Shen Ling Bai Zhu San

Functions

This formula’s main function is to enforce the spleen and stomach and to invigorate lung qi. It is primarily used for the following conditions: hypofunction of spleen and stomach, poor appetite with diarrhea, shortness of breath with cough, and limb weakness with fatigue.

Dosage Info

Powder: 6g administered after being mixed with juice of Da Zao (Zizyphus). Doses for children change with age). Oral administration: powder: 6-9g 2 or 3 times a day. Pill form: 6g three times a day. Tablet form: 6-12 tablets three times a day. Oral solution: 10ml 2 or 3 times a day or take according physician’s recommendation.

Ingredients

Precautions

It should be cautiously used in yin deficiency with excessive fire. It is contraindicated for patients with hypertension and upper respiratory infections with heat syndrome, and for pregnant women. 1 case of hypoglycemia after taken of Shen Ling Bai Shu San has been reported. (1)

Pharmacology

Regulatory effects on gastrointestinal movement: A small dose of this decoction was effective in stimulating the intestines and releasing the partial inhibitory action of adrenaline on the intestine. In large doses it inhibited intestinal contraction and antagonized the intestinal contraction caused by barium chloride and pilocarpine. It also promoted intestinal absorption of water and chlorine ions. (2)

Improving metabolism and promoting immune functions: Shen Ling Bai Zhu San was used in many studies on gastrointestinal diseases (chronic gastritis, chronic colitis, gastric or duodenal ulcer) caused by deficiency of spleen qi. The results showed that the urinary creatinine, uric acid, and urea nitrogen levels of the treated patients were elevated. (3) At the same time, it improved disturbed energy metabolism, increased the body’s immune functions, and improved the indices of blood rheology. In mice models of spleen deficiency, this formula was effective in increasing the anti-fatigue capability, increasing the thymus and spleen weight lost during modulation process, elevating blood glucose levels, and decreasing the content of lipid peroxide of the liver and brain. (4) In models of mice with spleen deficiency, symptoms such as weight loss, hypothermia, diarrhea, loss of appetite, and slow movement occurred when given a high dose of this formula. This demonstrated that Shen Ling Bai Shu San is effective in invigorating the spleen. (5)

Clinical Applications

Treatment on liver cirrhosis
30 cases of cirrhosis of the liver were treated with Shen Ling Bai Shu San with some additional ingredients. For stagnation of qi, the following herbs were added, Zhi Qiao (Aurantium Fruit), Chuan Lian Zi (Melia), Yuan Hu (Corydalis Tuber), and Chao Mai Ya (cooked Malt). For stagnation and retention of the damp type, the herbs added were Da Fu Pi (Areca Peel), Ze Xie (Alisma), Ze Lian (Lycopus), and Gui Zhi (Cinnamon Twig). For stagnation of qi and blood stasis type, Bie Jia (Tortoise Plastron), Chuan Shan Jia (Anteater Scales), Ze Lian (Lycopus), and Dan Shen (Salvia) were added. In cases of yin deficiency of the liver and kidney, Tian Dong (Asparagus), Gou Qi Zi (Lycium Fruit), Chan Yi (Cicada), and Zheng Huang Jing (steamed Ploygonatum Root) were added. Western drugs were used in combination for symptomatic relief. The results showed that 9 cases fully recovered, 14 cases improved, 3 cases had no effectiveness, and 4 cases aggravated. (6)

Treatment on superficial gastritis
32 cases of superficial gastritis were treated with modified Shen Ling Bai Zhu San. The basic formula consisted of Ren Shen (Ginseng), Bai Zhu (Atractylodes), Fu Ling (Hoelen), Huai Shan Yao (Huai Dioscorea), Gan Cao (Licorice), Bai Shao (White Peony Root), Yuan Hu (Corydalis Tuber), Bian Dou (Dolichos), Yi Ren (Coix), Sha Ren (Amomum Fruit), Ying Su Ke (Opium Poppy Pericarp), and Bai Ji (Bletilla Tuber). The formula was modified according to individuals’ symptoms. For accumulation of cold pathogen, Wu Zhu Yu (Evodia) and Gao Liang Jiang (Galanga) were added. For excessive gastric heat, Chai Hu (Bupleurum), Huang Qin (Scutellaria), and Huang Liang (Coptis) were added. In cases of qi stagnancy Chai Hu (Bupleurum) and Xiang Fu (Cyperus) were added. In cases of cold insufficiency type Fu Zi (Aconite) and Gui Zhi (Cinnamon Twig) were added. In situations of stagnancy of food Shen Qu (Leaven), Shan Zha (Crataegus), and Mai Ya (Malt) were added. In case of blood stagnancy Dan Shen (Salvia), Mo Yao (Myrhh), and E Zhu (Zedoaria) were added. The results illustrated that 15 cases clinically recovered, 9 cases had significant improvement, 7 cases had some improvement, and 1 case had no improvement. (7)

Treatment on chronic diarrhea 36 cases of chronic diarrhea were treated with Shen Ling Bai Shu Tang with additional modifications to the ingredients according to individuals’ symptoms. After 1 to 2 months of therapy, 28 cases had fully recovered, 6 cases showed significant improvement, and 2 cases had some improvement. (8)

