Thyroid Tumors — Master TCM Practitioner He Ren’s “Saniei Sanjie Fang” (Scattering Nodules Formula)
5. Thyroid Tumors — Master TCM Practitioner He Ren’s “Saniei Sanjie Fang” (Scattering Nodules Formula)
He Ren, first cohort National Master of TCM, professor and doctoral supervisor at Zhejiang Chinese Medical University.
Pathomechanism
The pathomechanism of thyroid cancer is qi stagnation and phlegm coagulation, blood stasis and nodular accumulation in the neck. Emotional frustration leads to liver qi stagnation; qi stagnation causes body fluids to coagulate into phlegm; phlegm obstruction impairs blood flow forming stasis; phlegm and stasis mutually bind in the thyroid at the front of the neck, and over time form goiter and masses. Phlegm-dampness accumulating in the neck presents as hard lumps; stasis blocking the collaterals presents as immovable on palpation; qi mechanism stagnation is the initiating factor.
Formula Composition
Composition: Sichuan Magnolia Bark 9g, Ginger-processed Pinellia 9g, Curcuma (Yujin) 9g, Sparganium (Sanleng) 6g, Poria 15g, Kombu 9g, Seaweed 9g, Echinopsis (TUBEIMU) 9g, Raw Oyster Shell 12g, Angelica 12g, Fresh Ginger 2 slices
Efficacy: Regulates qi and resolves stagnation, removes dampness and transforms phlegm, softens hardness and scatters nodules
Primary Application: Thyroid cancer
| Herb Group | Herb Dosage | Function |
|---|---|---|
| Regulate Qi & Resolve Stagnation | Sichuan Magnolia Bark 9g, Curcuma 9g | Magnolia Bark moves qi and removes fullness, Curcuma invigorates blood and regulates qi to resolve stagnation, unblocks qi mechanism to open the way for scattering nodules |
| Transform Phlegm & Remove Dampness | Ginger-processed Pinellia 9g, Poria 15g, Fresh Ginger 2 slices | Pinellia dries dampness and transforms phlegm, Poria leaches dampness and promotes urination, Fresh Ginger warms the middle and harmonizes the stomach; the formula borrows the phlegm-transforming dampness-removing principle of Banxia Houpo Tang |
| Soften Hardness & Scatter Nodules | Kombu 9g, Seaweed 9g, Echinopsis 9g, Raw Oyster Shell 12g | Kombu and Seaweed dissipate phlegm, soften hardness, and scatter goiter; Echinopsis transforms phlegm, scatters nodules, and reduces swelling; Oyster Shell softens hardness, scatters nodules, and anchors yang; together they directly attack goiter masses and nodules |
| Invigorate Blood & Resolve Masses | Sparganium 6g, Angelica 12g | Sparganium breaks blood, moves qi, and resolves masses; Angelica tonifies blood and invigorates it, scatters stasis and nodules without damaging vitality |
This formula derives from modifications of Banxia Houpo Tang. Banxia Houpo Tang originally treats plum-pit qi (qi stagnation and phlegm coagulation, sensation of obstruction in the throat); He Ren, on the basis of retaining the Pinellia, Magnolia Bark, and Fresh Ginger core group, removed Perilla Leaf’s dispersing action, added Curcuma to regulate qi and resolve stagnation, Kombu, Seaweed, and Oyster Shell to soften hardness and scatter nodules, Echinopsis to transform phlegm and reduce swelling, and Sparganium and Angelica to invigorate blood and resolve masses, thereby transforming the formula from treating formless qi stagnation and phlegm coagulation to treating tangible goiter masses and nodules. Kombu and Seaweed used together are key herbs for goiter treatment; combined with Oyster Shell, all three are salty and cold to soften hardness, directly attacking hard cervical lumps. Sparganium is used at only 6g — strong blood-breaking power with light dose, paired with 12g Angelica to tonify and invigorate blood, mutually supporting attack and tonification. Magnolia Bark uses Sichuan Magnolia Bark rather than processed, with stronger qi-moving power.
