IngredientesShen-chu — also rendered shen qu, shenqu, or shinkiku (Japanese) / singug (Korean) — is a fermented traditional medicinal preparation rather than a single botanical species. It is also known as Massa Medicata Fermentata or medicated leaven and is a commonly used substance in Traditional Chinese Medicine (TCM). In Chinese its full name is 神曲 (shén qū), meaning "spirit ferment" or "divine ferment." An alternate Chinese name, liuqu (六曲), means "six-ingredient ferment," referring to the six materials used in the canonical preparation.
Known as shinkiku in Japan, shenqu in China, and singug in Korea, Massa Medicata Fermentata is prepared from wheat (Triticum sativum), apricot kernel (Prunus armeniaca), red beans (Phaseolus angularis), polygonum (Polygonum hydropiper), sweet wormwood (Artemisia apiacea), and cocklebur (Xanthium strumarium). Other sources describe the same six ingredients with slight botanical-name variants: MMF is fermented using wheat (Triticum aestivum L.), red bean (Vigna umbellata), bitter almond (Prunus armeniaca L.), sweet wormwood (Artemisia annua L.), cocklebur (Xanthium sibiricum L.), and water pepper (Polygonum hydropiper L.).
Shenqu (shen-chu) is an unusual preparation of wheat (or sprouted barley) combined with herbs used as a digestive aid and as a component of treatments for acute ailments. The preparation is classified in the Chinese Materia Medica under the category of food stagnation-relieving herbs (消食药). It is characterised as sweet, pungent, and warm in nature, entering the spleen and stomach meridians.
Shen-chu is manufactured and sold in several processed forms that have distinct therapeutic emphases in TCM practice:
In modern commerce, standardised versions are available in powder or pill form in Chinese pharmacies and are often included in classical digestive formulas such as Bao He Wan (Preserve Harmony Pill). It is often packaged and sold as a tea (cha) and so is often called shenque cha. Additionally, shen-chu is a key constituent of the proprietary oral liquid preparation Shenqu Xiaoshi Oral Liquid (神曲消食口服液), which has been evaluated in formal clinical trials.
Shenqu, called by various names "massa fermentata," "Chinese yogurt," and "mysterious ferment," was first recorded in the Yaoxing Bencao (Treatise on Herb Property, ca. 600 CE). It is recorded in multiple famous classics of Traditional Chinese Medicine, including the Qi Min Yao Shu (Jia S.X., 533–544 CE), the Treatise on Chinese Herbal Nature (Zhen Q., Tang Dynasty, 618–907 CE), and Seeking Truth from Materia Medica (Huang G.X., Qing Dynasty, 1769).
The preparation evolved from a process of using fermented wheat as a nutrient to grow yeast as a starter for making wine. Later, herbs were added to provide medicinal properties — directing qi downward, relieving the surface, and promoting digestion — eventually replacing the sprouted wheat (xiaomai) with sprouted barley (maiya) in some preparations.
The charred form (CLSQ) is also recorded in multiple famous classics of traditional Chinese medicine, such as Yi Sheng Wei Lun (Li Z.Z., Ming Dynasty), and is widely used in multiple TCM formulas such as the Baohe Pill (Ming Dynasty, 1368–1644 CE) and Zhishi Pill (Yuan Dynasty, 1271–1368 CE).
Shen-chu has been used across multiple East Asian medical traditions. It is a traditional crude drug used to treat anorexia and dyspepsia of elderly patients in East Asia and is also used in Japanese Kampo medicine as a component of Hangebyakujutsutemmato (半夏白朮天麻湯). The preparation is manufactured primarily in China and Korea, though it is employed medicinally across the broader East Asian region.
In TCM, shen-chu is primarily used to aid digestion and harmonise the stomach. It is categorised as a "food stagnation" remedy — used when undigested food accumulates in the gastrointestinal tract, resulting in bloating, fullness, indigestion, or diarrhoea.
It is a traditional Chinese medicine known for fortifying the spleen, enhancing stomach function, and improving digestion, with extensive clinical use for conditions like spleen and stomach weakness, dietary stagnation, chest and abdominal distension, as well as paediatric food accumulation.
