Wu Mingjie's Traditional Chinese Medicine - Pharmacological Analysis and Symptom Adaptation of Bai Shao Gan Cao Tang

Bai Shao Gan Cao Tang (White Peony and Licorice Decoction) is primarily used to relieve muscle spasms and pain. Its core function is to nourish the blood, soothe the liver, relax tense muscles, and alleviate pain. Clinically, it is indicated for the following conditions:

1. Liver Blood Deficiency Leading to Poor Nourishment of the Tendons and Muscles

– Symptoms: Muscle cramps, spasms, soreness, particularly in the legs or limbs.

Indications: Frequent leg cramps at night or after exercise, muscle tightness, stiffness, and discomfort, common in cases of liver blood deficiency affecting the tendons and muscles.

2. Liver Qi Stagnation and Liver-Stomach Disharmony

– Symptoms: Epigastric pain, abdominal pain, worsened by emotional stress or tension, sometimes accompanied by gastric spasms.

Indications: Chronic gastritis, gastric spasms, functional digestive disorders, liver-stomach qi stagnation-type epigastric pain (worsened by stress or emotions).

3. Dysmenorrhea (Menstrual Pain)

– Symptoms: Severe lower abdominal cramps during menstruation, pain relieved by warmth and pressure, sometimes with scanty or dark-colored menstrual flow.

Indications: Dysmenorrhea caused by liver blood deficiency or qi and blood deficiency, menstrual cramps with a tight and constricted sensation in the lower abdomen.

4. Other Pain Related to Muscle Spasms and Tendon Constriction

– Symptoms: Pain caused by muscle or tendon spasms, such as stiffness in the neck, shoulders, lower back, or other areas. Indications: Neck pain and stiffness due to cervical spondylosis, lower back pain due to muscle strain, muscle pain and spasms after physical exertion.

Classic Formula Composition

  • Bai Shao (White Peony Root, 30g): Nourishes blood, soothes the liver, relaxes tendons, and relieves pain.

  • Gan Cao (Licorice Root, 10g): Tonifies qi, harmonizes the formula, and alleviates pain.

The key mechanism of this formula is the combination of sour (Bai Shao) and sweet (Gan Cao) to generate yin, where Bai Shao nourishes liver blood and relaxes the muscles, while Gan Cao boosts qi, harmonizes the formula, and soothes pain.

Modifications Based on Symptoms

  • Severe pain due to liver qi stagnation → Add Chai Hu (10g), Xiang Fu (6g), Zhi Ke (20g).

  • Stabbing pain with blood stasis → Add Chuan Xiong (6g), Dan Shen (10g).

  • Gastric pain with cold and excess acid → Add Wu Zhu Yu (6g), Sheng Jiang (6g), Yuan Hu (6g), Hai Piao Xiao (15g).

  • Menstrual pain with cold stagnation and blood stasis → Add Dang Gui (10g), Ai Ye (6g), Wu Zhu Yu (6g).

  • Significant lower back pain → Add Du Zhong (10g), Xu Duan (10g), Chuan Niu Xi (10g).

Summary of Applicable Conditions

  • Muscle spasms and cramps (e.g., nighttime leg cramps, post-exercise muscle stiffness).

  • Gastric pain and spasms (particularly those influenced by emotions and stress).

  • Menstrual pain and lower abdominal cramps (due to liver blood deficiency).

  • Neck, shoulder, and lower back pain (related to muscle stiffness and spasms).

Precautions

  • Not suitable for damp-heat or blood stasis pain (e.g., fixed, stabbing pain with swelling or heat).

  • Not suitable for severe pain caused by cold stagnation and blood stasis (in such cases, warming herbs should be added).

  • Diabetic patients should use with caution (due to the high sugar content of licorice).

Conclusion

Bai Shao Gan Cao Tang is a classic formula for relieving muscle spasms and pain. It is especially effective for pain caused by liver blood deficiency, muscle tension, and qi and blood deficiency. This gentle yet effective formula is widely used in clinical practice for muscle-related pain relief.

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