IV. Modifications by Pattern
| Combined Pattern | Modification Herbs | Therapeutic Intent |
|---|---|---|
| Dry throat | Add Trichosanthes 9g, Scophularia 9g | Nourish yin and generate fluids, clear the throat and moisten dryness |
| Severe liver stagnation with qi | Add Bupleurum 6g, Perilla Stem 6g | Disperse the liver and regulate qi, ventilate and scatter stagnation |
| Hard goiter mass difficult to dissipate | Add Prunella 12g, Fritillaria 9g | Clear the liver and scatter nodules, transform phlegm and reduce goiter |
| Deeply fixed phlegm-stasis binding | Add Curculigo (Ji Shu) 6g, Pangolin Scale 6g | Break blood and resolve masses, unblock collaterals and scatter nodules |
| Qi deficiency with fatigue | Add Codonopsis 15g, Astragalus 20g | Tonify qi and support vitality, consolidate the root and strengthen the source |
| Yin deficiency with dry mouth and tidal fever | Add Ophiopogon 12g, Raw Rehmannia 15g | Nourish yin and clear heat, nourish water to contain wood |
| Cervical distending pain | Add Corydalis 10g, White Peony 12g | Regulate qi and stop pain, soften the liver and relieve urgency |
V. Comparison with Haizao Yuhu Tang
Both He Ren’s Sanjie Fang and Haizao Yuhu Tang treat goiter masses, but their formulation principles differ. Haizao Yuhu Tang primarily uses Seaweed, Kombu, and Kelp to soften hardness and scatter nodules, combined with Green Tangerine Peel and Tangerine Peel to regulate qi; suitable for early goiter with phlegm coagulation and qi stagnation. He Ren’s formula adds softening-hardness scattering-nodule and blood-invigorating mass-resolving herbs to the Banxia Houpo Tang phlegm-transforming dampness-removing base, with stronger qi-regulating and stagnation-resolving power; Sparganium’s blood-breaking mass-resolving is especially suitable for goiter masses with hard texture.
| Comparison Dimension | He Ren Sanjie Fang | Haizao Yuhu Tang |
|---|---|---|
| Core Pairing | Banxia Houpo Tang modification + Kombu, Seaweed, Oyster Shell + Sparganium, Angelica | Seaweed, Kombu, Kelp + Green Tangerine Peel, Tangerine Peel + Fritillaria, Pinellia |
| Emphasized Pathomechanism | Qi stagnation and phlegm coagulation with stasis accumulation | Phlegm coagulation and qi stagnation, early goiter |
| Suitable Pattern | Thyroid cancer (hard goiter, phlegm-stasis mutual binding) | Early goiter (phlegm coagulation and qi stagnation, soft movable mass) |
| Differentiation Key Point | Hard mass immovable on palpation, with stasis signs | Early goiter with firm but movable texture, no obvious stasis signs |
Summary
He Ren’s Sanjie Fang derives from Banxia Houpo Tang; eleven herbs regulate qi and resolve stagnation, transform phlegm and remove dampness, soften hardness and scatter nodules, invigorate blood and resolve masses; suitable for thyroid cancer of the qi stagnation phlegm coagulation, stasis accumulation type. Regulating qi and opening stagnation first, softening hardness and scattering nodules as the main approach, invigorating blood and resolving masses as the auxiliary.
References:
[1] Jin Guoliang. He Ren’s Use of Zhang Zhongjing Formulas for Difficult and Complex Diseases. Journal of Traditional Chinese Medicine, 1994, 35(3):151
[2] Shang Huaihai, Cao Shihua, Feng Shangcai. Famous and Proven Formulas for Tumor Treatment. People’s Medical Publishing House
[3] Chen Ruquan, Zuo Xinhe. TCM Academic Sources and Research on Thyroid Diseases
[4] He Ren. Clinical Interpretation of Jinkui Yaolüe