San Bi Tang三痹汤
Three Painful Obstructions Decoction
Ingredients16 herbs
Indications
Chronic painful obstruction with qi and blood exhausted and Liver and Kidney depleted: the pathogens remain in the channels while the body no longer has the resources to expel them or to nourish the sinews.
Clinical Manifestations
- Long-standing joint pain with weakness and fatigue
- Contracted, stiff hands and feet
- Chronic low back and knee pain with cold
- Numbness of the limbs in a depleted patient
- Painful obstruction that recurs whenever the patient is run down
Health Categories
Modern Applications
Common adjustments
- Cold pain is severe — increase Gui Xin and add Zhi Chuan Wu 制川乌, decocted first, under close supervision
- Damp with swelling and heaviness — add Yi Yi Ren 薏苡仁 and Cang Zhu 苍术
- Marked blood stasis with fixed stabbing pain — add Ji Xue Teng 鸡血藤 and Ru Xiang 乳香
- Upper limbs chiefly affected — add Qiang Huo 羌活 and Sang Zhi 桑枝
- Heat has developed in the joints — remove Gui Xin and Xi Xin 细辛, and add Ren Dong Teng 忍冬藤
Contraindications
Not for an acute painful obstruction with hot red swollen joints, and not in the early stage of a bi syndrome when the pathogen is still strong and the body is not yet depleted — the rich tonifying herbs would trap the pathogen. The formula contains Xi Xin 细辛, which is used in small doses only and is not appropriate for long-term unsupervised use. Progressive deformity or systemic inflammatory arthritis needs medical management alongside any herbal treatment.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy — it contains Xi Xin, Chuan Xiong, Niu Xi and Gui Xin, all of which are avoided in pregnancy. Note that the parent formula's Sang Ji Sheng, the herb that made it fetus-calming, is precisely what this version removes.
Related Formulas
References
Source Jiao Zhu Fu Ren Liang Fang 《校注妇人良方》 · Ming
- Classical source of record (public domain).
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— 附方 note and pattern analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.