Professor Yao Naili of the China Academy of Chinese Medical Sciences: Empirical Formulas for Treating Various Liver Diseases

Professor Yao Naili is a renowned TCM expert in China, a doctoral supervisor and postdoctoral co-supervisor at the China Academy of Chinese Medical Sciences, and a former president of Guang’anmen Hospital, affiliated with the Academy. He specializes in treating liver diseases and has created several empirical formulas for them. This article introduces his important liver-treatment prescriptions.

Qizhu Formula (Qizhu Granules)

Composition: Huangqi (Astragali Radix) 30 g, Ezhu (Curcumae Rhizoma) 10 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 15 g, Danshen (Salviae Miltiorrhizae Radix) 30 g, Yujin (Curcumae Radix) 15 g, Yinchen (Artemisiae Scopariae Herba) 30 g, Beidougen (Menispermi Rhizoma) 10 g, Chaihu (Bupleuri Radix) 10 g, Taoren (Persicae Semen) 10 g, Sheng Gancao (raw Glycyrrhizae Radix) 10 g.

Indications: hepatic fibrosis or early cirrhosis due to chronic hepatitis B, presenting the pattern of liver–spleen disharmony, internal accumulation of dampness–heat, and injury to the liver collaterals.

Modifications: when liver qi stagnation is marked, add Zhiqiao (Aurantii Fructus), Qingpi (Citri Reticulatae Pericarpium Viride), Yuzhizi (Akebiae Fructus), Chuanlianzi (Toosendan Fructus), Hehuanpi (Albiziae Cortex), as appropriate; when spleen–stomach qi deficiency is marked, add Dangshen (Codonopsis Radix), Taizishen (Pseudostellariae Radix); when dampness turbidity predominates, add Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fabanxia (processed Pinelliae Rhizoma), Doukou (Amomi Rotundus Fructus), Cheqianzi (Plantaginis Semen), Zexie (Alismatis Rhizoma); when dampness–heat is heavy, add Jinqiancao (Lysimachiae Herba), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex); when prolonged dampness–heat engenders toxin with abnormal liver function, add Chuipencao (Sedi Herba), Huzhang (Polygoni Cuspidati Rhizoma), Baijiangcao (Patriniae Herba), Baihuasheshecao (Hedyotidis Herba); when phlegm and stasis have formed concretions with marked hepatosplenomegaly, add Xiakucao (Prunellae Spica), Muli (Ostrea Concha), Cu Biejia (wine-processed Trionycis Carapax), Zhebeimu (Fritillariae Thunbergii Bulbus), Jineijin (Galli Gigerii Endothelium Corneum); when hypochondriac pain is marked, add Yanhusuo (Corydalidis Rhizoma), Chuanlianzi (Toosendan Fructus), Suoluozi (Aesculi Semen), Baishao (Paeoniae Alba Radix); when abdominal distension is marked, add Houpo, Muxiang (Aucklandiae Radix), Chaobinglang (toasted Arecae Semen), Chaolaifuzi (toasted Raphani Semen), Dafupi (Arecae Pericarpium).

Tiao-Hua (Liver-Harmonizing Turbidity-Transforming) Formula

Composition: Chishao (Paeoniae Rubrae Radix) 15 g, Baishao (Paeoniae Alba Radix) 15 g, Baizhu 15–20 g, Danggui 12–15 g, Danshen 15–30 g, Zexie 15–20 g, Fuling (Poria) 15–20 g, Ezhu 6–10 g, Jiao Shanzha (parched Crataegi Fructus) 15–30 g, Chenpi (Citri Reticulatae Pericarpium) 10–12 g, Gancao 6 g.

Indications: alcoholic or non-alcoholic fatty liver, elevated blood lipids, metabolic syndrome, presenting the pattern of liver–spleen disharmony with turbidity stasis accumulation. Symptoms include obesity, a pale lusterless or sallow complexion; a pale tender tongue with teeth marks, a darkish tongue, and a greasy or slippery glossy coating; a weak low voice, dry or sticky mouth or foul breath; fatigue and lassitude; discomfort in the hypochondria; dull abdominal pain or abdominal distension; irritability and easy anger; poor appetite; loose stools. Auxiliary tests may show abnormal blood lipid and blood glucose levels; the pulse is deep, fine, and wiry, or possibly wiry-slippery.

