Source 出处 · Taiping Huimin Hejiju Fang · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Shi Quan Da Bu Tang comes from Taiping Huimin Hejiju Fang, the Song-dynasty official formulary that fixed much of what later generations call a standard formula. Its structure is worth reading before its reputation. Take Si Jun Zi Tang, the four-gentleman qi formula, and Si Wu Tang, the four-substance blood formula, and lay them together; that joining is Ba Zhen Tang, the eight-treasure formula. Add astragalus and cassia bark and you have ten herbs, and the name says exactly that: ten, complete, great, supplementing. The two additions are the whole argument of the formula. Astragalus pushes the qi side upward and outward; cassia bark adds warmth, because the classical reading is that blood that has been depleted needs warmth to move and that a cold formula of this size sits badly in a weak digestion.
This is also one of the few formulas in this library that exists in two modern worlds at once. In Japan it is Juzentaihoto, one of the Kampo extract preparations covered by the national health insurance system, and it has been studied there in fatigue, postoperative recovery and cancer supportive care. Small trials exist. The body of evidence is small and heterogeneous, and it has not established a clear benefit in any of those settings, so this library does not claim one. What can be said without overreaching is that it is among the most widely used and most closely watched formulas in Japan, which is itself a reason to take its safety literature seriously.
Four safety points deserve plain language. First and most important for a formula people take for months: it contains honey-fried licorice. Glycyrrhizin, the sweet principle in licorice, can produce a syndrome that looks like excess aldosterone - falling potassium, rising blood pressure, oedema, and in bad cases weakness and rhythm problems. It is dose and duration dependent, and the risk climbs with diuretics, digoxin, corticosteroids, and with age. Anyone on those medicines should not add a licorice-containing formula without telling their own doctor. Second, cassia bark is Cinnamomum cassia, the Chinese cinnamon used in cooking, not Ceylon cinnamon; cassia carries appreciable coumarin, and European food-safety authorities set a tolerable daily intake for coumarin on the basis of liver findings. A pinch in a stew and a daily medicinal dose are not the same arithmetic. Third, dang gui has published case reports of potentiating warfarin, and chuan xiong has antiplatelet activity in laboratory work; both are reasons to stop the formula before planned surgery and to tell the surgeon. Fourth, the formula is classically avoided during an acute illness - fever, infection, an active exterior condition - and where the digestion is weak and the stool loose, because prepared rehmannia and the glues of this family are cloying. Ginseng has mixed evidence on warfarin, meaning published studies point in different directions, and this library reports it as mixed rather than picking a side. White peony (bai shao) is not the same material as red peony (chi shao). Honey pill forms contain sugar.
十全大补汤出自《太平惠民和剂局方》—— 宋代官修方书，后世所谓「常用方」有相当一部分是它定下来的。读它的组成比读它的名声更有价值。把补气的四君子汤与补血的四物汤叠在一起，就是八珍汤；再加上黄芪与肉桂，十味药，方名直白：十、全、大、补。加的两味正是此方的全部主张：黄芪把气的一面往上往外推，肉桂加温 —— 古典的读法是血已亏者得温乃行，而这么大一首寒凉方的底子压在弱脾胃上是要出问题的。
它也是本库少数同时活在两个现代世界里的方子之一。在日本它是「十全大補湯」，国民健康保险覆盖的汉方制剂之一，围绕癌性疲乏、术后恢复、肿瘤支持治疗做过研究。有小规模试验。证据体量小且异质性大，在任何一项上都未确立明确获益，故本库不作此声称。可以不夸大地说的是：它是日本使用量与监测强度都排在前列的方剂之一，这本身就是认真对待其安全性文献的理由。
四点安全提示要说白。第一，也是长期服用者最要紧的一点：方中含炙甘草。甘草的甜味成分甘草酸可引起类似醛固酮过多的一组表现 —— 血钾下降、血压升高、水肿，重者乏力与心律问题。它与剂量和疗程相关，与利尿剂、地高辛、糖皮质激素同用以及高龄都会抬高风险；正在用这些药的人不该在医生不知情时自行加服含甘草的方。第二，肉桂是 Cinnamomum cassia（中国肉桂），不是锡兰肉桂；桂皮含较多香豆素，欧洲食品安全机构基于肝脏方面的发现为香豆素设定了可耐受日摄入量。炖肉里的一小撮与每日药用剂量不是同一种算术。第三，当归与华法林相互作用的病例报告有文献记载，川芎在实验研究中显示抗血小板活性；两者都是择期手术前应停用并告知外科医生的理由。第四，外感发热、急性感染期传统上不用此方；脾胃虚弱、大便溏薄者也不宜，因为熟地一类在本方里偏滋腻。人参对华法林的影响证据方向不一致（不同研究结论相左），本库照实写「证据混杂」而不替它下结论。白芍与赤芍不是同一物。蜜丸剂型含糖。