Buzhong Yiqi Tang
Overview
Buzhong Yiqi Tang (补中益气汤) is a traditional Chinese herbal formula that translates to "Tonify the Middle and Raise Qi Decoction." This formula is classified as a Qi-replenishing formula (补气剂) within the broader category of tonifying agents (补益剂). It was first recorded in "Nei Wai Shang Bian Huo Lun" (《内外伤辨惑论", "Discernment of Internal and External Injury") by Li Dongyuan (李东垣) during the Jin-Yuan period. The formula is primarily indicated for spleen qi collapse syndrome (脾虚气陷证) and qi deficiency fever syndrome (气虚发热证), and has been widely used in clinical practice for centuries.
History
Buzhong Yiqi Tang was created by the famous Jin-Yuan physician Li Dongyuan (1180-1251), who was one of the four great masters of the Jin-Yuan school of Chinese medicine. Li Dongyuan developed this formula based on his extensive clinical experience and theoretical understanding of the spleen and stomach as the foundation of postnatal qi (后天之本). The formula reflects his emphasis on the importance of the spleen's function in generating qi and blood, and its role in maintaining the body's equilibrium. The original formula has been preserved in classical texts and has been widely studied and modified by subsequent generations of practitioners.
Key Information
| Aspect | Details |
|---|---|
| Chinese Name | 补中益气汤 (Buzhong Yiqi Tang) |
| Classification | Qi-replenishing formula (补气剂) |
| Primary Functions | Replenish middle qi, raise yang to collapse (补中益气，升阳举陷) |
| Main Indications | Spleen qi collapse syndrome, qi deficiency fever syndrome |
| Original Source | "Nei Wai Shang Bian Huo Lun" (《内外伤辨惑论》) |
Composition and Dosage
The original formula consists of the following ingredients:
- Huangqi (黄芪, Astragalus root): 15g
- Renshen (人参, Ginseng) or Dangshen (党参, Codonopsis root): 15g
- Baizhu (白术, Atractylodes rhizome): 10g
- Zhigancao (炙甘草, Honey-fried licorice root): 15g
- Danggui (当归, Angelica sinensis root): 10g
- Chenpi (陈皮, Dried tangerine peel): 6g
- Shengma (升麻, Cimicifuga rhizome): 6g
- Chaihu (柴胡, Bupleurum root): 12g
- Shengjiang (生姜, Fresh ginger): 9 slices
- Dazao (大枣, Jujube fruit): 6 pieces
Preparation and Administration
The traditional preparation method involves grinding the herbs (㕮咀) and decocting them together in 300ml of water until reduced to 150ml. The decoction is then strained, and the liquid is taken warm on an empty stomach. Modern clinical practice may modify this preparation method according to convenience and individual patient needs.
Therapeutic Mechanism
The formula addresses conditions caused by dietary overexertion and fatigue that damage the spleen and stomach, leading to qi deficiency and the sinking of clear yang. The spleen and stomach are considered the source of the body's nutritive qi, defensive qi, blood, and fluids. When spleen qi is deficient, it results in reduced food intake, fatigue, shortness of breath, loose stools, and a pale tongue with a deficient pulse. The sinking of clear yang can manifest as organ prolapse such as rectal or uterine prolapse, chronic diarrhea, or dysentery. When clear yang sinks to the lower energizer, it can cause heat stagnation, while deficient qi fails to secure the body's exterior, leading to spontaneous sweating.
Formula Analysis
- Huangqi (Astragalus): Sweet and slightly warm, it enters the spleen and lung meridians, serving as the principal herb (君药) to tonify middle qi, raise yang, and secure the exterior.
- Renshen (Ginseng) and Zhigancao (Honey-fried licorice): These herbs assist in tonifying qi and strengthening the spleen as minister herbs (臣药).
- Danggui (Angelica): Nourishes blood and harmonizes nutritive qi, working with Renshen and Huangqi to tonify qi and blood.
- Chenpi (Dried tangerine peel): Regulates qi and harmonizes the stomach, preventing the other tonifying herbs from causing stagnation.
- Shengma (Cimicifuga) and Chaihu (Bupleurum): In small amounts, these herbs raise yang and address collapse, serving as assistant and envoy herbs (佐使药).
