Zhi Shi Xie Bai Gui Zhi Tang: a classic prescription for promoting yang and dispersing stagnation, removing phlegm and relieving qi

Zhi Shi Xie Bai Gui Zhi Tang comes from "Jingui Yaolue", a medical classic written by Zhang Zhongjing, a famous physician in the Eastern Han Dynasty. "Jingui Yaolue" is a part of "Shanghan Zabing Lun", which specializes in the diagnosis and treatment of various diseases. The book mentions: "Chest numbness, fullness in the heart, qi stagnation in the chest, chest fullness, and downward pressure on the heart, Zhi Shi Xie Bai Gui Zhi Tang is the main treatment, and Ginseng Decoction is also the main treatment." This passage describes the symptoms and treatment methods of chest pain, among which Zhi Shi Xie Bai Gui Zhi Tang is one of the main prescriptions.

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Explanation of the recipe of Zhi Shi Xie Bai Gui Zhi Tang

Zhi Shi Xie Bai Gui Zhi Tang is composed of five medicinal ingredients, which can be divided into the following parts according to the grouping method of monarch, minister, assistant and envoy:

• Main medicine : Zhishi, Xiebai

  • Zhishi : It has the effects of breaking up qi and eliminating stagnation, resolving phlegm and dispersing lumps. It can move qi downward, break up lumps, and eliminate lumps. It has a good effect on qi stagnation and phlegm obstruction in the chest.

  • Xiebai : Spicy and warm in nature, it can promote the flow of Yang Qi in the chest, disperse stagnation, and dissolve phlegm and cold. It can effectively remove the Yin and coldness stagnated in the chest, dissolve the phlegm and dampness accumulated in the upper part of the body, and promote the flow of Yang Qi in the chest to relieve the chest.

• Minister drug : Magnolia officinalis

  • Magnolia officinalis : It has the effects of drying dampness and resolving phlegm, promoting the downward movement of qi, and eliminating distension. It can assist Zhishi and Xiebai to relieve chest tightness, disperse stagnation, promote the downward movement of qi, eliminate distension, promote yang and resolve phlegm.

• Adjuvant : Melon

  • Melon : It is cold in nature and mainly acts on the lungs, clearing away phlegm and dampness, dispersing stagnation, and opening the chest and relieving chest pain. It has a good effect on phlegm and dampness that hinder the normal functioning of the lungs, thereby causing coughing, wheezing and shortness of breath.

• Adjuvant drug : cinnamon twig

  • Cinnamon twig : It has the effects of promoting yang and dispersing cold, reducing adverse qi, and calming the upward rushing qi. It can invigorate the yang in the chest, reduce phlegm and dampness, eliminate yin and cold, and make the qi flow smoothly, thus eliminating symptoms such as chest obstruction and adverse qi rushing upward.

Pathogenesis of Zhi Shi Xie Bai Gui Zhi Tang

The main pathogenesis of Zhi Shi Xie Bai Gui Zhi Tang is "chest yang deficiency, phlegm stagnation and qi reversal". In simple terms, it is the lack of yang in the chest, which causes dampness and phlegm in the body to be blocked in the chest, making the circulation of qi and blood unsmooth, and eventually forming a situation of qi stagnation in the chest . This kind of phlegm obstruction and qi stagnation will make people feel chest distension and pain, and in severe cases, they may even feel chest pain penetrating to the back .

枳實薤白桂枝湯

When the yang qi in the chest is insufficient, the cold qi will flow upward, causing qi to rush from the lower abdomen, causing discomfort in the chest, abdomen and heart area. In this case, phlegm and turbidity will block the normal functioning of the lungs, causing coughing, wheezing and shortness of breath. Zhi Shi Xie Bai Gui Zhi Tangregulates the qi mechanism to achieve the effect of reducing reverse qi and calming the upward rush, so as to restore the normal ascending and descending function of the qi mechanism, while dissolving cold qi and phlegm and dampness, and unblocking the parts blocked by cold phlegm and dampness.

Effects of Zhi Shi Xie Bai Gui Zhi Tang

The main effect of Zhi Shi Xie Bai Gui Zhi Tang is to "promote Yang and disperse stagnation, remove phlegm and relieve Qi". It is suitable for chest discomfort, such as chest tightness and chest pain. In severe cases, the chest pain may penetrate to the back. Accompanied by shortness of breath, cough, phlegm, Qi rushing from the lower abdomen (chest ribs and heart discomfort), white and greasy tongue coating, and deep and tight pulse.

