Xiao Yao Wan

Functions

Xiao Yao Wan mainly functions to relieve depression by soothing the liver and to nourish the blood by strengthening the spleen. It is used to treat hypochondriac pain, headache and dizziness, dry mouth and throat, fatigue and lack of appetite, irregular menstruation, and distending pain of the breast.

Dosage Info

Oral administration: 1 pill, 3 times a day, to be taken before meal; appropriate reduction of the dosage for children. 5:1 concentrated extract: 9 grams/day.

Ingredients

• Bai Shao
• Bai Zhu
• Bo He
• Chai Hu
• Dang Gui
• Fu Ling
• Gan Cao
• Sheng Jiang

Precautions

Toxicity: LD₅₀ (mice/abdominal administration/raw herbs): 20.77 ± 2.83g/kg.; MTD (mice/oral/raw herbs): 200g/kg.

Side Effects: There have been reports that this formula may lead to somnolence and leukorrhagia. (1) , (2)

Pharmacology

Effects on the central nervous system: Xiao Yao San can significantly raise the level of hypothalamic norepinephrine in rats, increasing the content of striatal dopamine while decreasing that of 3,4-dihydroxyphenyl acetic acid. This indicates that Xiao Yao San can selectively act on the central catecholamine nervous system. (3)

Protective effects on the liver: The formula can decrease the hepatic collagen level and prevent cirrhosis. This effect is achieved through its main ingredient’s (Fu Ling, Dang Gui, Chai Hu, and Licorice) inhibition of degenerative necrosis of hepatic cells, which effectively prevents inflammation and hepatic fibrosis. (4)

Effects on gastrointestinal movement: Experiments show that fed to mice, this formula promotes gastrointestinal peristalsis, increases food consumption and body weight. (5)

Counteracting lipid peroxidation: Experiments show that Xiao Yao San has an ameliorative effect on lipid perioxidation-induced damages to rats of experimental liver depression. (6)

Clinical Applications

Depressive neurosis
Xiao Yao Wan was used to treat 58 cases of depressive neurosis. The results: 17 cases fully recovered, 24 significantly improved, 12 improved, and 5 did not respond to the treatment, with a total effective rate of 91.38%. It is speculated that the formula’s therapeutic effect on depressive neurosis is related to its enhancement of central norepinephrine metabolism. (7)

Depression
Modifications of this formula were used to treat 30 cases of depression. The modifications were made as follows: for patients suffering from blood stasis and qi stagnation; Dan Shen, Xiang Fu, Wu Yao, Chuan Xiong, and Chi Shao were added. For patients with internal heat due to a long-depressed liver; Dan Shan and Zhi Zi were added. For patients with both qi and blood deficiencies; Dang Shen, Huang Qi, Shu Di Huang were added. And for patients with spleen-yang and kidney-yang deficiencies; Ba Ji Tian, Xian Mao, Yin Yang Huo, Gan Jiang, Fu Pian, and Ji Nei Jin were added. One unit of treatment lasted 30 days. The treatment featured a 30-day treatment unit and reported a total effective rate of 87%. (8)

Cholecystitis
A modification of this formula was used to treat 168 cases of acute and chronic cholecystitis. The results: 79 cases significantly improved, 89 cases improved, with a total effective rate of 100%. (9)

Hepatitis
A modification of this formula was used to treat 105 cases of chronic hepatitis. The modified formula consisted of Chai Hu, Dang Gui, Bai Shao, Bai Zhu, Dan Shen, Ji Nei Jin, Huang Qi, processed Gan Cao, and Bai Hua She She Cao. Further modifications were made to suit individual patient’s symptoms. The results: 48 cases significantly improved, 46 improved, and 11 did not respond to the treatment, with a total effective rate of 89.5%. (10)

Menopausal syndrome
This formula was used to treat 56 cases of menopausal syndrome. Modifications were made to suit individual patient’s symptoms. One unit of treatment lasted 7 days. Following, 1 to 4 units of treatment, 32 cases diminished, 14 significantly improved, 8 improved, and 2 did not respond to the treatment, with a total effective rate 96.43%. (11)

Chloasma
This formula was used to treat 31 cases of chloasma. Modifications were made to suit individual patient’s symptoms. The results: 6 cases resolved, 15 significantly improved, 7 improved, and 3 did not respond to the treatment, with a total effective rate of 90.3%. (12)

Oophoritic cyst
Modified as needed to suit individual patient’s symptoms, this formula was used to treat 186 cases of oophoritic cyst. The results: 124 cases resolved and another 48 cases improved, with a total effective rate of 92%. (13)

Hyperplasia of mammary glands
In combination with vitamin E, this formula was used to treat 86 cases of hyperplasia of mammary glands. Nine grams of the formula and 50 milligrams of vitamin E were administered three times a day. Twenty days constituted a unit of treatment. The formula was continued for a week after the lumps had dissolved. The results: 56 cases resolved, 20 improved, and 10 did not respond to the treatment, with a total effective rate of 85.7%. (14)

