Qingtan Wan for Treating Heartburn and Acid Regurgitation
In Introduction to Medicine (Yixue Rumen) there is a pill formula named "Qingtan Wan" (Phlegm-Clearing Pill). Its composition is: cangzhu (Atractylodis Rhizoma) 2 liang (60 g); xiangfu (Cyperi Rhizoma) 1 liang 5 qian (45 g); gualouren (Trichosanthis Semen) and banxia (Pinelliae Rhizoma), each 1 liang (30 g); huanglian (Coptidis Rhizoma) and huangqin (Scutellariae Radix), each 5 qian. The herbs are ground together into a powder and formed with a flour paste into pills the size of a parasol-tree seed (about 6–8 mm in diameter). Take 50 pills each time, washed down with tea after meals, twice daily.
This formula clears heat and resolves phlegm, moves qi and harmonizes the stomach. It is indicated for stomach heat with phlegm obstruction, acid regurgitation and reflux, and an uneasy, gnawing sensation in the stomach. In modern practice it is commonly used for reflux esophagitis and reflux gastritis presenting as burning in the upper digestive tract, belching, acid regurgitation and reflux, nausea, vomiting, and an uneasy stomach disturbing sleep. It may also be used for cancer patients who develop these side effects during chemotherapy or targeted-therapy treatment.
According to traditional TCM theory, huanglian and huangqin in the formula are both heat-clearing, fire-draining herbs; modern pharmacological research shows both have broad-spectrum antibacterial and anti-inflammatory effects. The berberine contained in huanglian is a common modern medicine for gastritis; the berberine tablets commonly sold in pharmacies are berberine hydrochloride extracted from huanglian. In this formula, cangzhu and xiangfu both move qi and can relieve belching and abdominal bloating; gualouren and banxia are phlegm-resolving agents that downbear counterflow and stop vomiting. These six herbs, combined, address both the root and the branch of reflux esophagitis and reflux gastritis.
Because there is as yet no ready-made patent medicine, we may also convert the pill formula into a decoction, directly buying the prepared herbs at the pharmacy and decocting them. The adult decoction dose is as follows: cangzhu 12 g, xiangfu 10 g, gualou 6 g, fabanxia 6 g, huanglian 3 g, huangqin 3 g. The huanglian in this formula is very bitter; those who cannot tolerate its bitterness may leave out the huanglian when decocting and substitute berberine tablets. If the patient has a chronic course, it is best to prepare the pills yourself according to this formula and take them, so that long-term use of a decoction does not affect the appetite.