- Zhigancao (Honey-fried licorice): Also harmonizes the effects of all the other herbs.
Clinical Applications
The formula is primarily indicated for spleen qi collapse syndrome, with clinical manifestations including reduced food intake, fatigue, shortness of breath, a pale tongue, deficient pulse, and organ prolapse. It is also used for qi deficiency fever characterized by fever, spontaneous sweating, preference for hot drinks, shortness of breath, and fatigue.
Modifications
The formula can be modified based on specific symptoms:
- For abdominal pain, add Baishao (白芍, White peony root) to soften the liver and relieve pain.
- For headache, add Manjingzi (蔓荆子, Vitex fruit), Chuanxiong (川芎, Ligusticum root), Gaoben (藁本, Ligusticum root), or Xixin (细辛, Asarum root) to dispel wind and relieve pain.
- For cough, add Wuweizi (五味子, Schisandra fruit) and Maidong (麦冬, Ophiopogon root) to astringe the lungs and stop cough.
- For qi stagnation, add Muxiang (木香, Aucklandia root) and Zhiqiao (枳壳, Immature bitter orange) to regulate qi and relieve depression.
Contraindications
The formula should not be used in cases of yin deficiency fever or excessive internal heat.
Related Formulas
Several related formulas have been developed based on Buzhong Yiqi Tang:
Shengyang Yiwei Tang (升阳益胃汤)
- Composition: Huangqi, Banxia (半夏, Pinellia tuber), Renshen, Gancao (甘草, Licorice root), Duhuo (独活, Angelica pubescens root), Fangfeng (防风, Saposhnikovia root), Baishao, Qianghuo (羌活, Notopterygium root), Jupi (橘皮, Tangerine peel), Fuling (茯苓, Poria), Baizhu, Zexie (泽泻, Alisma rhizome), Chaihu, Huanglian (黄连, Coptis root), Shengjiang, Dazao.
- Functions: Tonify qi, raise yang, clear heat, and eliminate dampness.
- Indications: Spleen and stomach qi deficiency with dampness-heat stagnation.
Shengxian Tang (升陷汤)
- Composition: Sheng Huangqi (生黄芪, Raw astragalus), Zhimu (知母, Anemarrhena rhizome), Chaihu, Jiegeng (桔梗, Platycodon root), Shengma.
- Functions: Tonify qi and raise yang that has collapsed.
- Indications: Collapse of qi in the chest cavity.
Juyuan Jian (举元煎)
- Composition: Renshen, Huangqi, Zhigancao, Shengma, Baizhu.
- Functions: Tonify qi and raise yang.
- Indications: Qi collapse with uterine bleeding or collapse of yang qi.
Cultural Significance
Buzhong Yiqi Tang represents the essence of Li Dongyuan's medical philosophy, emphasizing the central role of the spleen and stomach in maintaining health. The formula has been passed down through generations and is considered a cornerstone of traditional Chinese herbal medicine. Its influence extends beyond China to other East Asian countries that have incorporated traditional Chinese medicine into their healthcare systems.
Modern Status
Today, Buzhong Yiqi Tang continues to be widely used in clinical practice in China and other countries practicing traditional Chinese medicine. Modern research has explored its pharmacological effects, including immune modulation, gastrointestinal function regulation, and effects on uterine and other organ prolapses. The formula is available in various forms, including traditional decoctions, granules, and patent medicines, making it accessible to modern patients while maintaining its traditional therapeutic principles.
References
- Li, D. (1249). Nei Wai Shang Bian Huo Lun (Discernment of Internal and External Injury). Jin Dynasty.
- Luo, M. (1682). Gu Jin Ming Yi Fang Lun (Discussions on Famous Physician Formulas Through History). Qing Dynasty.
- Bensky, D., Clavey, S., & Stöger, E. (2011). Chinese Herbal Medicine: Materia Medica (3rd ed.). Eastland Press.
- Chen, J. K., & Chen, T. T. (2004). Chinese Medical Herbology and Pharmacology (2nd ed.). Art of Medicine Press.
- World Health Organization. (2001). WHO Monographs on Selected Medicinal Plants. WHO Press.