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Traditional Chinese medicine

Massa fermentata (shen qu)Massa Medicata Fermentata (a fermented mixture, not a single plant)

A fermented herbal cake that the tradition uses for food stagnation; we found no human trial of it, only rat and mouse studies and a classical formula.

Botanical name
Massa Medicata Fermentata (a fermented mixture, not a single plant)
Part used
fermented cake made from six traditional Chinese materials, usually used stir-baked or charred
Also called
pinyin Shen qu (the standard type is Liu shen qu) (神曲 / 六神曲); Medicated leaven, Massa medicata fermentata
Used in
Traditional Chinese medicine
Taken for
Indigestion, Bloating, Appetite
Sold as
dried cake pieces, pills in formulas, decoction, granules

The plant

Shen qu is not a plant. It is a fermented cake, produced by fermenting six traditional Chinese materials together, and the Chinese name Liu shen qu means the “six-divine” leaven. Apricot kernel is one of its components, according to a laboratory paper on the fermentation. The cake is dried, broken up and usually stir-baked or charred before use. A modern production study describes fermenting it with Aspergillus oryzae, the koji mold, and a separate paper compares cakes made with different pure starter cultures.

It is a standard member of Bao He Wan, the pill for food stagnation. The version tabulated in an animal paper contains hawthorn, medicated leaven (the paper’s term for shen qu), pinellia, poria, tangerine peel, radish seed and forsythia, and the Pharmacopoeia of the PRC version adds barley sprout. It is also an ingredient of other digestive pills, usually in the charred form.

How the traditions use it

Traditional Chinese medicine (about TCM)

Shen qu is classed in the Chinese materia medica as sweet, pungent and warm, entering the spleen and stomach channels. The tradition says it disperses food accumulation and harmonizes the stomach, and uses it for what the texts describe as fullness and distension after eating, belching, poor appetite and loose stools from food stuck in the stomach. A rat study describes charred Liu shen qu as having been used for strengthening the spleen and enhancing digestion for over a thousand years, and as the form commonly used in clinical practice. Bao He Wan applies the same idea to a food accumulation syndrome, which the texts attribute to improper or excessive diet. These are the tradition’s own statements and not findings about the body.

What is in it

Because the cake is a microbial fermentation, its chemistry depends on its starters. A study of its phenolic compounds found that fermentation changes the phenolic profile, and a paper on the apricot kernel component reports a digestion-enhancing effect that arises during the fermentation. A rat study found charred and uncharred cakes both changed gut microbiota composition and serum gastrointestinal hormones. These are laboratory and animal findings, and the sources do not identify one compound that explains the traditional digestive effect.

What the human trials show

We found no human trial of shen qu alone, and no published human trial with results of Bao He Wan in the sources we searched. The evidence is animal work.

In a rat model of functional dyspepsia induced by reserpine, Liu shen qu decoction and charred Liu shen qu decoction (each at a low and a high dose, given for 18 days) both improved the tissue structure of the stomach and duodenum, raised serum motilin and gastrin and tissue ghrelin, lowered VIP, CCK and substance P, and improved microbiota composition. The charred form did better than the uncharred one on those measures. In a separate study of 45 rats with a model of irritable bowel syndrome with diarrhea, shen qu reversed the model’s drop in fecal Lactobacillus and Bifidobacterium, its raised gut permeability, its excess inflammatory cytokines and its visceral hypersensitivity (P below 0.05 for each against the untreated model).

For the formula, 30 young mice were fed a high-fat, high-protein diet plus oil to induce diarrhea, and a Bao He pill decoction at 6.63 g per kg a day for 3 days restored the activity of lactase and the microbiota of the intestinal mucosa (P below 0.01 for each against the untreated model). These are mouse and rat data, and the doses are not human doses.

What has not been tested: shen qu in people with dyspepsia, the cake against a placebo, or Bao He Wan against a standard treatment. The formula trials covered elsewhere in this encyclopedia (Zhi Shi Xiao Pi, Xiang Sha Liu Jun Zi) do not contain it.