The main ingredients in the Zhi Shi Xie Bai Gui Zhi Tang, such as Zhishi and Magnolia officinalis, can break up qi and eliminate stagnation, resolve phlegm and relieve lumps, while Xiebai and Guizhi can promote the flow of yang qi in the chest, disperse stagnation, and resolve phlegm, dampness and coldness. Guarana mainly acts on the lungs, clearing phlegm, dispersing stagnation, and can open the chest and relieve chest pain. These drugs work together to achieve the effect of promoting yang, dispersing stagnation, removing phlegm and relieving qi, thereby improving chest pain and other related symptoms.

枳實薤白桂枝湯

The main effect of Zhi Shi Xie Bai Gui Zhi Tang is to "promote Yang and dissipate stagnation, dispel phlegm and relieve Qi". In simple terms, this prescription can help restore the Yang in the chest, dissolve phlegm and cold, and thus improve symptoms such as chest tightness and chest pain.

This prescription can also relieve various discomforts caused by phlegm, such as cough, wheezing and shortness of breath. The herbs in Zhi Shi Xie Bai Gui Zhi Tang can clear the phlegm and dampness in the lungs, disperse the stagnation, and open the chest to relieve chest pain. In this way, it can not only improve breathing problems, but also reduce chest and back pain, making patients feel more comfortable.

In addition, Zhi Shi Xie Bai Gui Zhi Tang also has the function of regulating Qi, which can reduce adverse Qi, calm the upward Qi, and restore the normal ascending and descending function of Qi. This has a good effect on relieving symptoms such as adverse Qi rushing to the heart, chest and rib discomfort, and heart discomfort.

Modern application of Zhi Shi Xie Bai Gui Zhi Tang

Zhi Shi Xie Bai Gui Zhi Tang is also widely used in modern medicine. It is often used to treat coronary heart disease, angina pectoris, arrhythmia, chest pain due to trauma, chronic bronchitis, chronic nephritis, non-suppurative costitis, intercostal neuralgia, back coldness, epigastric pain, children's hyperrespiration syndrome, etc., which are caused by weak chest yang and phlegm and qi stagnation.

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In addition, this prescription has two variations, namely "Guarana Xiebai Baijiu Tang" and "Zhi Shi Xie Bai Gui Zhi Tang". If the patient has asthma with phlegm, chest and back pain, shortness of breath, cough, deep and slow pulse at Cunkou, and small and tight pulse at Guanshang, "Guarana Xiebai Baijiu Tang" is used for treatment. It is the basic prescription for treating chest pain. If there is a lot of turbid phlegm in the body, you can add Banxia, which is called "Zhi Shi Xie Bai Gui Zhi Tang". It has the function of promoting yang and dispersing stagnation, removing phlegm and widening the chest. It is mainly used to treat chest pain with severe turbid phlegm, chest pain and restless sleep.

Notes

When using Zhi Shi Xie Bai Gui Zhi Tang, you need to pay attention to the following points:

1. This prescription alone should not be used for chest pain due to yang deficiency and weak qi : For patients with yang deficiency and weak qi, this prescription alone may not be effective and needs to be combined with other yang-tonifying and qi-invigorating medicines for treatment.

2. Treatment based on syndrome differentiation : This prescription is mainly used for chest pain caused by weak chest yang, phlegm blocking qi stagnation and qi reversal. The clinical diagnosis points are chest fullness and pain, qi reversal from the lower abdomen rushing up to the heart and chest, white and greasy tongue coating, and deep, stringy or tight pulse.

3. Add or subtract medication : Depending on the patient's specific symptoms, medication can be appropriately added or subtracted. For example, if the patient has chest pain but cannot lie flat, which indicates that there is fluid in the chest, add Pinellia to reduce the chest fluid. If the chest feels full, add Citrus aurantium to dredge the Qi in the chest. If the Qi is reversed and rushes to the heart, add Magnolia officinalis to dredge the Qi near the chest and ribs.

Conclusion

As a classic Chinese medicine prescription, Zhi Shi Xie Bai Gui Zhi Tang has the effects of promoting yang and dispersing stagnation, removing phlegm and relieving qi, and has a significant effect on the treatment of chest diseases such as chest pain. Through a detailed introduction to its origin, prescription explanation, indications, efficacy, modern application and precautions, we can better understand and apply this traditional prescription and provide effective treatment plans for related diseases in modern medicine. I hope this article can help readers better understand Zhi Shi Xie Bai Gui Zhi Tang and achieve good therapeutic effects in practical applications.