Anyang Jingzhi Plaster: An External Medicated Plaster for Reducing Swelling and Relieving Pain
Anyang Jingzhi Gao (Anyang Refined Plaster) is a modern external plaster formula included in the 2005 edition of the Pharmacopoeia of the People's Republic of China, Part I. Its composition is: raw Chuanwu (Aconitum carmichaelii) 24g, raw Caowu (Aconitum kusnezoffii) 24g, Wuyao (Lindera aggregata) 24g, Bailian (Ampelopsis japonica) 24g, Baiji (Bletilla striata) 24g, Mubiezi (Momordica cochinchinensis) 24g, Mutong (Akebia quinata) 24g, Mugua (Chaenomeles speciosa) 24g, Sanleng (Sparganium stoloniferum) 24g, Ezhu (Curcuma zedoaria) 24g, Danggui (Angelica sinensis) 24g, Chishao (Paeonia lactiflora rubra) 24g, Rougui (Cinnamomum cassia) 24g, Dahuang (Rheum palmatum) 48g, Lianqiao (Forsythia suspensa) 48g, Xuejie (Daemonorops draco) 10g, Awei (Ferula assa-foetida) 10g, Ruxiang (Boswellia carterii) 6g, Moyao (Commiphora myrrha) 6g, Ercha (Acacia catechu) 6g, Bohenao (menthol) 8g, methyl salicylate 8g, Bingpian (borneol) 8g.
To prepare the plaster, first pulverize Xuejie, Ruxiang, Moyao, Awei, and Ercha into a coarse powder, and use 90% ethanol to make a fluid extract with a relative density of 1.05. After it cools, add menthol, methyl salicylate, and borneol and mix well. The remaining 16 herbs, including raw Chuanwu and raw Caowu, are decocted in water three times—3 hours each for the first two times and 2 hours for the third. The three decoctions are combined, filtered, and the filtrate is concentrated to a clear extract with a relative density of 1.25–1.30 (at 80°C). This is combined with the above fluid extract and mixed well; then a base made of rubber, rosin, and the like, weighing 8.5–9 times the total, is added to make a plaster mass, which is spread on backing, covered with liner, and cut into small pieces of 8×0.5 cm. When needed, take one piece and apply it to the affected area.
Anyang Jingzhi Plaster is manufactured by many pharmaceutical companies and is available as a ready-made Chinese patent medicine, which can be purchased online or at offline pharmacies, so patients using this formula need not go through the trouble of preparation. The formula's actions are to disperse accumulation and resolve concretions, expel stasis and stop pain, relax the tendons and invigorate blood, and expel wind and scatter cold. It is indicated for abdominal masses and accumulations (zheng-jia), wind-cold-damp bi syndrome, stomach pain due to cold, and numbness of the hands and feet. When using this plaster, patients should avoid foods that are difficult to digest.
In Anyang Jingzhi Plaster, Chuanwu, Caowu, Wuyao, and Rougui are all potent herbs that warm the meridians, scatter cold, reduce swelling, and relieve pain; Bailian clears heat, resolves toxins, reduces swelling, and dissipates nodules; Baiji stops bleeding and reduces swelling; Mubiezi, Sanleng, and Ezhu are commonly used herbs that break blood and reduce swelling, and are also frequently used anticancer Chinese medicines; Danggui, Dahuang, Chishao, Xuejie, Ruxiang, Moyao, Awei, and Ercha all invigorate blood and reduce swelling; Bingpian, menthol, and methyl salicylate have excellent transdermal penetration and are all fast-acting analgesics; Mutong unblocks the meridians and collaterals, promotes diuresis, and reduces edema; Mugua relaxes the tendons and relieves pain. Thus, when combined, this formula constitutes a multi-target external plaster for reducing swelling and relieving pain.
This formula can be used to relieve cancer pain. While relieving pain, it can also moderately inhibit tumor progression, and may be used as an adjuvant for tumors palpable on the body surface. It can also be used to treat stomach pain caused by chronic gastritis and limb pain and numbness caused by atherosclerosis.
Chuanwu, Caowu, Baiji, and Bailian are originally a herb pair listed among the “eighteen incompatibilities” (shiba fan). However, first, the traditional eighteen incompatibilities are not scientifically grounded; the reason dark-colored herbs such as Chuanwu, Caowu, and Fuzi were considered to oppose Baiji and Bailian is merely that the ancients regarded white and black as opposites—a notion without scientific basis. Second, external application is quite safe, so even if the pair belongs to the eighteen incompatibilities, there is no need to worry about serious side effects.
Patients with advanced tumors often have emaciated muscles and loose skin, so applying a plaster can easily injure the skin. If allergy or skin intolerance occurs when using Anyang Jingzhi Plaster, it should no longer be used. Leaving the plaster on too long without ventilation can also easily cause skin breakdown, so it is advisable to apply it for 2–4 hours each time, or apply it at bedtime and remove it upon rising. If the patient's cancer pain is severe and continuous application is needed, there should still be intervals between applications, and during the intervals some skin-care products should be used.