Modifications: when liver qi stagnation is heavy, add Chaihu, Zhishi (Aurantii Fructus Immaturus), Zhiqiao, Qingpi; when spleen deficiency is marked, add Dangshen, Huangqi, Taizishen; when damp turbidity predominates, add Doukou, Houpo, Cangzhu, Banxia; when phlegm turbidity predominates, add Gualoupi (Trichosanthis Pericarpium), Chenpi, Banxia; when dampness–heat is heavy, add Yinchen, Huangqin, Huanglian, Huangbai; when liver function is abnormal, add Yinchen, Chuipencao, Huzhang, Baihuasheshecao; when phlegm and stasis form concretions with hepatosplenomegaly, add Xiakucao, Muli, Biejia, Jineijin; when there is retained alcohol and food stagnation, add Zhijuzi (Hoveniae Semen), Gehua (Puerariae Flos), Doukou, Jineijin; when hypochondriac pain is marked, add Yujin, Yanhusuo; when abdominal distension is marked, add Houpo, Muxiang, Jiao Binglang; when sleep is poor, add Sheng Longgu (raw Draconis Os), Sheng Muli, Hehuanhua (Albiziae Flos), Chao Suanzaoren (toasted Ziziphi Spinosae Semen); when blood lipids are high, add Heye (Nelumbinis Folium), Juemingzi (Cassiae Semen).

Ruan-Gan (Liver-Softening Collateral-Unblocking) Formula

Composition: Danggui 20 g, Chishao 15 g, Baishao 15 g, Danshen 20 g, Ezhu 10 g, Chaihu 10 g, Cu Qingpi (wine-processed Qingpi) 12 g, Taizishen 30 g, Mi Huangqi (honey-fried Huangqi) 30 g, Fuling 30 g, Chao Baizhu (toasted Baizhu) 20 g, Huangjing (Polygonati Rhizoma) 20 g, Shengdihuang (Rehmanniae Radix) 20 g, Tubiechong 10 g, Cu Biejia 45 g (decocted first), Sheng Muli 30 g (decocted first), Cu Jineijin (wine-processed Jineijin) 20 g, Quanxie (Scorpio) 6 g, Yinchen 30 g, Shuihonghuazi (Polygoni Orientalis Fructus) 30 g, Cheqianzi 30 g (wrapped), Zelan (Lycopi Herba) 15 g, Sharen (Amomi Fructus) 10 g (added near the end), Mi-zhi Gancao (honey-fried Gancao) 10 g.

Indications: cirrhosis. This formula may be prepared as a pill for long-term use.

Modifications: none.

Jiedu Ruanjian Xiaoliu (Detoxifying, Mass-Softening Tumor-Resolving) Formula

Composition: Sheng Huangqi 30 g, Taizishen 20 g, Fuling 20 g, Baizhu 15 g, Danggui 15 g, Baishao 15 g, Danshen 15 g, Ezhu 12 g, Shengdihuang 30 g, Yinchen 20 g, Jinqiancao 30 g, Baihuasheshecao 20 g, Shijianchuan (Salviae Chinensis Herba) 15 g, Chenpi 12 g, Cu Jineijin 20 g, Zhi Biejia (processed Biejia) 30 g (decocted first), Muli 30 g (decocted first), Tubeimu 20 g, Gancao 6 g.

Indications: primary liver cancer.

Modifications: when dampness–heat is heavy, add Huzhang, Chuipencao, Zhuling (Polyporus); when the tumor mass is marked, add Longkui (Solanigri Herba), Banzhilian (Scutellariae Barbatae Herba), Banbianlian (Lobeliae Chinensis Herba), Maozhaocao (Ranunculi Ternati Radix), Jiuxiangchong (Aspongopus); when blood stasis is marked, add Tao ren, Jixueteng, Sanqi (Notoginseng Radix), Tubiechong, Sanleng; when there is gingival or nasal bleeding, add Xianhecao (Agrimoniae Herba), Baimaogen (Imperatae Rhizoma), Lugen (Phragmititis Rhizoma), Qiancao (Rubiae Radix); when appetite is poor, add Chao Guya (toasted Setariae Fructus Germinatus), Chao Maiya (toasted Hordei Fructus Germinatus); when abdominal distension is marked, add Qingpi, Houpohua (Magnoliae Officinalis Flos), Foshou (Citri Sarcodactylis Fructus), Muxiang; when there is acid reflux and heartburn, add Haipiaoxiao (Sepiae Endoconcha), Duanwalengzi (calcinated Arcae Concha), Zhuru (Bambusae Caulis in Taeniam); when insomnia, add Suanzaoren, Hehuanhua, Hehuanpi; when qi–blood deficiency is marked, add Dangshen, Ziheche (Placenta Hominis), Shanyao (Dioscoreae Rhizoma), Tusizi (Cuscutae Semen), Hongshen (Ginseng Radix Rubra); when liver–kidney yin deficiency, add Sangjisheng (Taxilli Herba), Huangjing, Beishashen (Glehniae Radix), Gouqizi (Lycii Fructus), Maidong (Ophiopogonis Radix); when fever accompanies, add Qinghao (Artemisiae Annuae Herba), Digupi (Lycii Cortex), Sheng Shigao (Gypsum Fibrosum), Chaihu, Jinyinhua (Lonicerae Flos), Shuiniujiao (Bubali Cornu).