Shen-chu is additionally added to pill formulas containing heavy mineral or shell-based substances (such as magnetite or cinnabar) to protect the stomach and aid absorption of these hard-to-digest ingredients. This role as a digestive adjuvant in compound mineral formulas is a long-standing application unique to TCM polypharmacy.
Shen-chu is one of the most commonly used digestive herbs in Chinese medicine, often combined with hawthorn berry and barley sprout to form the classic trio known as the "Three Charred Immortals" for comprehensive digestive support. Shen-chu is often combined with Shan Zha (for meat and fat) and Mai Ya (for starch and fruit) in the classical formula Bao He Wan for comprehensive food stagnation.
The most pharmacologically prominent constituents of shen-chu are the digestive enzymes generated during fermentation. Digestive enzymes — α-amylase, protease, and lipase — are commonly found in shen-chu products. The fermentation process creates amylase, protease, lipase and other digestive enzymes alongside beneficial microorganisms.
The digestion-promoting function of shenqu is likely due to the yeasts, which are rich in amylase and thus aid digestion of grains; yeasts also have other digestive enzymes in lesser amounts. Research indicates that changes in digestive enzyme activity during MMF fermentation can serve as a key indicator for regulating fermentation and assessing quality.
Organic acids — including ferulic acid, citric acid, lactic acid, and acetic acid — are commonly found in shinkiku (Massa Medicata Fermentata). These acids are generated through microbial metabolism during the fermentation process and may contribute to the preparation's effects on gastrointestinal physiology.
Because phenolic compounds are key ingredients of MMF, one study investigated how fermentation reshapes the phenolic profile. Using UPLC-ESI-MS/MS-based metabolomics, 119 phenolic compounds were identified, 66 of which were previously unreported in MMF. Comparative analysis showed that fermentation significantly remodelled the phenolic composition, notably enriching free phenolic acids, methoxylated flavonoids, and flavonoid C-glycosides compared to the unfermented precursor.
Wide-target metabolomic analysis identified 902 metabolites, classified as phenolic acids, flavonoids, lipids, amino acids and derivatives, organic acids, alkaloids, nucleotides and derivatives, terpenoids, lignans, coumarins, tannins, and quinones.
During fermentation, microorganisms secrete digestive enzymes such as cellulases, lipases, and proteases, which facilitate the breakdown of complex chemical components present in feedstock, resulting in the production of various bioactive metabolites including fatty acids, amino acids, saccharides, acylglycerols, and flavonoids.
A new benzochroman, 3(S)-3,4-dihydro-5,10-di-β-d-glucopyranoside-2,2-dimethyl-2H-naphtho(2,3-b)pyran-3-ol, and five known galactosyl acylglycerols have been isolated from a methanol extract of MMF. Compounds 1–3 exhibited significant inhibitory effects on LPS-induced production of IL-6 and IL-12 p40, with IC50 values ranging from 1.6 to 10.2 μM. Compounds 2 and 3 also exhibited strong inhibitory effects on LPS-stimulated production of TNF-α with IC50 values of 12.0 and 11.2 μM, respectively. These findings are preliminary and derive from in vitro cell culture work.
Liu Shenqu (MMF) is a natural fermented product of flour and/or wheat bran and five medicinal herbs: Prunus armeniaca, Vigna umbellata, Artemisia annua, Polygonum hydropiper, and Xanthium strumarium. Betaine has been identified as a chemical constituent of significance for quality control. Analysis of 58 commercially available MMF batches revealed that betaine concentrations in 49 batches (84.5%) ranged from 0.75 to 4.0 mg/g, whereas only 9 samples contained concentrations below 0.5 mg/g. Betaine levels were significantly lower in charred products compared with unprocessed ones (p < 0.001), suggesting that betaine may serve as a potential biomarker for the quality control of MMF.
A study collected 13 shen-chu products manufactured in China and Korea and investigated the microbial structure; amplicon sequence analysis revealed that Aspergillus sp. was the most common microorganism in these products. Additional potential strains identified include Bacillus, Burkholderia/Caballeronia/Paraburkholderia, Enterobacter, Aspergillus heterocaryoticus, Rhizopus arrhizus, and Kazachstania bulderi. During the fermentation process, bacterial diversity generally shows an increasing trend, whereas fungal diversity generally shows a decreasing trend.
