妇科合剂

• Main symptoms:
  • Irregular menstruation: menstrual cycle early or late without a fixed pattern, or prolonged menstrual periods, or excessive menstrual flow that is pale in color and thin in quality.
  • Dysmenorrhea: dull lower abdominal pain or a sensation of emptiness and bearing-down during or after menstruation, relieved by warmth and pressure.
  • Infertility or threatened miscarriage: prolonged failure to conceive, or, after conception, restless fetal movement, lower back soreness and abdominal pain and other signs of threatened miscarriage.
• General and accompanying symptoms:
  • Blood deficiency manifestations: sallow or pale complexion, dizziness and palpitations, insomnia with profuse dreaming, pale lips and nails.
  • Qi deficiency manifestations: fatigue and lack of strength, shortness of breath and reluctance to speak, easy sweating.
  • Qi stagnation manifestations: breast distension and pain before menstruation, discomfort in the rib-side region, frequent sighing.
  • Kidney deficiency with cold uterus manifestations: soreness and weakness of the lower back and knees, aversion to cold with cold limbs, coldness in the lower abdomen.

3. Tongue and pulse

• Tongue: pale, swollen tongue, possibly with tooth marks on the edges, thin white coating.
• Pulse: fine and weak, or deep, fine and forceless.

Summary and cautions

• Characteristics of this formula: it combines attacking and tonifying methods, with tonification predominant; it tonifies qi and blood together, using qi to generate blood; it regulates the Liver, Spleen and Kidney together, with emphasis on the Chong and Ren vessels. It is a gentle yet effective formula used for deficient, cold-type gynecological disorders.
• Modern applications: commonly used for irregular menstruation, dysmenorrhea, dysfunctional uterine bleeding, infertility, threatened miscarriage, postpartum weakness and other conditions presenting with the pattern described above.
• Contraindications:
  • Contraindicated in yin deficiency with effulgent fire (such as heat in the palms and soles, dry mouth and throat, red tongue with scanty coating).
  • Contraindicated for irregular menstruation or dysmenorrhea caused by excess heat or internal damp-heat (such as early menstruation with heavy, dark-red flow, yellow greasy tongue coating).
  • Should be discontinued during episodes of common cold with fever.

This formula fully embodies the core treatment principles of TCM gynecology: "in women, blood is the foundation and qi is the function," as well as "regulating menstruation, promoting conception, and preventing miscarriage."

4. Complete composition after proportional conversion (raw herb dosage)

The specific dosage calculation for each herb is as follows:

• Blood-nourishing and blood-moving group (Sovereign & Minister herbs)
  • Dang Gui (Chinese angelica root): 9.00 g
  • Shu Di Huang (prepared rehmannia root): 79.2g × 11.36% = 9.00 g
  • Bai Zhu (atractylodes rhizome): 79.2g × 11.36% = 9.00 g
  • Chao Bai Shao (stir-fried white peony root): 79.2g × 8.52% = 6.75 g
  • Chuan Xiong (chuanxiong rhizome): 79.2g × 8.52% = 6.75 g
• Qi-regulating and menstruation-regulating group (Minister & Assistant herbs)
  • Cu Xiang Fu (vinegar-processed cyperus rhizome): 79.2g × 8.52% = 6.75 g
  • Yi Mu Cao (motherwort herb): 79.2g × 8.52% = 6.75 g
  • Huang Qi (astragalus root): 79.2g × 5.68% = 4.50 g
  • Du Zhong (eucommia bark): 79.2g × 5.68% = 4.50 g
  • Ai Ye (mugwort leaf): 79.2g × 5.68% = 4.50 g
• Assistant and Guide herbs group
  • Fu Ling (poria): 79.2g × 2.84% = 2.25 g
  • Mai Dong (ophiopogon root): 79.2g × 2.84% = 2.25 g
  • Chen Pi (aged tangerine peel): 79.2g × 2.84% = 2.25 g
  • Gan Cao (licorice root): 79.2g × 2.84% = 2.25 g
  • E Jiao (donkey-hide gelatin): 79.2g × 2.84% = 2.25 g
  • Sha Ren (amomum fruit): 79.2g × 0.60% = 0.48 g (approx. 0.5 g)

Total raw herb weight: approximately 79.2 g

5. Granule conversion and dose

• Converting to 5:1 granules:
  • 79.2 g raw herb ÷ 5 = 15.84 g granules.
• Recommended dose:
  • One dose per day, dissolved in warm water and taken in two portions, morning and evening, about 8 g per portion.

Important notes:

1. Formula classification: this formula tonifies qi and nourishes blood, and regulates qi and menstruation, while also tonifying the Kidney and preventing miscarriage. It is suitable for irregular menstruation, dysmenorrhea, and restless fetal movement caused by dual qi-blood deficiency with Liver constraint and Kidney deficiency. Its nature leans toward warming and tonifying, and it is suitable for patterns of deficiency-cold or combined deficiency and excess.
2. Handling of E Jiao: E Jiao is an animal-derived gelatin that does not decoct and concentrate well together with other herbs into granules. The standard method of granule preparation is: the remaining 15 herbs are decocted and concentrated into granules, while E Jiao is dissolved separately. When dispensing, patients should be instructed to dissolve the E Jiao portion of the daily dose (2.25 g) in hot water or yellow wine, then mix it evenly with the dissolved granule solution before taking it.
3. Cautions: use with caution in yin deficiency with effulgent fire (such as heat in the palms and soles, dry mouth and throat) or in excess-heat patterns. Discontinue temporarily during episodes of common cold with fever.