Tiaomian (Immune-Regulating) Formula

Composition: Yinchen 30 g, Chuipencao 30 g, Jinqiancao 30 g, Gancao 9 g, Heye 30 g, Cu Jineijin 15 g, Baishao 30 g, Danggui 15 g, Hongjingtian (Rhodiolae Crenulatae Radix) 20 g, Baizhu 30 g, Shengdihuang 15 g, Cu Xiangfu (wine-processed Cyperi Rhizoma) 10 g, Yujin 15 g, Cu Biejia 20 g (decocted first), Muli 30 g (decocted first), Zelan 9 g.

Indications: autoimmune hepatitis.

Modifications: when there is pruritus, add Baijili (Tribuli Fructus), Difuzi (Kochiae Fructus); when dampness–heat is heavy, add Baijiangcao, Jinyinhua, Lianqiao (Forsythiae Fructus); when hypochondriac pain is severe, add Chuanlianzi, Yanhusuo; when appetite is poor, add Maiya and Jiao Sanxian (the three parched digestive herbs) to promote digestion; when there is epigastric and abdominal fullness, add Muxiang, Chenpi, Foshou to move qi and unblock the fu-organs; when jaundice, add Chishao, Qinjiao (Gentianae Macrophyllae Radix), Baijiangcao; when phlegm–dampness accompanies, add Zhebeimu, Chao Dongguazi (toasted Benincasae Semen), Huajuhong (Citri Exocarpium Rubrum); when qi deficiency, add Huangqi, Taizishen; when blood stasis is heavy, add Ezhu, Danshen, Jianghuang, Chishao, Tubiechong; when the course is prolonged with liver–kidney yin deficiency, add Maidong, Beishashen, Nüzhenzi (Ligustri Lucidi Fructus), Mohanlian (Ecliptae Herba).

Jianpi Tiaogan Xiaonang Decoction (Spleen-Fortifying, Liver-Harmonizing Cyst-Dissolving Decoction)

Composition: Taizishen 30 g, Fuling 30 g, Chao Baizhu 15 g, Zexie 10 g, Guizhi (Cinnamomi Ramulus) 3 g, Zelan 15 g, Danshen 15 g, Cu Ezhu (wine-processed Ezhu) 9 g, Danggui 12 g, Baishao 10 g, Yinchen 30 g, Chaihu 9 g, Xiangfu 9 g, Sheng Muli 30 g (decocted first), Haizao 15 g.

Indications: hepatic cyst.

Modifications: when dampness–heat is severe, add Jinqiancao, Chuipencao, Baijiangcao; when heat is severe, add Mudanpi (Moutan Cortex), Chishao, Zhizi (Gardeniae Fructus); when fluid retention is marked, add Shuihonghuazi, Yiyiren (Coicis Semen), Dongguapi (Benincasae Exocarpium), Cheqianzi; when pain is severe, add Yanhusuo, Chuanlianzi; when qi stagnation is severe, add Yujin, Wuyao (Linderae Radix); when stasis is severe, add Wangbuliuxing (Vaccariae Semen), Taoren, Sigualuo (Luffae Fructus Retinervus); when food stagnation, add Jiao Shanzha, Jineijin, Laifuzi (Raphani Semen); when there is belching and hiccup, add Xuanfuhua (Inulae Flos), Daizheshi (Hematitum), Zhuru; when the bowels are constipated, add Dahuang (Rhei Radix et Rhizoma), Gualou (Trichosanthis Fructus); when spleen deficiency is marked, add Huangqi, Shanyao; when yin deficiency, add Dihuang, Xuanshen (Scrophulariae Radix), Beishashen; when the cyst is overly large, add Jineijin, Zhebeimu, Xuanshen, Zaojiaoci, Huajuhong.

Jiedu Hegan Decoction (Detoxifying Liver-Harmonizing Decoction)

Composition: Danggui 20 g, Chishao 15 g, Baishao 15 g, Danshen 20 g, Fuling 20 g, Baizhu 20 g, Yinchen 30 g, Chuipencao 30 g, Baihuasheshecao 30 g, Banzhilian 15 g, Baijiangcao 20 g, Huzhang 15 g, Jiao Zhizi (parched Zhizi) 10 g, Chaolaifuzi 15 g, Jineijin 20 g, Huangjing 20 g, Mi-zhi Gancao 6 g.

Indications: chronic viral hepatitis.

Modifications: none.

Baogan Jiangmei Formula (Liver-Protecting Enzyme-Lowering Formula)

Composition: Taizishen 20 g, Chao Baizhu 15 g, Fuling 20 g, Danggui 20 g, Chishao 12 g, Baishao 12 g, Tufuling (Smilacis Glabrae Rhizoma) 15 g, Yujin 12 g, Wuweizi (Schisandrae Fructus) 10 g, Chuipencao 20 g, Danshen 20 g, Yinchen 20 g, Chaihu 12 g, Zhi Gancao (honey-fried Gancao) 10 g.

Indications: liver injury with elevated transaminases.

Modifications: none.

The above formulas are all excerpted from Clinical Records of Yao Naili on Gallbladder and Liver Diseases.