Treatment on chronic colitis 58 cases of chronic colitis of spleen deficiency combined with dampness type were treated with Shen Ling Bai Shu San. The formula was modified according to each individual’s symptoms. One tablet of Metronidazole 0.4g twice a day and 2 capsules of Da Suan (Garlic) oil, three times a day were used in combination. The results showed that 42 cases had fully recovered (72.4%), 14 cases had improved (24.1%), and 2 cases had no effect (3.5%). (9)

Treatment on irritable colon
52 cases of irritable colon were treated with modified Shen Ling Bai Zhu San. The total effectiveness rate was 96.2%. (10)

Treatment on periodic paralysis
40 cases of periodic paralysis were treated with Shen Ling Bai Zhu San with some additional modifications according to patients’ symptoms. The results provided that 40 cases had diminished symptoms within 3 to 5 days and 10 cases had fully recovered within 1 week. There was no recurrence in 30 cases within one year. (11)

Treatment on functional edema
50 cases of functional edema were treated with Shen Ling Bai Zhu San. 42 cases fully had recovered, 5 cases had improved, and 3 cases had no improvement. (12)

Treatment on chronic ulcerative colitis
Modified Shen Ling Bai Zhu San was used to treat 38 cases of chronic ulcerative colitis. The formula consisted of the following herbs: Dang Shen (Codonopsis), Bai Zhu (Atractylodes), Huang Qi (Astragalus Root), Fu Ling (Hoelen), Shan Yao (Dioscorea), Yi Ren (Coix), Chen Pi (Citrus), Zhi Gan Cao (processed Licorice), Bai Bian Dou (Dolichos), and Sha Ren (Amomum Fruit). For severe spleen insufficiency, the amount of Huang Qi (Astragalus Root) was increased and Pao Jiang (processed Ginger), Wu Zhu Yu (Evodia), and Lian Zi (Hindu Lotus Seed) were added. For spleen and kidney yang insufficiency, Fu Zi (Aconite), Bu Gu Zhi (Psoralea), and Rou Dou Kou (Common Nutmeg Seed) were added. For hyperactivity of the liver combined with spleen deficiency, Chao Bai Shao (cooked White Peony Root), Fang Feng (Siler), and Mu Xiang (Saussurea) were added. In cases of spleen deficiency combined with damp heat, Bai Tou Weng (Pulsatilla Root), Qin Pi (Fraxinus), and Di Yu (Sanguisorba) were added. For retention of fluid pathogen in intestine, Yi Ren (Coix) was replaced with Chao Yi Ren (cooked Coix), Gui Zhi (Cinnamon Twig), and Ze Xie (Alisma). After treatment, 28 cases had fully recovered, 8 cases had improved, and 2 cases had no effectiveness. The total effectiveness rate was 94.7%. (13)

Treatment on chronic pharyngitis
Shen Ling Bai Zhu San was used to treat 60 cases of chronic pharyngitis. The formula was modified according to individuals’ symptoms. After treatment of 1 to 5 courses, the results were: 57 cases fully recovered, 2 cases improved, and 1 case had no known effect. The total effectiveness rate was 98.3%. (14)

Treatment on central serous retinochoroiditis
Shen Ling Bai Zhu San was used to treat 56 cases of retinochoroiditis. The formula was modified according to the patients’ symptoms. The total effectiveness rate was 94.6%. Visual acuity of the diseased eyes improved markedly. (15)

Treatment on Pediatric diseases
Shen Ling Bai Zhu San was used to treat pediatric diseases such as diarrhea, infantile malnutrition, poor appetite, recurrent asthma, and recurrent upper respiratory tract infections. Among the 86 cases of diarrhea, 79 cases fully recovered, and 2 cases improved. Among the 27 cases of infantile malnutrition, 20 cases fully recovered, 4 cases showed significant improvement, 3 cases had some improvement, and 1 case had no effectiveness. Among the 31 cases of asthma, 27 cases fully recovered, 2 cases showed significant effectiveness, and 2 cases had some improvement. Among the 37 cases of upper respiratory infection, 32 cases fully recovered, 3 cases had a significant improvement, and 32 cases had some improvement. (16)

Treatment on toxic and other side effect of chemotherapy
Shen Ling Bai Zhu Tang was used to treat 40 cases of indigestion that occurred after chemotherapy for malignant tumors. The total effectiveness rate was 90.2%. (17) Shen Ling Bai Shu Sang was combined with Metronidazole and noticeably reduced the toxic side effects of chemotherapy as well as increased the tolerance of chemotherapy. (18)

Others
Shen Ling Bai Zhu San had been used to treat hyperlipidemia, (19) sequel of apoplexia, (20) chronic delayed type rectitis, (21) pityriasis, (22) chronic sinusitis, (23) oral mucus membrane diseases, (24) impotence, (25) immunologic hypofunction, (26) and iron deficiency anemia of children. (27) There has been some effectiveness.

