Xiang Fu (香附) — Cyperus Rhizome TCM Herb | Liver Qi, Dysmenorrhea & Menstrual Regulation

At a Glance

Herb: Xiang Fu
Chinese name: 香附 (Xiāng Fù)
Latin name: Rhizoma Cyperi
Nature: Neutral
Taste: Acrid / Slightly Bitter / Slightly Sweet
Meridian: Liver / Spleen / Triple Burner
Category: Herbs that Regulate Qi
Introduction: Xiang Fu (香附, Rhizoma Cyperi) is the dried rhizome of Cyperus rotundus L. — the purple or nut sedge, one of the most widespread weeds on earth, found in tropical and subtropical regions across six continents. Its medicinal rhizome — small, dark brown, and intensely aromatic — has been used in Chinese medicine since the Tang dynasty (Xinxiu Bencao, 659 CE). Li Shizhen called it ‘气病之总司，女科之主帅’ — ‘the general commander of qi diseases, the chief commander of women’s medicine’ — a designation that captures its two defining clinical roles: regulating qi stagnation in any channel, and treating gynecological conditions from Liver qi constraint. Its neutral nature and aromatic dispersing quality make it the most versatile and widely applicable qi-moving herb in the materia medica.

Spreads Liver qi and relieves constraint: The foremost herb for Liver qi stagnation — treats hypochondriac pain, chest oppression, sighing, and emotional depression. 2. Regulates menstruation and alleviates pain: Moves qi and blood to relieve dysmenorrhea, irregular menstruation, PMS, and breast distension — essential in gynaecological formulas. 3. Harmonises the Middl e Jiao: Regulates Spleen and Stomach qi stagnation with epigastric and abdominal distension, nausea, and poor appetite. 4. Moves qi throughout the Triple Burner: Reaches all thre e jiao, making it useful as an envoy herb to direct actions throughout the body.

Xiang Fu is the cornerstone qi-moving herb in gynaecology — virtually every formula for menstrual irregularity, dysmenorrhea, and Liver qi constraint contains it. In Xiao Yao San it combines with Chai Hu and Bo He for Liver qi stagnation with Spleen deficiency. In Yue Ju Wan (越鞠丸) with Chuan Xiong, Cang Zhu, Shen Qu, and Zhi Zi, it treats the six stagnations (qi, blood, fire, food, damp, phlegm). For dysmenorrhea from Liver qi and blood stasis it combines with Yan Hu Suo and Chuan Xiong. Processing dramatically changes its properties: raw Xiang Fu moves qi and disperses stagnation; vinegar-processed (Cu Xiang Fu) enters the Liver and relieves pain; salt-processed directs to the Kidney; wine-processed moves blood; charred (Jiao Xiang Fu) stops bleeding.

Use with caution in patients with qi deficiency, yin deficiency with fire, or bleeding disorders. Avoid in patients with profuse sweating from deficiency without stagnation. Processing is clinically important: vinegar-processed for Liver and pain; salt-processed for Kidney; wine-processed for blood; charred for bleeding. Avoid excessive doses in pregnancy — uterine-stimulating at high concentrations.

Xiao Yao San (逍遥散): Chai Hu, Dang Gui, Bai Shao, Bai Zhu, Fu Ling, Bo He, Sheng Jiang, Zhi Gan Cao — Xiang Fu often added.
Yue Ju Wan (越鞠丸): Xiang Fu, Chuan Xiong, Cang Zhu, Shen Qu, Zhi Zi.
Xiang Fu Wan (香附丸): Xiang Fu with various combinations for menstrual regulation.

Xiang Fu + Chai Hu + Bai Shao + Bo He (Xiao Yao San): Liver qi stagnation with Spleen deficiency — depression, irregular menstruation. Source: Beneficial Formulas from the Taiping Imperial Pharmacy (太平惠民和剂局方).
Xiang Fu + Chuan Xiong + Cang Zhu + Shen Qu + Zhi Zi (Yue Ju Wan): Six stagnations — qi, blood, fire, food, damp, phlegm. Source: Danxi’s Experiential Therapy (丹溪心法).
Xiang Fu + Yan Hu Suo + Chuan Xiong: Dysmenorrhea from qi stagnation and blood stasis. Source: Classical gynaecological formula tradition.
Xiang Fu + Wu Yao + Xiao Hui Xiang (Tian Tai Wu Yao San): Cold hernia with testicular pain and lower abdominal cramping. Source: Medical Formulas Collected and Analyzed (医方集解).
Xiang Fu + Chen Pi + Mu Xiang: Qi stagnation in the Middl e Jiao — epigastric and abdominal distension with poor appetite. Source: Classical qi-regulating formula tradition.

Alpha-cyperone and sesquiterpene ketones
- Analgesic and anti-inflammatory: inhibit COX-2, PGE2 synthesis, and reduce visceral pain in animal models — consistent with dysmenorrhea use
Volatile oil components
- Uterine relaxant: relax uterine smooth muscle in vitro — explains paradoxical use for both menstrual cramps (pain relief via qi movement) and threatened miscarriage
Flavonoid fraction weakly
- Oestrogenic: binds oestrogen receptors — may regulate cycle
Anxiolytic
- Reduces anxiety-like behaviour in rodent models via GABAergic modulation
Antimicrobial
- Active against Staphylococcus aureus, E. coli, and Candida albicans

《本草纲目》(Bencao Gangmu, 1596): ‘香附，利三焦，解六郁，消饮食积聚，痰饮痞满，跗肿，腹胀，脚气，止心腹、肢体、头目、齿耳诸痛，痈疽疮疡，吐血下血尿血，妇人崩漏带下，月候不调，胎前产后百病。’ (Xiang Fu benefits the Triple Burner, resolves the six stagnations, disperses food and drink accumulations, phlegm-fluid, oppression and fullness, oedema, abdominal distension, leg qi; stops pain in the chest-abdomen, limbs, head, eyes, teeth, and ears; treats abscesses and sores, haematemesis, rectal bleeding, haematuria; and women’s flooding, discharge, irregular menstruation, and all diseases before and after childbirth.)
《丹溪心法》(Dan xi Xinfa, 1347): ‘香附，能推陈致新，故诸书皆云益气，而俗有耗气之说，宜详辨之…妇人以血为主，女科之至要药也。’ (Xiang Fu can push out the old and bring in the new — hence all texts say it benefits qi, though there is a popular theory it depletes qi; this should be carefully distinguished… Women are governed by blood; it is the most essential herb in women’s medicine.)
《本草正义》(Bencao Zhengyi, 1920): ‘香附，辛味甚烈，香气颇浓，皆以气用事，故专治气结为病。’ (Xiang Fu: its acrid flavour is very intense, its fragrance quite concentrated — both act through qi. Hence it specifically treats diseases arising from qi binding.)