Wu Ji San

 《五积散》是中医经典方剂之一，最早出自《太平惠民和剂局方》。此方以温阳散寒、理气化湿、活血消积为主要功效，广泛用于治疗因寒湿、气滞、血瘀、食积等多种病邪郁滞体内所致的“五积”病证。

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🌿 一、方剂组成（原方）

• 麻黄 6g

• 白芷 6g

• 陈皮 6g

• 半夏（制） 6g

• 茯苓 6g

• 当归 6g

• 芍药 6g

• 川芎 6g

• 白术 6g

• 枳壳 6g

• 厚朴 6g

• 苍术 6g

• 桔梗 6g

• 肉桂 3g

• 甘草 3g

（上药等分为末，水煎服或入丸散服。）

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🌸 二、五积的含义

“五积”指体内五种积滞并存：

1. 寒积：外感寒邪，气血凝滞。

2. 湿积：脾运失健，湿浊内停。

3. 气积：气机不畅，郁滞不行。

4. 血积：血行不畅，瘀阻经络。

5. 食积：饮食停滞，中焦不运。

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⚖️ 三、功效主治

功效：
温中散寒，行气消滞，活血化瘀，调和脏腑。

主治：
寒湿内盛、气滞血瘀、饮食不化所致的：

• 头身疼痛、四肢酸重

• 胸腹胀满、食欲不振

• 恶寒发热、咳嗽痰多

• 妇女痛经、闭经

• 消化不良、脘腹胀痛

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🩸 四、方义解析

• 麻黄、肉桂：发汗散寒、温经通阳。

• 苍术、厚朴、陈皮、半夏、茯苓、白术：燥湿化痰、行气除满。

• 当归、川芎、芍药：养血活血、调经止痛。

• 枳壳、桔梗：宽胸利气、宣肺化痰。

• 甘草：调和诸药，缓急止痛。

此方兼顾表里寒湿、气血瘀滞、饮食内停，结构严谨，是治疗寒湿杂滞型证候的代表方。

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🌿 五、现代临床应用

现代多用于：

• 呼吸系统疾病：感冒、支气管炎、咳嗽痰多、鼻塞头痛。

• 消化系统疾病：慢性胃炎、消化不良、胃脘胀痛。

• 妇科疾病：痛经、闭经、宫寒。

• 风湿痹痛：关节酸痛、寒湿阻络。

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⚠️ 六、使用注意

• 属于温散之剂，忌用于阴虚火旺、热性病、体虚多汗者。

• 孕妇慎用。

• 若症见发热重、口干舌燥，应改用清热化湿之方。

Wu Ji San is a classic Traditional Chinese Medicine (TCM) formula, first recorded in Taiping Huimin Heji Ju Fang. Its main functions are warming yang, dispersing cold, regulating qi, transforming dampness, activating blood, and resolving accumulation. It is widely used to treat conditions caused by stagnation of cold-damp, qi stagnation, blood stasis, or food retention—collectively known as the “Five Accumulations.”

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🌿 1. Formula Composition (Original Prescription)

• Ephedra (Ma Huang) – 6g

• Angelica Dahurica Root (Bai Zhi) – 6g

• Tangerine Peel (Chen Pi) – 6g

• Prepared Pinellia (Ban Xia) – 6g

• Poria (Fu Ling) – 6g

• Angelica Sinensis (Dang Gui) – 6g

• Peony (Shao Yao) – 6g

• Chuanxiong (Chuan Xiong) – 6g

• Atractylodes (Bai Zhu) – 6g

• Bitter Orange (Zhi Ke) – 6g

• Magnolia Bark (Hou Po) – 6g

• Atractylodes (Cang Zhu) – 6g

• Platycodon Root (Jie Geng) – 6g

• Cinnamon (Rou Gui) – 3g

• Licorice (Gan Cao) – 3g

(The herbs are usually decocted in water or made into pills/powder.)