References

  1. Fan Jian. One case of hypoglycemia due to taking Shen Ling Bai Zhu San. Journal of Traditional Chinese Medicine. 1998;39(4):243.
  2. Liu Wei Xing, et al. Primary inquiry into enforcing Qi and improving spleen with Shen Ling Bai Zhu San. Journal of Chinese Patented Medicine Research. 1982;(8):25-27.
  3. Liu Chuan Zhen, et al. Clinical research on gastrointestinal disease and deficiency of spleen Qi. Journal of Shandong College of TCM. 1995;19(2):111-113.
  4. Hou Jian Ping, et al. Shen Ling Bai Zhu San’s effects on acidophilous mice model of spleen deficiency. Journal of Shaanxi College of TCM. 1997;20(2):33-35.
  5. Lu Chong, et al. Experimental research on Shen Ling Bai Zhu San Chong Ji’s invigorating spleen on mice mode of spleen deficiency. China Journal of Experimental Recipes. 1999;5(4):39-41.
  6. Zhang Shan Ju. Observation on treating 30 cases of liver cirrhosis with modified Shen Ling Bai Zhu San. Henan Journal of TCM. 1990;10(2):16-17.
  7. Gong Feng Ping. Treating 32 cases of superficial gastritis with modified Shen Ling Bai Zhu San. Journal of Shaanxi Correspondence School of TCM. 1990;(2):31-32.
  8. Zhang Hua Ying. Treating 36 cases of chronic diarrhea with modified Shen Ling Bai Zhu Tang. Journal of Applied TCM. 1998;14(10):22.
  9. Qin Wei, et al. Treating 58 cases of chronic colitis of spleen deficiency combined with dampness type with modified Shen Ling Bai Zhu San. Henan Journal of TCM Pharmacy. 1998;13(2):50-51.
  10. Zhang Shu Er, et al. Treating 52 cases of irritable colon with modified Shen Ling Bai Zhu San. Shaanxi Journal of TCM. 1998;19(7):312.
  11. Guo Lun Cong, et al. Treating 40 cases of periodic paralysis with modified Shen Ling Bai Zhu San. Fujian Journal of Chinese Medicine. 1999;30(1):23-24.
  12. Li Ying Shun, et al. Clinical report on treating 50 cases of functional edema with Shen Ling Bai Zhu san. Journal of Traditional Chinese Medicine and Herbs. 1999;27(4):23.
  13. Zhao Rui Xian, et al. Treating 38 cases of chronic ulcerative colitis with modified Shen Ling Bai Zhu San. Henan Journal of TCM Pharmacy. 1999;14(5):37.
  14. Wang Nian Qiao. Treating 60 cases of chronic pharyngitis with modified Shen Ling Bai Zhu San. Jiangsu Journal of TCM. 1999;20(12):31.
  15. Zhao Hong. Treating 56 cases of central serous retinochoroiditis with modified Shen Ling Bai Zhu San. Journal of Research in Traditional Chinese Medicine. 2000;13(2):40-41.
  16. Li Shuang Xi, et al. Clinical observation on treating pediatric diseases with modified Shen Ling Bai Zhu San. Journal of Chinese Patented Medicine. 1996;18(8):19-20.
  17. Shen Li Da, et al. Clinical application of Shen Lin Bai Zhu San on chemotherapy for malignancy. Yunnan Journal of TCM and Chinese Drug. 1999;20(3):24-25.
  18. Huang Ping, et al. Prevention and cure of reaction of digestive tract during chemotherapy with modified Shen Ling Bai Zhu San. Journal of Guiyang College of Medicine. 1996;21(2):123-124.
  19. Xie Bing. Clinical observation on treating 50 cases of hyperlipidemia with modified Shen Ling Bai Zhu San. National Journal of Medicine Forum. 2000;15(1):31.
  20. Zhang Dao Yuan, et al. Using Shen Ling Bai Zhu San for sequel of apoplexia. Hebei Journal of Integrated Medicine. 1998;7(12):1944-1945.
  21. Xu Cai Shun, et al. Treating 12 cases of chronic delayed type rectitis with modified Shen Ling Bai Zhu San. Journal of Nanjin University of TCM. 1998,;4(5):318.
  22. Wang Rui Feng. Therapeutic observation on treating 66 cases of pityriasis with Shen Ling Bai Zhu San. Tianjin Journal of TCM. 1995;12(6):48.
  23. Liu Mao Hui. Clinical observation on treating chronic sinusitis of child with modified Shen Ling Bai Zhu San. Sichuan Journal of TCM. 1994;12(11):55-56.
  24. Wei En Pei. Treating disease of oral mucus membran with Shen Ling Bai Zhu san. Shaanxi Journal of TCM. 1996;17(11):515-516.
  25. Luo Shi Wei. Treating impotence with Shen Ling Bai Zhu San. Sichuan Journal of TCM. 1989;7(10):30-31.
  26. Deng Xiang Xong, et al. Treating 48 cases of immunologic hypofunction with modified Shen Ling Bai Zhu San. Jilin Journal of TCM. 1997;17(4):14-15.
  27. Xia Ying. Therapeutic observation on treating iron deficiency anemia of child with modified Shen Ling Bai Zhu San. Journal of Shizhen Medicinal Material Research. 1994;5(3):13.