BLACK PEARL BP022 SHU GAN WAN CYPERUS & PEONY

SHU GAN WAN
舒肝丸
Cyperus & Peony Formula
Product Code: BP022

TCM Actions
Soothes the Liver, harmonises the Liver and the Stomach, regulates the Qi and the Blood to alleviate pain.

Indications
Stress related digestive disorders (e.g. dyspepsia, irritable bowel), flatulence, gastritis, duodenitis, gastroduodenal ulcer, Crohn’s disease, Inflammatory Bowel Disease (e.g. ulcerative colitis), chronic liver disease, hepatic cirrhosis, chronic cholecystitis, costochondritis.

Dosage & Course Of Treatment
8 pills, 3 times daily, half to one hour away from food.

Course of treatment: 1 – 3 months.

Once symptoms have been relieved, continue with an appropriate tonic or constitutional formula

Not to be taken long term.

Signs and Syndromes
Liver Qi constraint Liver Qi invasion of the Stomach

Epigastric pain and distension

Belching, reflux, nausea or vomiting

Symptoms brought on or aggravated by emotional strain

Hypochondrial distending pain

Poor appetite, bloating after meals

Irritability, emotional volatility, depressed mood, history of stress

Sense of tightness or oppressive sensation in the chest, the need to make an effort to take a deep breath, sighing

Pale tongue with a white coat, possibly with red edges

Wiry or slippery pulse

Cautions & Contraindications
Caution for those on anti-coagulant medications (i.e. heparin, warfarin or aspirin).

Caution for those on any type of sedative drug.

Caution duing the early stages of pregnancy.

Contraindicated for patients taking interferon.

Comments
This is a variant of the formula developed by Zhu Tian-bi, a physician of the Ming dynastic period (1368 – 1644), which treats Liver Qi constraint with Liver Qi invading the Stomach causing Qi stagnation in the middle Jiao. The original formulation had eighteen herbal ingredients, which may be regarded as ‘overkill’: the same therapeutic goals may be accomplished with fewer herbs in a more focused combination. This variant follows such an approach. Prolonged stress or emotional strain generally leads to Liver Qi constraint, from which may arise a variety of pathological consequences. In the clinical scenario covered by this formula, the Liver Qi counterflows ‘transversely’ to invade the Stomach, leading to stagnation of the Qi and disruption of the normal Qi movements of the middle Jiao. In contrast to the syndrome of Liver Qi invasion of the Spleen, most of the clinical features centre on the upper gastrointestinal tract, as described above. This particular condition tends to occur in patients with a robust constitution and may be regarded as an excess type syndrome because the Liver Qi is overactive. Thus, the Liver (Wood) ‘overacts’ on the Stomach (Earth) and overly restricts it activity, leading to stagnation of the Qi in the middle Jiao, which may lead to localized Blood stasis, manifesting as localized epigactric pain. Clinically it may be used alone for functional disorders of the upper GIT, as described above. Alternatively, it may be used as an adjunctive treatment for the upper GIT disturbances associated with chronic liver, gallbladder or inflammatory lower bowel diseases. The synergistic actions of the herbs are as follows:

• Paeonia root (bai shao), Bupleurum root (chai hu), Cyperus rhizome (xiang fu), Curcuma tuber (yu jin): soothe the Liver and disperse the stagnant Liver Qi

• Corydalis turtschaninovii, rhiz. (yan hu suo), Curcuma tuber (yu jin): activate the Blood and dispel stasis to alleviate pain

• Citrus aurantium, fruit (zhi ke), Citrus medica, fruit (fo shou), Amomum fruit (bai dou kou): regulate the Qi and harmonise the Stomach to redirect the Stomach Qi downwards

• Paeonia root (bai shao), Glycyrrhiza root (gan cao): nourish and soothe the Liver to alleviate spasmodic smooth muscular pain, protect the Liver Yin from the drying action of the other herbs

• Glycyrrhiza uralensis, root (gan cao): harmonises the herbs in the formula (moderates the harsh dispersing properties of the Blood regulating herbs and protects the Stomach)

Ingredients
PAEONIA LACTIFLORA, ROOT (bai shao) – 白芍 – 59.2 mg
BUPLEURUM FALCATUM, ROOT (chai hu) – 柴胡 – 44.4 mg
CYPERUS ROTUNDUS, RHIZ. (xiang fu) – 香附 – 44.4 mg
CORYDALIS TURTSCHANINOVII, RHIZ. (yan hu suo) – 延胡索 – 44.4 mg
CURCUMA LONGA, TUBER (yu jin) – 鬱金 – 44.4 mg
CITRUS AURANTIUM, FRUIT (zhi shi) – 枳實 – 44.4 mg
CITRUS MEDICA, FRUIT (fo shou) – 佛手 – 44.4 mg
AMOMUM AROMATICUM, FRUIT (dou kou) – 豆蔻 – 24.7 mg
GLYCYRRHIZA URALENSIS, ROOT (gan cao) – 甘草 – 24.7 mg