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🌸 2. Meaning of “Five Accumulations”

The “Five Accumulations” refer to five types of internal stagnation:

1. Cold accumulation – caused by cold invading the body, leading to qi and blood stasis.

2. Damp accumulation – due to spleen dysfunction and internal retention of dampness.

3. Qi accumulation – stagnation of qi movement, causing distension and discomfort.

4. Blood accumulation – blood circulation obstruction, causing stasis in the meridians.

5. Food accumulation – retention of undigested food, leading to middle-jiao stagnation.

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⚖️ 3. Functions and Indications

Functions:

• Warm the middle, disperse cold, regulate qi, remove stagnation, activate blood, and resolve accumulation.

Indications:
Used for cold-damp accumulation, qi stagnation, blood stasis, and food retention, presenting with:

• Head and body aches, heaviness in limbs

• Abdominal distension, poor appetite

• Chills and fever, cough with phlegm

• Dysmenorrhea or amenorrhea in women

• Indigestion and epigastric/abdominal pain

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🩸 4. Analysis of the Formula

• Ma Huang, Rou Gui – release exterior, disperse cold, warm the meridians.

• Cang Zhu, Hou Po, Chen Pi, Ban Xia, Fu Ling, Bai Zhu – dry dampness, transform phlegm, regulate qi, relieve fullness.

• Dang Gui, Chuan Xiong, Shao Yao – nourish blood, invigorate blood, regulate menstruation, relieve pain.

• Zhi Ke, Jie Geng – open chest, regulate qi, direct the lungs upward, transform phlegm.

• Gan Cao – harmonize the formula and relieve pain.

The formula addresses both exterior and interior cold-damp, qi and blood stasis, and food retention, making it a representative formula for cold-damp stagnation syndrome.

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🌿 5. Modern Clinical Applications

Used in modern practice for:

• Respiratory system disorders: colds, bronchitis, cough with phlegm, nasal congestion, headache

• Digestive system disorders: chronic gastritis, indigestion, epigastric or abdominal distension

• Gynecological disorders: dysmenorrhea, amenorrhea, uterine cold

• Musculoskeletal disorders: joint pain, cold-damp obstruction

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⚠️ 6. Precautions

• As a warming and dispersing formula, avoid in patients with yin deficiency and heat signs, febrile diseases, or those prone to sweating.

• Use with caution in pregnancy.

• If symptoms include high fever or dry mouth/tongue, consider switching to a heat-clearing and damp-resolving formula.

a detailed breakdown of modern modifications of Wu Ji San (五积散) for different symptom patterns, based on TCM clinical practice:

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1. Wu Ji San for Cold-Damp Stagnation / Common Cold

Modified herbs:

• Retain: Ma Huang, Cang Zhu, Chen Pi, Ban Xia, Fu Ling, Bai Zhu, Gan Cao

• Add: Ginger (Sheng Jiang), Jujube (Da Zao) to support warming and tonifying the middle.

• Remove or reduce: Blood-invigorating herbs like Dang Gui, Chuan Xiong if no blood stasis symptoms.

Indications:

• Chills, mild fever, body aches

• Nasal congestion, cough with white phlegm

• Heavy limbs, poor appetite

Notes: Focus on warming, dispersing cold, and resolving dampness.

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2. Wu Ji San for Digestive Disorders / Food Stagnation

Modified herbs:

• Retain: Chen Pi, Ban Xia, Hou Po, Zhi Ke, Bai Zhu, Fu Ling

• Add: Shen Qu, Lai Fu Zi to aid food digestion and remove retention.

• Reduce: Strongly dispersing herbs like Ma Huang, Rou Gui, if patient is weak or lacks cold signs.

Indications:

• Abdominal distension, bloating, poor appetite

• Nausea, belching, acid reflux

• Loose stools or constipation depending on damp/heat balance

Notes: Focus on regulating qi, resolving food stagnation, and strengthening the spleen.