A total of 39 volatile compounds are commonly found in shen-chu products. These aromatic compounds contribute to the characteristic "mossy" smell of the product that is used as a quality indicator in classical pharmacopoeias.
Modern analysis confirms significant digestive enzyme content that directly supports carbohydrate, protein and fat digestion. The α-amylase content in particular supports the breakdown of starches, and shen-chu is especially effective at aiding in the processing and digestion of dietary starches and is commonly used for addressing epigastric and abdominal pain and bloating.
Animal studies have demonstrated that shen-chu modulates key gastrointestinal hormones. LSQ and charred Liu Shenqu (CLSQ) improved pathological tissue histological structure in functional dyspepsia (FD) rats and increased the levels of motilin (MTL) and gastrin (GAS) in serum and the levels of ghrelin in the gastric antrum, spleen, and duodenum, while reducing VIP (vasoactive intestinal peptide), CCK (cholecystokinin), and SP (substance P) hormone levels.
LSQ exerts a therapeutic effect on FD through regulating gastrointestinal activity, promoting gastrin secretion, inhibiting cholinesterase and serum NO, influencing food consumption, and improving gut microbiota of FD rats.
Recent research has shown that MMF not only enhances digestive function but also improves intestinal health by regulating the intestinal microbiota. Both LSQ and CLSQ can improve the composition and diversity of the gut microbiota. Prebiotic compounds from the fermentation process support gut microbiota diversity.
The anti-inflammatory activity of fermented medicine may be under the involvement of multiple strains and the interaction between these microorganisms; Liu Shenqu is one of the most widely used fermented medicines whose potential processing mechanism is still being elucidated. The benzochroman and acylglycerol compounds isolated from MMF showed in vitro inhibition of pro-inflammatory cytokine production (IL-6, IL-12, and TNF-α), though the clinical relevance of these findings has not been established in human studies.
Metabolomic analysis demonstrated that 20 metabolites changed after LSQ treatment and 16 underwent continuous changes after CLSQ treatment; LSQ mainly intervened in the metabolic pathways of glycerophospholipid metabolism and arginine and proline metabolism. The mechanism of charred Liu Shenqu in treating functional dyspepsia may involve affecting ether lipid metabolism, sphingolipid metabolism, and glycerophospholipid metabolism.
The most substantial body of clinical evidence for shen-chu concerns its use in children with functional dyspepsia (FD), primarily through the proprietary preparation Shenqu Xiaoshi Oral Liquid (SXOL).
Key randomised controlled trial: Between February 2019 and March 2021, a total of 373 patients were assessed for eligibility and 356 patients were enrolled and randomised. The clinical response rate at week two was similar for SXOL (118 of 142, or 83.10%) and domperidone (128 of 158, or 81.01%), with a difference of 2.09 and a 95% CI of −6.74 to 10.71, thereby establishing non-inferiority. Subjects were recruited by paediatric gastroenterologists in outpatient clinics at 17 tertiary medical centres across China; children aged 3–14 years diagnosed with FD according to Rome IV criteria were eligible.
Design of a Phase 4 trial: A multi-centre, randomised, double-blind, double-simulation Phase 4 trial registered with ClinicalTrials.gov (NCT05030116) was designed by Ruijin Hospital to evaluate shenqu xiaoshi oral liquid versus domperidone suspension in children with functional dyspepsia.
Systematic review (functional constipation in children): A systematic review of electronic databases including PubMed, Embase, Scopus, Cochrane Library, and Chinese databases (inception to October 2025) assessed Shenqu Xiaoshi Oral Liquid for paediatric functional constipation using randomised controlled trials, retrospective and prospective studies; the observed heterogeneity was attributed to a lack of standardised clinical guidelines and inconsistencies in medical resources across hospitals.
Evidence strength: For paediatric functional dyspepsia specifically, there is moderately strong clinical evidence from at least one well-designed multi-centre RCT establishing non-inferiority compared to domperidone. For other paediatric conditions such as constipation, the evidence is preliminary and limited by heterogeneity.
