Jia Wei Xiao Yao San

TCM rationale (pattern-based):

Jia Wei Xiao Yao San is a classic modification of Xiao Yao San that adds Moutan cortex (牡丹皮) and Gardenia fruit (梔子) to “soothe Liver qi,” move blood, and “clear heat.” In practice it’s chosen when endometriosis presents with irritability, breast tenderness, flank tension, PMS, and heat signs (e.g., mouth sores, red eyes), often alongside pelvic pain—i.e., “Liver-qi stagnation with heat.” Reputable monographs describe the exact composition and traditional indications. tsumura.co.jp

Biological plausibility (constituent data):

• Bai Shao (白芍, Paeonia lactiflora) provides paeoniflorin, which reduced ectopic lesion burden and modulated inflammatory-lipid pathways in rat models of endometriosis (“cold coagulation and blood stasis” model). This supports anti-inflammatory and anti-nociceptive effects relevant to pelvic pain. RSC Publishing
• Chai Hu (柴胡, Bupleurum) supplies saikosaponins with experimentally demonstrated anti-inflammatory activity and, in a uterine-inflammation mouse model, suppression of TNF-α/IL-1β/IL-6 and MPO—pathways also implicated in endometriosis pain biology. ScienceDirect
• Zhi Zi (梔子, Gardenia) yields genipin/geniposide, widely studied for anti-inflammatory actions; although not tested directly in endometriosis patients, mechanistic reviews outline targets overlapping with endometriosis pain and angiogenesis pathways. Meanwhile, independent lines of research underscore the role of COX-2/PGE₂ signaling in endometriosis—targets influenced by several botanicals used in TCM. SpringerLink

Real-world utilization:

Large Taiwanese insurance-database studies show women with endometriosis frequently receive TCM/CHM (Chinese herbal medicine), and Jia Wei Xiao Yao San (as “Kamishoyosan/TJ-24”) is a commonly used gynecologic formula within that ecosystem. Europe PMC

Important: Correct use in TCM is pattern-driven—the formula is appropriate only if your presentation matches its indication. A registered TCM practitioner should confirm the fit and co-manage with your gynecologist.

Typical composition & form: 10-herb extract granules or pills containing Bupleurum, Peony root, Atractylodes, Angelica sinensis, Poria, Gardenia, Moutan, Licorice, Ginger, and Mint. tsumura.co.jp

Adult dosing (example—Kampo OTC label):

Tsumura TJ-24 “Kamishoyosan” lists 1 packet (≈1.875 g) twice daily before meals for ≥15 years old (2 packets = 3.75 g contain 2.0 g of dried extract). Product labeling also lists indications such as menstrual irregularity and dysmenorrhea, which overlap with endometriosis symptoms. Always follow your clinician’s instructions and the exact product’s label; strengths vary across brands. tsumura.co.jp

Duration & timing:

Labels advise reassessing if there’s no improvement after ~1 month, and to avoid prolonged unsupervised use. In clinical TCM, courses often span several cycles with periodic review and modification; evidence-based cycle-phase timing data are lacking, so practitioner guidance is essential. tsumura.co.jp

Co-treatment:

If you’re on conventional therapy (e.g., COCs, progestins, GnRH analogs) or post-surgical, discuss with your care team; small trials and cohort studies support CHM as an adjunct after laparoscopy or alongside hormones to aid symptoms or recurrence metrics, but they are not Jia Wei Xiao Yao San-specific. BioMed Central

Evidence specific to endometriosis + CHM overall (not one formula):

• A population-based cohort (Taiwan NHIRD; 22,488 women with endometriosis, 2000–2010) found CHM users had a lower subsequent surgery rate than matched non-users (observational; cannot prove causality). دانشیاری | دانستنی‌های جذاب برای زندگی+1
• A nationwide analysis described prescription patterns in endometriosis; CHM use was common in reproductive-age women and detailed frequently used formulas (descriptive utilization data). Europe PMC
• Reviews and meta-analyses suggest CHM may improve pain or recurrence in aggregate, but the heterogeneity and variable trial quality mean conclusions are low- to moderate-certainty, and modern guidelines state benefits/harms remain unclear. alternative-therapies.com

Evidence for Jia Wei Xiao Yao San specifically in endometriosis:

• Direct, high-quality randomized controlled trials in endometriosis using Jia Wei Xiao Yao San/Kamishoyosan are not available in the peer-reviewed literature as of 25 Sep 2025. Most human RCTs of Kamishoyosan address climacteric or PMS-type symptoms, not endometriosis. Mechanistic and animal studies support constituents (e.g., paeoniflorin; saikosaponins), but that doesn’t prove clinical efficacy for endometriosis. Europe PMC

Related mechanistic/animal data touching endometriosis biology:

• Paeoniflorin reduced lesion burden and altered inflammatory-lipid metabolites in rat endometriosis models. RSC Publishing
• Saikosaponin A suppressed key inflammatory cytokines in a uterine inflammation model and shows broad anti-inflammatory effects. SpringerLink
• Independent human/animal studies outside CHM confirm COX-2/PGE₂ pathways are therapeutic targets in endometriosis—consistent with the anti-inflammatory rationale (but not proof for this formula). OUP Academic