Jichuan Jian: Analysis of a classic prescription for warming the kidneys and laxatives

Jichuan Jian is a classic traditional Chinese medicine prescription for treating constipation due to kidney yang deficiency. It is composed of six herbs: Cistanche deserticola, Angelica sinensis, Achyranthes bidentata, Alisma, Cimicifuga, and Citrus aurantium. It has the effects of warming the kidneys and replenishing essence, moistening the intestines and laxative. This article will focus on the four aspects of prescription composition, mechanism of action, applicable symptoms and modern applications, focusing on analyzing its compatibility characteristics of "combination of warming and nourishing, moisturizing and lowering", and comparing modern medicine's understanding of senile constipation. The secondary content covers decoction methods, precautions and typical medical cases to help readers fully understand the clinical value of this traditional prescription.

The wisdom of the combination of monarch, minister and envoy

Jichuan Jian uses Cistanche deserticola as its royal medicine. It is warm in nature and sweet and salty in taste. It can not only nourish kidney yang but also moisten intestinal dryness. "Compendium of Materia Medica" calls it "a medicine that nourishes life, nourishes kidney qi, and nourishes essence and blood." Angelica sinensis and Achyranthes bidentata are both ministerial drugs. Angelica sinensis nourishes the blood and moistens the intestines, and Achyranthes bidentata leads the medicine downward. Alisma and Cimicifuga form an ingenious ascending and descending combination. Alisma exfoliates and reduces turbidity, while Cimicifuga gently promotes Yang and regulates the ascending and descending of Qi. Citrus aurantium is used as an auxiliary medicine, which can relax the middle and lower Qi and help relieve constipation. This combination of "warm and moist, rising and falling" is particularly suitable for intestinal dryness and constipation caused by insufficient kidney yang, and embodies Zhang Jingyue's academic thought of "those who are good at nourishing yang must seek yang from yin".

Typical manifestations of constipation due to kidney yang deficiency

The constipation treated by this prescription has distinctive characteristics: patients often suffer from kidney-yang deficiency syndromes such as soreness and coldness in the waist and knees, long and clear urine, pale tongue with white coating, and weak defecation despite dry stool. This contrasts with constipation caused by excess heat, such as a full abdomen and refusal to press, and a red tongue with yellow coating. "Jingyue Quanshu" of the Ming Dynasty records: "The elderly suffer from constipation, mostly due to dryness of blood, so Jichuan Jian should be used." Modern clinical research has found that this type of constipation is common in the elderly, postpartum women and patients with chronic diseases, and is related to weakened intestinal peristalsis and degradation of secretory function. Studies have shown that Jichuan Jian can significantly increase the rate of colon propulsion (see table below), and its effect is better than simple stimulant laxatives.

Modern applications and considerations

Contemporary Chinese medicine has expanded the application of Jichuan Jian in difficult diseases such as diabetic autonomic neuropathy, constipation, and Parkinson's disease with constipation. A study by the China Academy of Chinese Medical Sciences found that this prescription combined with abdominal massage can increase the effectiveness of constipation in the elderly to 86.7%. Please note when using: It is prohibited for those with excessive heat and constipation; avoid raw or cold food while taking the medicine; it is recommended to take it on an empty stomach in the morning to adapt to the rise of Yang Qi. Famous Chinese medicine scientist Jiao Shude once emphasized: "Using Jichuan Jian is to seize the pathogenesis of kidney deficiency and essence deficiency. If the secret is not visible, it will be cast."

Modern inspiration from traditional prescriptions

Jichuan Jian demonstrates the traditional Chinese medicine concept of "treating the root cause of the disease" and provides new ideas for the modern management of chronic constipation. Compared with the short-term effects of laxatives, they restore the autonomous motility of the intestines by warming and nourishing kidney yang. This overall regulation model is being confirmed by more and more studies. It is worth noting that this recipe is mild and non-dependent, making it a preferred alternative to stimulant laxatives. As stated in "Prescriptions of Traditional Chinese Medicine": "The beauty of Jichuan Jian is that it combines tonic and tonic, which can solve the symptoms without damaging the healthy energy." This treatment philosophy still has important reference value for the prevention and treatment of functional diseases today.

Quote sources:
1. "The Complete Book of Jingyue" written by Zhang Jingyue in the Ming Dynasty
2. "Collection of Jiao Shude's Clinical Experience" People's Medical Publishing House
3. China Academy of Chinese Medical Sciences' "Guidelines for the Prevention and Treatment of Functional Constipation in the Elderly with Traditional Chinese Medicine" 2020 Edition
4. "Chinese Journal of Traditional Chinese Medicine" 2018 pharmacological research data of Jichuan Jian