Psychoneurosis
A modification of this formula was used to treat 47 cases of neurosis. The modified formula consisted of Chai Hu, Dang Gui, Bai Shao, Bai Zhu, Fu Ling, Gan Cao, Yuan Zhi, Shi Chang Pu, Long Gu, Mu Li, Ci Shi, Hu Po, Da Zao, and Xiao Mai. Further modifications were made to suit individual patient’s symptoms. The results: 31 cases resolved, 14 improved, and 2 did not respond to the treatment, with a total effective rate of 96%. (15)

Hyperlipidemia
A modification of this formula was used to treat 40 cases of hyperlipidemia. The modified formula consisted of Chai Hu, Dang Gui, Bai Zhu, Ze Xie, Bai Shao, Fu Ling, Chen Pi, Dan Shen, Shan Zha, and Gan Cao. Further modifications were made to suit individual patient’s symptoms. The results: after receiving one unit of treatment, 15 cases had their condition clinically under control, 14 significantly improved, 8 improved, and 3 did not respond to the treatment, with a total effective rate of 92.5%. (16)

Heterotypic proliferation of the gastric mucosa
A modification of this formula was used to treat 40 cases of heterotypic proliferation of the gastric mucosa. The modified formula consisted of Chai Hu, Chen Pi, Dang Gui, Xiang Fu, Fu Ling, Bai Shao, Bai Zhu, Mu Xiang, and processed Gan Cao. Further modifications were made to suit individual patient’s symptoms. The results: 21 cases resolved, 6 improved, and 3 did not respond to the treatment, with a total effective rate of 90%. (17)

References

1. Huang Fa Rong, et al. One case of somnolence cause by Xiao Yao Wan. Jilin Journal of TCM. 1998;18(2):49.
2. Hu Dong Yun, et al. Two cases of leukorrhagia caused by Xiao Yao Wan. Journal of Applied TCM. 1996;12(6):33.
3. Wu Chun Fu, et al. Xiao Yao San’s effect on mice’s monoamine nerve transmitter content. Journal of Pharmacology and Clinical Application of TCM. 1993;9(2):8-10.
4. Ma Xue Hui, et al. Xiao Yao Wan’s effect on experimental hepatocirrhosis. Journal of Chinese Materia Medica. 1990;21(11):508-510.
5. Tao Jian Sheng, et al. The pharmacodynamics of Xiao Yao San. Journal of Chinese Patent Medicine. 1993;15(4):16-17.
6. Lu Zhi Ping, et al. Xiao Yao San’s protective on lipid peroxidation in liver-depressed mice. Journal of Shandong College of TCM. 1995;19(3):199-201.
7. Zhang Mei Zeng, et al. Treating depression with Xiao Yao San. Journal of Shandong Univeristy of TCM. 1998;22(1):34-37.
8. Wei Ping, et al. 30 cases of depression treated modified Xiao Yao San. Journal of Research in Traditional Chinese Medicine. 1999;12(5):54-55.
9. Gu Xiao Xia. 168 cases of acute and chronic cholecystitis treated with modified Xiao Yao San. Jiangxi Journal of TCM. 1999;30(1):27.
10. Zha De Hua. 105 cases of chronic hepatitis B treated with modified Xiao Yao San. Journal of Anhui College of TCM. 1999;18(1):34-35.
11. Ma Xi Ying. 56 cases of menopausal syndrome treated with Xiao Yao San. Jilin Journal of TCM. 1999;19(2):21.
12. Yang Yu Feng, et al. 31 cases of chloasma treated with modified Xiao Yao San. Hebei Journal of Traditional Chinese Medicine and Pharmacy. 1999;14(1):17.
13. Wang Zhen, et al. 186 cases oophoritic cyst treated with modified Xiao Yao San. Henan Journal of TCM. 1999;19(3):46-47.
14. Jiang Jing, et al. 86 cases of hyperplasia of mammary glands treated with Xiao Yao Wan and Vitamin E. Heilongjiang Journal of Traditional Chinese Medicine and Pharmacy. 1998;(1):35.
15. Wang Zhao Cheng. 47 cases of psychoneurosis treated with modified Xiao Yao San. Fujian Journal of Chinese Medicine. 1999;30(5):26-27.
16. Zhu Jian Jun. 40 cases of hyperlipidemia treated with modified Xiao Yao San. Zhejiang Journal of Traditional Chinese Medicine. 1999;34(12):515.
17. Zhang Li Ping. 30 cases of heterotypic proliferation of gastric mucosa treated with modified Xiao Yao San. Journal of Folk Chinese Medical Treatment. 1999;7(11):21.