Da Chai Hu Tang and Chronic Cholecystitis

Da Chai Hu Tang and Chronic Cholecystitis

TCM holds that chronic cholecystitis is caused by accumulation of bile due to dysfuction of the liver. The normal function of the gallbladder in storing and secreting bile is closely related with the condition of the liver’s free flow of qi. A long-term stagnancy of qi in the liver may cause accumulation of bile, with damp-heat blocking the collaterals, forming blood stasis and leading to pain in the right hypochondriac region. In modern medicine, the pathogenesis of the disorder is thought to be closely related with the fat dysbolism and failure of the gallbladder in evacuation; and it may be caused by chronic bacterial infection or by chemical stimulation of the concentrated bile or the refluent pancreatic fluid entering into the gallbladder.

The TCM principle of treatment should be soothing the liver and gallbladder, regulating qi and removing stagnancy, and stopping pain by activating the blood circulation. In the prescription of Da Chai Hu Tang (大柴胡汤), Chai Hu (柴胡Radix Bupleuri)，Yin Chen ( 茵陈Herba Artemisiae Capillaris) and Jin Qian Cao (金钱草Herba Lysimachiae) were used to soothe the liver and remove stagnancy, and clear damp-heat from the gallbladder; Yan Hu Suo (延胡索 Rhizoma Corydalis), Chuan Lian Zi (川楝子Fructus Toosendan) and Zhi Qiao ( 枳壳Fructus Aurantii) were used to regulate qi, and remove stagnancy for checking the pain; Tao Ren ( 桃仁Semen Persicae) had the action of activating blood circulation and removing blood stasis; Bai Shao ( 白芍Radix Paeoniae Alba) may tonify the blood, soften the liver and stop pain; and Huang Qin ( 黄芩Radix Scutellariae) may show the effect of removing heat from the liver and gallbladder. In the acupuncture treatment, Qimen (LR 14), Yanglingquan (GB 34) and Taichong (LR 3) were used to regulate qi of the liver and gallbladder so as to improve circulation of qi and blood for checking the pain; Zusanli (ST 36) may regulate the function of the stomach in descending qi for relieving the distension; Sanyinjiao (SP 6) may promote qi and blood circulation and improve the functions of the spleen and stomach to reinforce the source of qi and blood; and Dannangxue (the Gallbladder point), an extra point, may help to clear heat and soothe the gallbladder, dredge the collaterals, and it may show the effect of removing the gall stones. All the above points used with the herbs administered may bring satisfactory therapeutic results for chronic cholecystitis.

Source: Zhou S. Thirty cases of chronic cholecystitis treated by acupuncture and oral adiministration of da chai hu tang. J Tradit Chin Med. 2008 Sep;28(3):173-4.