Two Stomach-Treating Chinese Patent Medicines: Weiyanning Granules and Weiyangning Granules
Weiyanning Keli (Stomach-Inflammation-Calming Granules) is composed of Tanxiang (Lignum Santali Albi, sandalwood), Muxiang (Radix Aucklandiae, dry-fried), Rougui (Cortex Cinnamomi), Xixin (Herba Asari), Jineijin (Endothelium Corneum Gigeriae Galli), Shanzha (Fructus Crataegi), Yiyiren (Semen Coicis, stir-fried), Chixiaodou (Semen Phaseoli), Wumei (Fructus Mume), and Zhigancao (Radix Glycyrrhizae Preparata), among others. Its main actions are to warm the middle and fortify the spleen, harmonize the stomach and downbear counterflow, digest food and resolve turbidity. It is indicated for stomachache and glomus/fullness due to spleen-stomach deficiency-cold with dampness obstruction and food stagnation, worsened by cold and relieved by warmth and pressure, with nausea, vomiting and poor appetite. It is now commonly used for superficial gastritis, atrophic gastritis, and functional dyspepsia presenting with the above symptoms.
In this formula, Tanxiang and Muxiang are qi-moving herbs; Rougui and Xixin warm, unblock and resolve phlegm; Jineijin and Shanzha aid digestion; Yiyiren and Chixiaodom dispel dampness and fortify the spleen; Wumei engenders fluids and stops thirst; Zhigancao fortifies the spleen and harmonizes the other herbs. Thus the formula targets the pattern of spleen-stomach deficiency-cold with dampness obstruction and food stagnation. However, the Xixin in this formula has certain toxic side effects, and prolonged use may induce malignant change; therefore this formula should not be taken long-term. If the patient's symptoms improve after using it, they may switch to Xiangsha Liujun Wan for convalescent support.
Weiyangning Keli (Stomach-Ulcer-Calming Granules) is composed of Huangqi (Radix Astragali), Guizhi (Ramulus Cinnamomi), Baishao (Radix Paeoniae Alba), Shengjiang (Rhizoma Zingiberis Recens), Dazao (Fructus Jujubae), and Zhigancao (Radix Glycyrrhizae Preparata); this is in fact Huangqi Guizhi Tang. It has the actions of warming the middle and supplementing qi, and moderating urgency to stop pain. It is indicated for stomachache due to spleen-stomach deficiency-cold and insufficiency of middle qi, presenting with abdominal pain and distension, preference for warmth and pressure, poor appetite and fatigue, a pale tongue and a weak pulse. It is now commonly used for duodenal ulcer and chronic gastritis presenting with the above pattern.
Chen Xiuyuan, a famous physician of the Qing dynasty, held that Guizhi Tang, besides harmonizing yin and yang, also has the function of regulating the spleen and stomach; adding Huangqi to Guizhi Tang further endows it with deficiency-supplementation action. Thus this formula both regulates the spleen and stomach and supplements qi and fortifies the spleen.
Comparing the two, Weiyanning Granules emphasize stopping vomiting, while Weiyangning Granules emphasize stopping pain; they should be selected according to the patient's different clinical symptoms. Weiyangning has almost no side effects and may be taken long-term, whereas Weiyanning should not be taken long-term.