Warm Soup Literature Research

Purpose:The exemplary formula for clinical signs of cold and deficiency of Chong and Ren channels with blood stasis is the classic formula Wenjing decoction from the Synopsis of Prescriptions from The Golden Chamber. The therapeutic action of this formula is warming channel to remove blood stasis and coordinating Chong and Ren channels. The primary clinical application is for women with cold in the lower abdomen, fertility difficulty, heavy menstruation, prolonged period, and delayed periods.In recent years, the use of Wenjing decoction has been expanded beyond the gynecology into many illnesses in the realm of internal medicine.The reserach on the clinical application of Wenjing decoction has made a great progress over a long period of time especially in the recent10years. However the majority seems to be reports on individual cases and general clinical observations, not much on the study and discussion on the theory. There is limited content on principle and commonality, while there are many reports purely based on clinical experiences. The present study provided comprehensive review from the standpoint of analyzing the academic theory and treatment strategy of this classic formula Wenjing decoction from Zhang Zhong-jing and incorporating the clinical experiences from Traditional Chinese Medicine doctors in the past10years.The purpose is to provide supportive documentations and references for clinical standardization and reasonable application of Wenjing decoction.Methods:Fifty-four literatures related to Wenjing decoction which are published in last10years (2002.1-2011.12) are collected from the CNKI database. The database of present study was established using the categories of name of prescription, composition, usage, standard of efficacy, clinical efficacy, and disease indication. The data base was further refined with statistical analysis and computational techniques into3aspects:disease indication, clinical efficacy, and adding-removing compatibility, in order to clarify and further explore the general rules and commonality in the clinical use of Wenjing decoction.Results:From the review of related reports on Wenjing decoction in the recent10years (1987- 2012), on an average, there are at least4reports every5years, moreover, the amount of related reports raised to30in recent5years. Overall, there is a trend in increased use of Wenjing decoction especially obvious in the past10years.Wenjing decoction can be used in a wide range of applications, including20various conditions in all medical specialties. Nevertheless it is primarily used in female and male reproductive problems. Currently, it is still mainly used in treating female patients. Among the indications, the most common is treating dysmenorrhea, up to1470cases, followed by irregular menstruation and fertility difficulty, with cases of464and300respectively.In the study of clinical efficacy of Wenjing decoction, overall, there are54related articles including3166cases were involved in present study. Among these literatures, there are1470cases from21articles related to the treatment of dysmenorrhea. From studies of the clinical applications of Wenjing decoction, the clinical efficacy ranges from the lowest of66.7%to the highest100%. There are one article reported that the efficacy is less than70%(1.85%of all the reviewed literatures),38articles reported that the efficacy is higher than90%which occupied70.37%of all the reviewed articles. From the studies of treating dysmenorrhea with Wenjing decoction, the efficacy ranges from the lowest of75%to the highest of97.56%. There is only one article reported that the efficacy is lower than80%(4.76%of all the reviewed literature); while,16articles reported that the efficacy is higher than90%(76.19%of all the reviewed literature).With the aspect of Addition and Subtraction compatibility,54articles were reviewed and the modifications are (in the order of the highest to the lowest frequency):Invigorating Blood and removing blood stasis herbs, Regulating Qi herbs, Warming Interior herbs, Nourishing Ying and Blood herbs, Replenishing Qi herbs, Replenishing Yang herbs, and Astringing herbs.In terms of the dosage used, most of studies had Addition and Subtraction compatibility to the original formula according to clinical symptoms;however the majority of the studies used the original dosages in the formula. The dosages used for Radicis Angelicae Sinensis, Radix Paeoniae Alba, Radix Ophiopogonis, and Codonopsis pilosula have wide variations; the difference between the highest and lowest dosages used is very obvious.Modern Pharmacological research shows that Wenjing decoction can regulate endocrine function, protect the function of the ovary, correct the damage from oxidative stress, and regulate vasomotor function; these are the fundamental pharmacological principles in the treatment of related diseases using Wenjing decoction.Conclusion:Recently, the applications of Wenjing decoction are more and more extensively. The uses of Wenjing decoction are not only limited in treating gynecological conditions but also applied in more clinical conditions in the system biology in recent years. However, the analysis of current literatures shows that the primary applications are used in the treatment of female and male reproductive diseases; female patients remain the majority in the treated subjects. Among the numerous indications, dysmenorrhea remains the most common indication and with the highest efficacy. From the collected literature, Wenjing decoction shows the trend of being the main focus in clinical application for dysmenorrhea. It is closely related to the capability of adding and subtracting compatibility by using Invigorating Blood and removing blood stasis herbs and Regulating Qi herbs and Warming Interior herbs. In the aspect of Addition and Subtraction Compatibility, it is common to combine Wenjing decoction with other components such as Invigorating Blood and removing blood stasis herbs, Regulating Qi herbs, Warming Interior herbs, Nourishing Ying and Blood herbs, Replenishing Qi herbs, Replenishing Yang herbs, and Astringing herbs. The first two frequently combined formulations are Invigorating Blood and removing blood stasis herbs and Regulating Qi herbs. The second common combined formulation is the Warming Interior herbs. The third common combined formulations are the Nourishing Ying and Blood herbs, Replenishing Qi herbs, and Replenishing Yang herbs. The last common combined formulation is Astringing herbs.In summary, whether it is Addition and Subtraction compatibility or the primary disease indication, it is consistent with Wenjing decoction’s characteristics of warming channels, nourishing blood and removing blood stasis in the pathophysiology.