Analysis of similarities and differences between Banxia Xiexin Decoction and Shengjiang Xiexin Decoction inTreatise on Febrile Diseases

This paper focuses on two classical formulas in theTreatise on Febrile Diseases (Shanghan Lun) used for regulating spleen and stomach qi dysfunction and treating syndromes with concurrent cold and heat patterns—Banxia Xiexin Decoction and Shengjiang Xiexin Decoction. Banxia Xiexin Decoction, with Banxia (Pinellia Rhizome) as the principal herb and combined with Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Ganjiang (Dried Ginger), and others, seeks to harmonize the interplay between cold and heat, resolve focal distension, and specifically address epigastric obstruction caused by spleen and stomach disharmony with mixed cold-heat patterns. In contrast, Shengjiang Xiexin Decoction involves a refined adjustment of herbal proportions, with Shengjiang (Fresh Ginger) as one of its principal constituents, emphasizing its gentle antiemetic, qi-regulating, and water-metabolizing properties, providing targeted treatment for epigastric fullness and vomiting induced by water-heat accumulation and gastric deficiency with food stagnation. This study conducts an in-depth comparison from the perspectives of herbal composition, therapeutic emphasis, core pathomechanism, and clinical application, analyzing the formulaic wisdom of "originating from the same source but each with a specialized focus", and revealing their complementary value in treating spleen and stomach disorders. The findings provide theoretical support and practical reference for syndrome-based treatment of modern gastrointestinal diseases and offer a perspective for expanding integrated Chinese and Western medicine approaches.