StudyDoseWhat it found
Rat study: reserpine-induced functional dyspepsia, Liu shen qu vs charred Liu shen qu decoction PMID 38462026Low and high dose by gavage for 18 daysBoth improved stomach and duodenum histology and raised motilin, gastrin and ghrelin; charred form stronger
Rat study: 45 rats, IBS-D model, shen qu vs untreated model vs normal PMID 41552721Rat dosesReversed bacterial shifts, gut permeability, cytokine excess and visceral hypersensitivity versus model (P below 0.05)
Mouse study: 30 mice on high-fat, high-protein diet; Bao He pill decoction PMID 372283796.63 g per kg a day for 3 daysRestored intestinal mucosal microbial and lactase activity versus untreated model (P below 0.01)

How much the studies and the texts used

There is no human dose from a trial. Mice received a Bao He pill decoction at 6.63 g per kg a day for 3 days; the formula in that paper holds 6 g of shen qu among 18 g of hawthorn, 9 g each of pinellia and poria, and 3 g each of tangerine peel, radish seed and forsythia. The Pharmacopoeia version of the pill lists 100 g of stir-baked shen qu in a batch with 300 g of charred hawthorn. In the tradition the cake is broken up and decocted or made into pills, and the rat paper calls the charred form the one commonly used. We found no single-herb dose for a human gut outcome.

Doses here describe what studies and pharmacopoeias used. They are not a recommendation for any person; a clinician or pharmacist who knows your medicines and conditions is the right person to ask.

Side effects and cautions

We found no clinical safety data for shen qu in people, and nothing on its use in pregnancy, breastfeeding or children. Because it is a mold fermentation, the quality of a batch depends on the starter and storage; a survey of 163 commercial edible and medicinal substances in China found fungi in 92% of samples and mycotoxins in 13, with ochratoxin A the most common, though the abstract does not break out shen qu. Because the cake is a mixture of six materials, anyone avoiding a specific food will need the ingredient list of the product. For patent-medicine pills containing it, a review of Asian herbal medicines reported toxic heavy metals and undeclared prescription drugs in some Chinese preparations, mostly as anecdotal reports; this concerns the products it reviewed and not every pill.

Interactions

We found no documented drug interaction for shen qu in the sources read. The formulas it sits in contain other herbs, such as hawthorn and forsythia, whose interactions are separate, and none of the studies we read measured drug levels. The animal work shows shen qu changes gastrointestinal hormones such as motilin and gastrin and the gut microbiota, which could in principle affect how a medicine is absorbed, but no human study has tested this.

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Often paired or compared

TCM Radish seed (lai fu zi) Raphanus sativus TCM Barley sprout (mai ya) Hordeum vulgare TCM / Western Hawthorn Crataegus pinnatifida (shan zha); Crataegus monogyna and C. laevigata (Western) TCM / Western Orange peel Citrus reticulata (chen pi); Citrus sinensis (sweet orange); Citrus aurantium (bitter orange) TCM Pinellia Pinellia ternata

The questions that come up

What is shen qu made of?

It is a fermented cake produced from six traditional Chinese materials and a microbial starter; apricot kernel is among the components reported in laboratory work. The exact recipe varies between producers.

Has shen qu been tested in people?

We found no human trial of it alone or of Bao He Wan with results. Rat studies of Liu shen qu in dyspepsia and IBS-D models, and a mouse study of a Bao He pill decoction, are the main evidence.

What does TCM say about it?

TCM classes it as sweet, pungent and warm, entering the spleen and stomach channels, and uses it to disperse what the texts call food accumulation and harmonize the stomach. That is the tradition’s framework.

Why is it charred?

The rat paper reports that charred Liu shen qu is commonly used in clinical practice and, in the animal model, outperformed the uncharred cake on the digestive measures. The rats are not people, so this does not show a human difference.

Sources