Shugan Sanyu Tang: Liver-Soaking Stasis-Resolving Decoction for Stabbing Hypochondriac Pain

Shugan Sanyu Tang comes from Dan Tai Yu An (Jade Table of the Cinnabar Terrace) by the Ming physician Sun Wenyin. It consists of Danggui (angelica), Honghua (safflower), Sumu (sappanwood), Qingpi (green tangerine peel), and Chaihu (bupleurum) each 1 qian (3 g), Shanzha (hawthorn) 2 qian (6 g), and Baishao (white peony), Wuyao (lindera), Guizhi (cinnamon twig), and Gancao (licorice) each 8 fen (2.4 g). Decoct in water, twice daily.

This formula soothes the liver and moves qi, dispels stasis and stops pain. It treats blood stasis and qi stagnation in the liver channel with stabbing pain in both hypochondria. This symptom is common in hepatobiliary and pancreatic diseases; modern pancreatitis, cholecystitis, and chronic hepatitis can all cause it. Indigestion from chronic gastroenteritis may also produce these symptoms.

In this formula chaihu and qingpi soothe the liver and move qi; baishao softens the liver and stops pain; wuyao moves qi and stops pain; danggui, honghua, sumu, and shanzha dispel stasis and stop pain, with shanzha also aiding digestion; guizhi warms yang and fortifies the spleen; licorice fortifies the spleen and harmonizes the other medicinals. Together they soothe the liver and move qi, fortify the spleen and soften the liver, and resolve stasis to stop pain.

This formula uses light dosages. Patients with digestive tract diseases may not tolerate heavy medication, so this small-dose approach is safer.