmodic sensations in the abdomen. What does this mean? In TCM understanding, it indicates that with Spleen and Stomach deficiency, the Earth (Spleen) is weak and the Wood (Liver) is overpowering. The Liver belongs to Wood, and the Spleen belongs to Earth. When the Spleen Earth is too weak, the Liver Wood, which naturally overcomes Earth, can more easily “bully” the Spleen, leading to “overpowering” or “overcoming Earth.” The Liver Qi then becomes less gentle. The Liver governs the tendons. This abnormality in Liver Qi manifests in the body as muscle spasms. In other words, the lack of gentleness in Liver Qi leads to stiffness in the muscles, resulting in spasms.Do you understand what I mean?So what should be done at this point? Since the Spleen and Stomach are weak, we need to tonify the Qi of the middle jiao Spleen and Stomach. Since the Liver Qi is not gentle, we need to soften the Liver and relieve spasms. Since there is cold in the middle jiao Spleen and Stomach, we need to disperse the cold and warm the Yang.Look at the ingredients used by the physician at that time:Gui Zhi 6g, Bai Shao 12g, Sheng Huang Qi 15g, Sheng Jiang 3 slices, Da Zao 5 pieces, Zhi Gan Cao 6g, Yi Tang 30g, Guang Mu Xiang 6g, Sha Ren 6g.Here, Huang Qi tonifies Qi and benefits the Spleen and Stomach Qi.Gui Zhi and Sheng Jiang are used to warm and promote the Yang Qi of the middle jiao, dispersing cold.Bai Shao nourishes blood, softens the Liver, and relieves pain.Sheng Jiang and Da Zao protect and support the middle jiao Spleen and Stomach, generating Qi and blood.Yi Tang, besides effectively alleviating pain, also warms and tonifies the middle jiao.Sha Ren and Mu Xiang are used to move Qi, relieve pain, and warm the middle while transforming dampness.You see, this combination is very neat and comprehensive.Dear readers, please remember that this is the application of Huang Qi Jian Zhong Tang we mentioned at the beginning. You will find that it only adds Mu Xiang and Sha Ren.
Huang Qi Jian Zhong Tang is based on Xiao Jian Zhong Tang, with the addition of Huang Qi. What does Xiao Jian Zhong Tang address? It addresses middle jiao Yang deficiency and pain caused by disharmony between the Liver and Spleen, especially spasmodic pain in the epigastric and abdominal regions, which prefers warmth and pressure. It works well for this. Huang Qi Jian Zhong Tang, of course, adds the effect of tonifying the Spleen and benefiting Qi, addressing the Qi deficiency issue in Xiao Jian Zhong Tang. For those with middle jiao Yang deficiency, the long-term insufficiency can easily lead to Spleen and Lung Qi deficiency. Therefore, Huang Qi Jian Zhong Tang has an advantage in treating clinical cases of middle jiao Yang deficiency. The advantage lies in its ability to tonify Qi.The patient in the clinical case is very representative. Modern people, due to their love for cold foods, irregular eating habits, and uneven meals, are prone to Spleen and Stomach Yang deficiency. Over time, Spleen and Stomach Yang deficiency can lead to significant Qi deficiency, causing patients to experience gastric pain, which worsens in cold conditions, along with fatigue, lack of energy, and loose stools. At this time, using Huang Qi Jian Zhong Tang is appropriate. If, as in the clinical case, it is combined with a bit of Mu Xiang and Sha Ren, that would be even better.In summary, Huang Qi Jian Zhong Tang is a formula worth our serious study and appreciation.Well, that’s all I want to share with you. Thank you for reading.
