🌿 Folk Prescriptions

Recurrent aphthous stomatitis, also known as aphthous ulcer, refers to small, painful ulcers occurring on oral mucosa with recurrent episodes. This condition is commonly linked to mental stress, endocrine imbalance, nutritional deficiencies, infections, genetics, immune dysfunction, and gastrointestinal disorders. TCM attributes external causes primarily to heat-toxin; internal causes stem from emotional injury, dietary indiscretion, and overwork. It commonly affects middle-aged women. Ulcers are usually scattered in mobile mucosal areas, causing severe pain that disrupts sleep and appetite. In clinical practice, we commonly differentiate and treat into six types.
External Pathogenic Toxicity Type: Ulcers frequently appear 1–2 days after exposure to external pathogens, accompanied by typical external symptoms. Initial stage features local mucosal congestion, redness, swelling, slight pain, with small red spots or vesicles on the tip of the tongue or inner lip, rupturing within 12 hours into shallow ulcers with clear borders. Treatment: Clear heat and detoxify, strengthen spleen and resolve dampness. Formula: Honeysuckle 18g, Forsythia 15g, Agastache 12g, Sandalwood 10g, Eupatorium 10g, Poria 12g, Shenqu 12g, Citrus Aurantium 10g, Kudzu Root 15g, Atractylodes 10g, Hematite 20g, Inula (wrapped) 10g. Decocted and taken once daily.
Spleen-Stomach Heat Accumulation Type: Multiple erosions and ulcers in mouth and tongue, red swollen surfaces, burning pain, severe cases with halitosis and gum swelling, accompanied by thirst, frequent drinking, yellow urine, constipation, red tongue with yellow coating, slippery rapid pulse. Treatment: Clear heat and purge fire, cleanse stomach heat. Formula: Gardenia 12g, Scutellaria 12g, Forsythia 12g, Rhubarb 10g, Mirabilite 3g, Mentha 8g, Coptis 10g, Bamboo Leaves 10g, Licorice 8g. Decocted and taken once daily.
Spleen-Kidney Yang Deficiency Type: Mouth and tongue ulcers with pale appearance, no surrounding redness, few in number, persistently unresolved, accompanied by cold limbs, dry mouth preferring warm drinks, lower back and waist soreness, frequent clear urination, loose stools, pale tongue with white greasy coating, deep weak pulse. Treatment: Warm and tonify spleen and kidney, guide fire back to source. Formula: Prepared Aconite 15g (boiled first for 30 minutes), Cinnamon 3g, Rehmannia 20g, Cornus 12g, Yam 30g, Cortex Moutan 10g, Poria 12g, Alisma 10g, Atractylodes 10g. Decocted and taken once daily.
Spleen-Stomach Weakness Type: Recurrent mouth and tongue ulcers, pale depressed ulcers, accompanied by fatigue, shortness of breath, poor appetite, cold limbs, loose stools, pale tongue with white coating, fine weak pulse. Treatment: Tonify central qi, strengthen spleen, resolve dampness. Formula: Astragalus 15–30g, Codonopsis 15g, Angelica 10g, Tangerine Peel 10g, Bupleurum 6g, Cimicifuga 6g, Agastache 15g, Poria 10g, Atractylodes 15g, Licorice 6g. Decocted and taken once daily.
Heart-Kidney Yin Deficiency Type: Ulcers bright red, numerous, irregular shapes and sizes, pain worse at night, accompanied by palpitations, restlessness, insomnia, forgetfulness, dizziness, tinnitus, soreness in waist and knees, dry mouth and throat, short yellow urine, red tongue with thin coating, fine rapid pulse. Treatment: Nourish yin, clear fire, nourish heart, calm spirit. Formula: Raw Rehmannia 30g, Cortex Lycii 15g, Yam 5g, Alisma 10g, Cornus 10g, Wild Chrysanthemum 15g, Forsythia 12g, Cimicifuga 6g, Cardamom 3g, Eucommia 30g. Decocted and taken once daily.
Blood Deficiency and Yin Insufficiency Type: Oral ulcers frequently 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: Nourish blood, enrich yin, subdue virtual fire. Formula: Angelica 20g, White Peony Root 20g, Raw Rehmannia 15g, Light Bamboo Leaves 10g, Poria 12g, Cortex Moutan 10g, Gardenia 10g, Bupleurum 10g, Ophiopogon 10g, Schisandra 10g, Scrophularia 10g. Decocted and taken once daily.
Additionally, patients with recurrent aphthous ulcers should avoid mental stress, eat light meals, consume more vegetables, and limit cold, spicy, alcoholic, and rich foods. They may also apply external medications such as Xilileisan, Zhu Huang San, or Yangyin Shengji San directly to the affected area, which can alleviate pain, relieve symptoms, and promote healing of oral ulcers.