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3. Wu Ji San for Dysmenorrhea / Gynecological Issues

Modified herbs:

• Retain: Dang Gui, Chuan Xiong, Shao Yao, Rou Gui

• Add: Yi Mu Cao, Tao Ren, Hong Hua if blood stasis is prominent

• Optional: Bai Shao for pain relief and nourishing blood

• Reduce: Strongly dispersing cold-damp herbs if there is no digestive or respiratory involvement

Indications:

• Lower abdominal pain before or during menstruation

• Irregular menstruation, amenorrhea

• Cold sensation in the lower abdomen

Notes: Focus on warming meridians, moving blood, and relieving pain.

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4. Wu Ji San for Joint Pain / Cold-Damp Bi Syndrome

Modified herbs:

• Retain: Rou Gui, Cang Zhu, Hou Po, Chen Pi, Ban Xia

• Add: Du Huo, Qin Jiao for wind-cold-damp bi syndrome

• Optional: Dang Gui, Chuan Xiong if blood stasis contributes to pain

Indications:

• Joint stiffness or pain, worse in cold or damp weather

• Heavy limbs, limited mobility

• Swelling or numbness

Notes: Focus on dispelling wind-cold-damp, warming the channels, and moving blood.

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5. General Principles for Modification

1. Focus on the dominant pattern: cold, damp, qi stagnation, blood stasis, or food retention.

2. Adjust dosage of strong herbs: e.g., reduce Ma Huang in weak or elderly patients.

3. Add auxiliary herbs to target specific symptoms without disturbing overall formula balance.

4. Monitor patient response and modify gradually.

Here’s a clear table of modern Wu Ji San (五积散) modifications with symptoms, core herbs, added herbs, and dosage adjustments:

Symptom Pattern	Core Herbs (from Wu Ji San)	Added / Modified Herbs	Notes / Dosage Adjustments
Cold-Damp Stagnation / Common Cold	Ma Huang, Cang Zhu, Chen Pi, Ban Xia, Fu Ling, Bai Zhu, Gan Cao	Sheng Jiang (Ginger), Da Zao (Jujube)	Reduce blood-invigorating herbs (Dang Gui, Chuan Xiong) if no stasis; focus on warming and dispersing cold
Digestive Disorders / Food Stagnation	Chen Pi, Ban Xia, Hou Po, Zhi Ke, Bai Zhu, Fu Ling	Shen Qu, Lai Fu Zi	Reduce Ma Huang, Rou Gui in weak patients; focus on regulating qi, strengthening spleen, resolving food retention
Dysmenorrhea / Gynecological Issues	Dang Gui, Chuan Xiong, Shao Yao, Rou Gui	Yi Mu Cao, Tao Ren, Hong Hua, Bai Shao	Adjust Cang Zhu, Ma Huang according to digestive/respiratory symptoms; focus on warming meridians and moving blood
Joint Pain / Cold-Damp Bi Syndrome	Rou Gui, Cang Zhu, Hou Po, Chen Pi, Ban Xia	Du Huo, Qin Jiao, optionally Dang Gui, Chuan Xiong	Focus on dispelling wind-cold-damp, warming channels, moving blood; adjust strong dispersing herbs for weak patients
Chronic Fatigue / Qi & Blood Deficiency	Bai Zhu, Fu Ling, Dang Gui, Shao Yao	Huang Qi, Ren Shen, Gan Cao	Reduce dispersing herbs (Ma Huang, Rou Gui) if patient is weak; focus on tonifying qi and blood while mild dispersing if needed

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✅ Tips for Clinical Use / Self-Use:

1. Identify dominant symptom pattern first: cold, damp, blood stasis, food stagnation, or qi deficiency.

2. Adjust the strength and dosage of warming herbs according to patient’s constitution.

3. Combine auxiliary herbs carefully to target symptoms without disrupting formula balance.

4. Monitor results and tweak herbs gradually based on response.