Yin Huihe's Self-Designed "Intestine-Clearing Formula" for Inflammatory Bowel Diseases
The Intestine-Clearing Formula (Qingli Changdao Fang) is one of the dozens of classic self-composed formulas of Professor Yin Huihe, a great contemporary TCM clinician. Its composition is: Huangqin (Scutellariae Radix) 15g, Chishao (Paeoniae Rubra Radix) 15g, Mudanpi (Moutan Cortex) 10g, Taoren (Persicae Semen) 10g, Xingren (Armeniacae Semen) 10g, raw Yiyiren (Coicis Semen) 30g, Dongguazi (Benincasae Semen) 30g, Machixian (Portulacae Herba) 30g, Baijiangcao (Patriniae Herba) 30g. Decoct in water; one dose daily, taken in two divided doses.
The formula is indicated for diseases of modern medicine such as acute and chronic colitis, ulcerative colitis, bacillary dysentery, and amoebic dysentery, when the pattern is damp-heat in the intestine, manifesting as sticky, unsatisfactory stools with intestinal debris 3–4 or more times daily, mild abdominal pain before defecation, borborygmus and tenesmus, a greasy yellow tongue coating, and a wiry fine pulse.
The disease mechanism here is damp-heat in the intestine obstructing the qi movement, hence borborygmus and tenesmus; stasis is not severe, so abdominal pain is mild but the stool is sticky and unsatisfactory. Huangqin (Tiaoqin), which clears lung heat and large-intestine damp-heat, is used first; Baijiangcao and Machixian assist by clearing heat and resolving toxin. Taoren, Xingren, raw Yiyiren, and Dongguazi open and free the lung qi and the qi and blood of the large intestine, removing tenesmus and unsatisfactory bowel movements. If pus and blood are prominent and abdominal pain is severe, increase Mudanpi and Chishao and add Baishao (Paeoniae Alba Radix) to activate blood, stop pain, and clear pus and blood; if qi stagnation with tenesmus is severe, add Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen) to regulate qi, unblock the intestine, and remove tenesmus; for chronic disease with vacuity cold in the lower burner, add Rougui (Cinnamomi Cortex) 1–2.5g to warm the middle and stop diarrhea.
Professor Yin Huihe used this formula to treat ulcerative colitis, chronic diarrhea, and abdominal pain, often with effect. In addition, the formula has the effect of improving liver function and lowering transaminases.
This formula embodies the compositional logic of Taoren Chengqi Tang (Peach Kernel Qi-Moving Decoction) and Qianjin Weijing Tang (Thousand Gold Reed-Stem Decoction), yet with modifications. Professor Yin's formula fuses the treatment methods of clearing heat and resolving toxin, fortifying the spleen and transforming dampness, activating blood and resolving stasis, and expelling pus and dissipating sores into one furnace; it is a classic TCM approach to treating intestinal abscess. The added Machixian and Baijiangcao are specific herbs for intestinal diseases; they not only have some efficacy against common intestinal pathogens but also exert some inhibitory effect on intestinal flora.
From the Western medicine perspective, chronic intestinal inflammation often involves both exudative and proliferative lesions, and dysentery is a fibrinous inflammation with even more complex pathology. To treat exudative lesions, TCM usually clears heat and resolves toxin and drains dampness; to treat proliferative lesions, TCM activates blood and resolves stasis and dissipates phlegm nodules. Such an approach accords both with traditional TCM treatment principles and with the pathology of modern medicine, and is well worth learning.
When studying Professor Yin's formulas, one should draw inferences from one instance. If intestinal abscess can be treated this way, other sores such as lung abscess can also be composed on the same logic.