🌿 Folk Prescriptions

Recurrent aphthous stomatitis, also known as aphthous oral ulcer, refers to small, painful ulcers occurring on oral mucosa with recurrent episodes. This condition is often linked to mental stress, endocrine disorders, nutritional deficiencies, infections, genetics, immune dysfunction, and gastrointestinal diseases. Traditional Chinese medicine attributes external causes primarily to heat-toxin, while internal causes stem from emotional injury, dietary indiscretion, and overwork. The condition commonly affects middle-aged women, with ulcers typically scattered across mobile mucosal areas, often causing unbearable pain and disrupting sleep and appetite. We commonly differentiate and treat this condition into six types in clinical practice.
External Pathogenic Toxicity Type: Ulcers frequently appear 1–2 days after exposure to external pathogens, accompanied by symptoms of external invasion. Initial stages involve local mucosal congestion, redness, swelling, and mild pain. Small red spots or vesicles appear on the tip of the tongue or inner lip, rupturing within 12 hours into shallow ulcers with clear borders. Treatment focuses on clearing heat and detoxifying, strengthening the spleen, and resolving dampness. Formula: Honeysuckle 18g, Forsythia suspensa 15g, Patchouli 12g, Costus root 10g, Eupatorium fortunei 10g, Poria 12g, Shenqu 12g, Citrus aurantium 10g, Kudzu root 15g, Atractylodes macrocephala 10g, Hematite 20g, Inula flower (wrapped) 10g, decocted once daily.
Spleen-Stomach Heat Accumulation Type: Multiple erosions and ulcers appear on the tongue and mouth, with red, swollen surfaces, burning pain, severe cases involving halitosis and gum swelling, accompanied by thirst, frequent drinking, yellow urine, and constipation, red tongue with yellow coating, slippery rapid pulse. Treatment aims to clear heat and purge fire, cleanse stomach heat. Formula: Gardenia jasminoides 12g, Scutellaria baicalensis 12g, Forsythia suspensa 12g, Rheum palmatum 10g, Mirabilite 3g, Mentha haplocalyx 8g, Coptis chinensis 10g, Bamboo leaf 10g, Glycyrrhiza 8g, decocted once daily.
Spleen-Kidney Yang Deficiency Type: Mouth and tongue ulcers with pale appearance, no surrounding redness, few in number, long-standing and resistant to treatment, accompanied by cold limbs, dry mouth preferring hot drinks, sore back and waist, frequent clear urination, loose stools, pale tongue with white greasy coating, deep weak pulse. Treatment aims to warm and tonify spleen and kidney, guide fire back to its source. Formula: Prepared Aconite root 15g (boiled first for 30 minutes), Cinnamon 3g, Rehmannia glutinosa 20g, Cornus officinalis 12g, Yam 30g, Cortex Moutan 10g, Poria 12g, Alisma 10g, Atractylodes lancea 10g, decocted once daily.
Spleen-Stomach Weakness Type: Recurrent mouth and tongue ulcers with pale, sunken surfaces, accompanied by fatigue, shortness of breath, poor appetite, cold limbs, loose stools, pale tongue with white coating, fine weak pulse. Treatment aims to tonify the middle energizer, strengthen the spleen, and resolve dampness. Formula: Astragalus membranaceus 15–30g, Codonopsis pilosula 15g, Angelica sinensis 10g, Citrus reticulata 10g, Bupleurum chinense 6g, Cimicifuga heracleifolia 6g, Patchouli 15g, Poria 10g, Atractylodes macrocephala 15g, Glycyrrhiza 6g, decocted once daily.
Heart-Kidney Yin Deficiency Type: Ulcers appear bright red, numerous, irregular in shape and size, pain worse at night, accompanied by palpitations, restlessness, insomnia, vivid dreams, forgetfulness, dizziness, tinnitus, soreness in waist and knees, dry mouth and throat, short yellow urine, red tongue with thin coating, fine rapid pulse. Treatment aims to nourish yin, clear fire, calm the heart, and soothe the spirit. Formula: Raw Rehmannia glutinosa 30g, Lycium barbarum root bark 15g, Yam 5g, Alisma 10g, Cornus officinalis 10g, Wild Chrysanthemum 15g, Forsythia suspensa 12g, Cimicifuga heracleifolia 6g, Cardamom 3g, Morinda officinalis 30g, decocted once daily.
Blood Deficiency with Yin Insufficiency Type: Oral and tongue ulcers often occur around menstruation, accompanied by early menstruation with heavy flow, five-palm heat, dry mouth preferring drinks, pale tongue with thin white coating, fine rapid weak pulse. Treatment aims to nourish blood, enrich yin, and subdue false fire. Formula: Angelica sinensis 20g, Paeonia lactiflora 20g, Raw Rehmannia glutinosa 15g, Light Bamboo Leaf 10g, Poria 12g, Cortex Moutan 10g, Gardenia jasminoides 10g, Bupleurum chinense 10g, Ophiopogon japonicus 10g, Schisandra chinensis 10g, Scrophularia ningpoensis 10g, decocted once daily.
Additionally, patients with recurrent aphthous stomatitis should avoid mental stress, maintain a light diet, eat more vegetables, and limit intake of cold, spicy, alcoholic, and rich foods. They may also apply external powders such as Xilile Powder, Zhu Huang Powder, or Yangyin Shengji Powder directly to the affected area to alleviate pain, relieve symptoms, and promote faster healing of oral ulcers.