Gui Zhi Fu Ling Wan (Cinnamon Twig and Poria Pill)

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Indications

Western Uses:

• What conditions is Gui Zhi Fu Ling Wan used for in modern practice?

  Gui Zhi Fu Ling Wan gently transforms blood stasis and a fixed lower-abdominal mass (zheng jia), so it is referenced chiefly for gynaecological conditions involving stasis: endometritis and adnexitis (pelvic inflammatory disease), uterine fibroids (hysteromyoma), ovarian cysts, painful periods (dysmenorrhoea), infertility, postpartum bleeding, retained lochia, and irregular menstruation.

  It is chosen for the blood-stasis-mass pattern, not for a diagnosis. Pelvic inflammatory disease, fibroids, ovarian cysts, infertility, and postpartum bleeding all require medical/gynaecological diagnosis and care — and postpartum haemorrhage is a life-threatening emergency. This formula is used within, not instead of, that care. Traditional-use correlates only, not a treatment claim.

  Source: Sacred Lotus sources & references (pattern) + Bensky & Barolet, Formulas & Strategies; biomedical correlates as reference only. Not medical advice.

Originally Appeared In:

• Essentials from the Golden Cabinet (Jin Gui Yao Lue)

Notes:

• What is the classical source of Gui Zhi Fu Ling Wan, and how does it compare to related formulas?

  Gui Zhi Fu Ling Wan comes from the Jin Gui Yao Lue (Essentials from the Golden Cabinet), attributed to Zhang Zhongjing (Han dynasty, c. 3rd century CE), in the chapter on diseases of pregnant women — making it one of the earliest recorded formulas specifically for a gynecological blood-stasis mass. Under its Japanese Kampo name, Keishibukuryogan (桂枝舲苶丣), it is among the most extensively studied Kampo formulas for gynecological conditions in Japan (see research).

  • vs Tao Hong Si Wu Tang: both use Tao Ren for blood stasis, but Tao Hong Si Wu Tang builds on the richer, more nourishing Si Wu Tang base (adding Hong Hua) for blood stasis with underlying blood deficiency, typically in menstrual irregularity; Gui Zhi Fu Ling Wan is comparatively lighter and more targeted at dissolving a discrete fixed mass, with Fu Ling added for dampness rather than deeper blood nourishment.
  • vs Shao Fu Zhu Yu Tang: Shao Fu Zhu Yu Tang is a stronger, warmer blood-invigorating decoction built for cold-based stasis with more pronounced pain, using a larger set of blood-moving and warming herbs; Gui Zhi Fu Ling Wan is the milder, classically pill-dosed formula for a more chronic, established mass.

  Common modifications: Yi Yi Ren is sometimes added where dampness is more pronounced; the formula is combined with heat-clearing herbs or formulas when a mass shows clearer heat signs.

  Source: the Jin Gui Yao Lue (classical origin) cross-referenced against multiple online sources; Bensky & Barolet, Formulas & Strategies (comparisons and modifications).

Clinical Studies & Research:

• Is there modern research on Gui Zhi Fu Ling Wan?

  Yes — under its Japanese Kampo name, Keishibukuryogan, this is one of the more heavily researched classical formulas for gynecological conditions, with clinical, systematic-review, and preclinical evidence concentrated on uterine fibroids. Evidence is encouraging but limited in size and rigor, and much of the mechanistic detail comes from animal studies rather than humans.

  • Uterine fibroids (clinical, early study): a clinical study of 110 premenopausal patients with uterine myomas treated with Keishi-bukuryo-gan reported improvement in hypermenorrhea and dysmenorrhea in over 90% of cases, with shrinkage of the fibroids in roughly 60% of cases (PMID 1471615).
  • Uterine fibroids (clinical, modern RCT): a randomized, double-blind trial comparing low-dose and conventional-dose modified Guizhi Fuling Wan in women with symptomatic uterine fibroids found both doses improved symptom severity, quality of life, and fibroid volume versus baseline over 16 weeks, with no serious adverse events (PMID 34562564).
  • Uterine fibroids (preclinical, systematic review): a systematic review of 21 in-vivo animal studies (461 animals) found Guizhi Fuling Wan had potentially beneficial effects over placebo on fibroid characteristics (reduced uterine weight and smooth-muscle thickness) and sex-hormone markers, though results varied by species and model, and the authors called for better-reported future studies (PMID 31445128).

  Sources: PubMed 1471615; PubMed 34562564; PubMed 31445128. Research context, not a therapeutic claim; direct high-quality clinical trial evidence remains limited, and pregnancy safety was not studied in these fibroid trials.