Source 出处 · Danxi Xinfa · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Tong Xie Yao Fang is a four-ingredient formula attributed to the Danxi Xinfa, and the name is unusually honest: it names the symptom pair it is recorded for, diarrhoea that comes with abdominal pain, rather than a disease. The classical explanation is compact and worth quoting in substance — the diarrhoea is attributed to the spleen, the pain to the liver, and the pattern is read as liver overacting on spleen. What makes the formula interesting to a modern reader is that the pair of symptoms it describes now sits inside a very large differential.
Chronic or recurrent diarrhoea today is worked through rather than named. Irritable bowel syndrome with diarrhoea is one end of it. The rest includes bile acid diarrhoea, microscopic colitis, coeliac disease, lactose and fructose malabsorption, small intestinal bacterial overgrowth, pancreatic exocrine insufficiency, thyroid disease, diabetic autonomic neuropathy, inflammatory bowel disease, drug effects — metformin, proton pump inhibitors, antibiotics, magnesium-containing antacids, and immune checkpoint inhibitors among them — and, at the other end, colorectal cancer. The features that push a person from the first group towards investigation rather than reassurance are not subtle: blood in the stool, diarrhoea that wakes a person from sleep, unintentional weight loss, fever, iron-deficiency anaemia, or a new change in bowel habit beginning after the age at which screening starts. Nocturnal diarrhoea in particular is treated as a marker of organic rather than functional disease.
It is also fair to say what has and has not been shown. Preparations in this line have been studied in small clinical trials for diarrhoea-predominant irritable bowel syndrome, and some report improvement. The trials are generally small, often unblinded or poorly described, and their results do not amount to established benefit. This library records that the formula exists in the literature and that the research is not conclusive. It makes no claim that it helps anything.
Each ingredient carries a real note. Atractylodes rhizome is used here dry-fried rather than raw; the two are not treated as the same material in the classical literature, and the processed form is what the formula names. White peony root is the barked, boiled and dried root of Paeonia lactiflora; it is a different material from red peony root, and the two are not interchangeable even though both are peony. Peony also appears in the classical incompatibility list against Veratrum. Tangerine peel is citrus peel stored for at least a year before use, and stored peel of this kind has been reported to carry mould and mycotoxin contamination when kept badly. Saposhnikovia root is an apiaceous root; the family is associated with furanocoumarin photosensitivity in some of its members, and root of this kind has a history of being substituted with other apiaceous roots, so what the label says and what is in the packet are not always the same thing.
This page is not a recommendation. No quantity, no preparation, no regimen, no claim. Pregnancy, breastfeeding, children, older adults, impaired liver or kidney function, and any anticoagulant, antidiabetic, antihypertensive, diuretic or immunosuppressant medicine taken on medical advice each remove what room there was. Blood in the stool, weight loss, fever, night waking, or anaemia are investigated rather than treated with a formula.
痛泻要方著录于《丹溪心法》，全方四味。它的方名异常老实 —— 它直接写明了自己对应的那一对症状（痛与泻），而不是一个病名。古典的解释很紧凑，值得一说：**泻责之脾，痛责之肝**，病机读成肝旺乘脾。而对今天的读者来说，这首方有意思的地方恰恰在于：它描述的那一对症状，如今落在一个很大的鉴别范围里。
慢性或反复的腹泻，今天是要逐一排查而不是直接命名的。腹泻型肠易激综合征只是其中一端。其余包括：胆汁酸性腹泻、显微镜下结肠炎、乳糜泻、乳糖与果糖吸收不良、小肠细菌过度生长、胰腺外分泌功能不全、甲状腺疾病、糖尿病自主神经病变、炎症性肠病、药物因素（二甲双胍、质子泵抑制剂、抗生素、含镁抗酸剂，以及免疫检查点抑制剂等），另一个极端是结直肠癌。把一个人从「可以解释观察」推向「应当检查」的那些特征并不隐晦：**便血、夜间腹泻把人从睡眠中唤醒、非自愿的体重下降、发热、缺铁性贫血、以及在筛查起始年龄之后新出现的排便习惯改变**。其中夜间腹泻尤其被视为器质性而非功能性疾病的标记。
也该如实说明：这一路制剂在腹泻型肠易激综合征上做过小规模临床研究，部分报告有改善。这些研究普遍样本小、多为未设盲或方法学描述不充分，其结果的证据强度不足以构成已确立的获益。本库记录的是文献中有此方，以及研究尚无定论 —— 不主张它对任何情况有益。
四味药各自都有一条实在的注脚。白术此处用的是炒制品而非生品，古典文献并不把两者当作同一物，方中写明的就是炮制品。白芍是芍药栽培品去外皮、煮后干燥的根，与赤芍是两种不同药材，虽同为芍药却不可互替；芍药亦在「诸参辛芍叛藜芦」的传统配伍禁忌之列。陈皮是橘的果皮，需陈放至少一年方可称「陈」，而存放不当的陈年果皮已有霉变与真菌毒素污染的文献报告。防风是伞形科的根，伞形科部分成员与呋喃香豆素光敏性相关，且此类根药材历来存在以同科其它根充代的情况 —— 标签上写的与袋子里装的不总是一回事。
本页不是建议。不列用量、不列制法、不列服法，也不做任何疗效主张。妊娠、哺乳、儿童、老年、肝肾功能受损，以及正在使用抗凝／降糖／降压／利尿／免疫抑制类处方药，任何一项都足以抹去残余的空间。便血、体重下降、发热、夜间腹泻或贫血，属于需要查明原因的情形，而不是用一首方去应对的情形。