One study analysed the effect of MMF on intestinal microorganisms in dyspepsia mice using 16S rRNA technology, using a dyspepsia model caused by a high-protein, high-calorie, high-fat diet. The 60 SPF KM mice were randomly divided into a model group (n=12), an MMF group (n=12), a Jianweixiaoshi group (n=12), a domperidone group (n=12), and a blank group (n=12). The results showed that shen-chu improved gastrointestinal motility and modulated the composition of intestinal bacteria, supporting its traditional use as a digestive aid. The study highlighted that the fermented preparation's benefits extend beyond simple enzyme supplementation to include broader effects on the gut-brain-microbiota axis.
A separate study examined shen-chu at doses of 1 or 3 g/kg/day (intragastric) in a rat model of FD induced by iodoacetamide with or without water platform sleep deprivation. In this study, SD rats received MMF at 1 or 3 g/kg/d, or mosapride citrate at 2 mg/kg/d, or saline for 21 days. The gastric emptying rate and intestinal propulsion rate were calculated, serum gastrin concentration and cholinesterase activity were measured, and 16S rRNA microbial detection was performed. A total of 95 chemical components were identified from three MMF extracts, 62 of which were the same, with differences in flavonoids and their glycosides, organic acids, and esters.
Evidence strength: Preclinical animal evidence is moderately consistent in demonstrating prokinetic and gut microbiota modulating effects, but these findings cannot be directly extrapolated to humans.
MMF (Shenqu) has long been applied in the treatment of indigestion in China and is the active ingredient in the medicine Shenqu xiaoshi oral solution (SQXSOS). Based on robust clinical evidence, SQXSOS has shown efficacy in treating infantile anorexia (IFA). The pharmacodynamic efficacy of SQXSOS was validated through a high-fat diet-induced IFA model of juvenile rats sharing physiological similarities to two-year-old humans. UHPLC-TOF MS was used to analyse the blood-dissolved components.
Evidence strength: Described as having "robust clinical evidence" in the peer-reviewed literature, but the primary evidence base is Chinese-language clinical studies; independent replication and blinded trials published in international journals remain limited.
MMF is made by fermenting a mixture of flour, wheat bran, and five herbs at controlled temperatures; in TCM theory it primarily enters the spleen and stomach meridians and is widely used to treat digestive disorders such as food stagnation, spleen and stomach deficiency, abdominal distension, and paediatric indigestion. Recent research showed that MMF not only enhances digestive function but also improves intestinal health by regulating the intestinal microbiota; in mice with spleen deficiency and food accumulation, the abundance of beneficial bacteria such as Bacteroides decreased while harmful bacteria like Verrucomicrobia increased. Evidence remains at the preclinical (animal model) level for this specific application.
The in vitro isolation of benzochroman and acylglycerol compounds with demonstrated cytokine-suppressive activity (inhibiting IL-6, IL-12 p40, and TNF-α in LPS-stimulated dendritic cells) represents a preliminary mechanistic finding. MMF has been used for treating indigestion, vomiting, diarrhoea, obesity, and related metabolic diseases according to traditional records, but anti-inflammatory claims in humans lack clinical trial evidence. The in vitro findings should be considered hypothesis-generating only.
Shinkiku (shen-chu) is also used in Japanese Kampo medicine as a component of the formula Hangebyakujutsutemmato (半夏白朮天麻湯). This formula is used to treat dizziness and nausea. The evidence for shen-chu's specific contribution within this compound formula has not been isolated in human clinical studies.
Shen-chu is administered in several forms and doses, as documented in sources:
The quality of shen-chu varies by manufacturer because there are no reference standards to control the quality of medicinal shen-chu. Variations in quantities, fermentation conditions, and processing procedures across different production regions can influence the quality of MMF products, ultimately affecting their efficacy.
MMF, a clinically important fermented traditional Chinese medicine for treating gastrointestinal and metabolic disorders, struggles with quality control due to insufficient reliable reference materials. The 2020 edition of the People's Republic of China Pharmacopoeia indicates that proprietary Chinese medicine prescriptions comprising fermented traditional Chinese medicines hold a significant market share.
Two candidate biomarkers have been proposed for quality standardisation: betaine (discussed above under chemical constituents) and amygdalin from apricot kernels. Amygdalin in apricot kernels could serve as a key regulating factor and potential biomarker in quality control for MMF by inhibiting pathogenic bacteria, stabilising core microbiota, and suppressing digestive enzymes.
