Adhesion-Relaxing Decoction (Nianlian Songjie Tang) for Intestinal Adhesions and Ileus

New Acute Abdomen Studies (Xin Jij Zheng Xue) includes a formula specifically for ileus and intestinal adhesions called Adhesion-Relaxing Decoction (Nianlian Songjie Tang), composed of Magnolia bark (Houpo), Aucklandia (Muxiang), Lindera root (Wuyao), stir-fried radish seed (Cha Laifuzi), red Peony (Chishao), peach kernel (Taoren), mirabilite (Mangxiao), and senna leaf (Fanxieye). The original book gives no dosages; users may decide the dosage of each herb according to the patient's clinical symptoms. The author suggests the following: Magnolia bark 6–30g; Aucklandia 6–10g; Lindera root 10–30g; stir-fried radish seed 10–30g; red Peony 6–30g; peach kernel 6–10g; mirabilite 10–30g; senna leaf 3–15g.

This formula moves qi and activates blood, and lubricates the intestines to free stool. It suits patients with intestinal adhesions or incomplete ileus of the qi stagnation and blood stasis pattern, presenting with abdominal distension, fullness, pain, and constipation.

In this formula Magnolia bark is the sovereign herb: it transforms dampness and conducts stagnation, promotes intestinal peristalsis, and removes abdominal distension and pain, hence its role as the main herb. Aucklandia moves qi and stops pain, assisting Magnolia bark to remove distension. Lindera root harmonizes qi and stops pain, relieving the abdominal pain common in ileus. Radish seed digests food and resolves stagnation and has a forceful pushing action; it is a common herb for abdominal distension and food accumulation. Red Peony and peach kernel activate blood and resolve stasis; red Peony additionally softens the liver and relieves pain, while peach kernel also lubricates the intestines. Mirabilite and senna leaf are both purgatives that relieve the constipation of patients with adhesions and incomplete ileus.

Used together, these herbs relieve the qi-stagnation, blood-stasis and heat-bound constipation of ileus and adhesions. It suits incomplete ileus and adhesions from various causes, and has some adjunctive value for tumor-related adhesions and ileus. But this formula has little effect on complete ileus and may even worsen the patient's symptoms, so patients with complete ileus should use it cautiously and seek other solutions. Pregnant women should use it cautiously.