Classical Chinese pharmacopoeia toxicity rating for shen-chu classifies it as non-toxic and generally very safe. It is a fermented food-medicine product rather than a potent pharmacological agent.
Because it is warm and pungent, excessive dosage may cause dry mouth, a burning sensation in the stomach, or acid regurgitation.
One clinical report noted that combining shen-chu with Shan Dou Gen (Sophora subprostrata root) produced symptoms of palpitations, nausea, fatigue, and sweating, so this combination should be avoided.
People with wheat or gluten allergies should not use shen-chu. Since the preparation contains wheat, wheat bran, and fermented grain substrates, it contains gluten and is contraindicated in coeliac disease or wheat hypersensitivity.
Variations in quantities, fermentation conditions, and processing procedures across different production regions can influence the quality of MMF products, ultimately affecting their efficacy. Because the fermentation process is biological and open to environmental microbial inoculation, batch-to-batch variation in enzyme activity and microbial content is a documented concern. Considerable inconsistencies in product appearance and intrinsic quality hamper clinical application.
No formal clinical trial evidence is available regarding the safety of shen-chu during pregnancy or lactation. The compound Xanthium sibiricum (cocklebur), one of the six classical ingredients, is known in the broader TCM literature to warrant caution in some contexts, though no specific interaction data for shen-chu as a complete preparation has been published in the peer-reviewed literature reviewed here.
No toxic components have been identified in properly prepared shen-chu. However, "proper preparation" is a critical qualifier given the documented quality-control challenges described above.
Condiciones de salud que shen-chu puede ayudar a apoyar.
Shen-chu is classically used for epigastric and abdominal bloating and fullness arising from food stagnation. Clinical trials of Shenqu Xiaoshi Oral Liquid in functional dyspepsia—a condition defined by epigastric symptoms including pain, fullness, and discomfort—provide supporting clinical evidence.
Shen-chu (as Shenqu Xiaoshi Oral Solution) has demonstrated clinical efficacy in treating infantile anorexia (IFA). Animal studies using juvenile rat models have validated its pharmacodynamic mechanism in restoring appetite and digestive function. It is also traditionally noted to relieve poor appetite arising from food stagnation.
Shen-chu (as Shenqu Xiaoshi Oral Liquid) has been evaluated in multiple RCTs for functional dyspepsia and functional constipation in children. A 2022 multicenter RCT (n=356 children, Rome IV criteria) demonstrated non-inferiority to domperidone syrup for pediatric functional dyspepsia. A 2026 systematic review and meta-analysis also found the formulation effective for pediatric functional constipation.
The fermentation process of shen-chu produces a clinically relevant spectrum of digestive enzymes including amylase, protease, lipase, cellulase, sucrase, and glucoamylase. Biochemical studies confirm these enzymes are produced during fermentation and are not present in the unfermented raw materials, directly supporting macronutrient breakdown.
Animal studies using 16S rRNA gene sequencing have shown that Massa Medicata Fermentata modulates intestinal microbiota composition in dyspepsia and spleen-deficiency models, improving α- and β-diversity. Prebiotic and probiotic components produced during fermentation are mechanistically implicated.
Preliminary research has identified Massa Medicata Fermentata as capable of relieving visceral hypersensitivity symptoms including abdominal tension, abdominal pain, and diarrhea in IBS with diarrhea (IBS-D). Evidence is preclinical and based on combination formulas; direct human RCT data for shen-chu alone in IBS are absent.
Shen-chu is traditionally indicated for loose stools and diarrhea arising from food stagnation in TCM. It appears in multi-herb formulas studied for chemotherapy-induced diarrhea and IBS-D, though direct clinical evidence for shen-chu alone in diarrhea is limited to traditional documentation.
Classical TCM texts indicate shen-chu for nausea and vomiting associated with food stagnation and summer-heat syndrome. It appears in multi-herb TCM formulas investigated for chemotherapy-induced nausea and vomiting, but direct clinical evidence for shen-chu alone is absent.
Sistemas corporales que shen-chu puede ayudar a apoyar.
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