IngredientsShen Qu (Chinese: 神曲; pinyin: shén qū; literally "divine leaven" or "divine ferment") is the principal name used within Traditional Chinese Medicine (TCM) for a preparation more formally designated Massa Medicata Fermentata (also written as Massa Medica Fermentata or Massa Fermentata Medicinalis). Shen Qu is not a single plant but a specially prepared fermented medicinal product. In English it is commonly called Medicated Leaven, and alternative romanizations include Shen-Chu, Shenqu, and the abbreviated abbreviation MMF, which appears frequently in modern research literature. Its older, fuller traditional name is Liu Shen Qu (六神曲, "Six Divine Ferment"), reflecting its classical six-ingredient composition.
Because Shen Qu is a processed, multi-ingredient fermented preparation rather than a botanical extract from a single species, it carries no single Latin binomial. Its source materials are described as: flour (from Triticum aestivum), Polygonum hydropiper, Artemisia annua, Prunus armeniaca, Vigna angularis, and Xanthium sibiricum. Formulations can vary by region and manufacturer, but this six-herb base is classical.
Within the TCM property system, Shen Qu is described as sweet and spicy in flavor and warm in thermal property, and it is held to act upon the Spleen and Stomach channels. It belongs to the category of herbs that relieve food stagnation (xiāo shí yào, 消食药) in the Chinese Materia Medica.
Shen Qu is a fermented product composed of wheat bran, Xing Ren (apricot kernel, Prunus armeniaca), Chi Xiao Dou (adzuki bean, Vigna angularis), Qing Hao (Artemisia annua), and Da Suan (garlic), fermented together to create a complex digestive medicine. Some formulations substitute garlic for Cang Er Zi (Xanthium sibiricum, cocklebur fruit) and La Liao (Polygonum hydropiper, water pepper), reflecting regional variation in the classical recipe.
The recipe evolved over centuries to include Qing Hao, Cang Er Zi, La Liao, Chi Xiao Dou, Xing Ren, and wheat flour, resulting in the original name of "Six Divine Ferment" (Liu Shen Qu 六神曲). Symbolically, the Qing Hao represents the Green Dragon/Qinglong, the wheat flour represents the White Tiger/Baihu, Chi Xiao Dou the Vermilion Bird/Zhuque, Xing Ren the Black Tortoise/Xuanwu, Cang Er Zi the Dragon Deer/Gouchen, and La Liao the Flying Serpent/Tengshe.
MMF is a natural fermentation product of bitter almond (the kernel of Prunus armeniaca L.), red bean (Vigna umbellata Thunb.), Xanthium sibiricum L., Polygonum hydropiper L., Artemisia annua L., and wheat bran or flour (Triticum aestivum L.) combined in a defined proportion.
The production of Shen Qu is a controlled solid-state fermentation procedure. The blend of wheat flour, bran, flowering plants, artemisia, and apricot is covered in hemp paper or mulberry leaves and left to ferment under regulated dampness; once the fermentation is complete (after approximately one week), it is cut into cubes and dried in the sun.
First documented in the Tang Dynasty's "Treatise on Medicinal Properties," MMF is crafted by blending an assortment of natural food and medicinal ingredients in precise proportions, followed by natural fermentation, dicing, and drying. During this process, microbial communities experience succession, accompanied by changes in their metabolic functions; microorganisms secrete digestive enzymes such as cellulases, lipases, and proteases, which facilitate the breakdown of complex chemical components present in the feedstock, resulting in the production of various bioactive metabolites, including fatty acids, amino acids, saccharides, acylglycerols, and flavonoids.
The finished raw product (生神曲, shēng shén qū) can also be further processed before use. In its characteristic form, it appears as a square or rectangular block approximately 3 cm wide and 1 cm thick, with yellowish-brown and rough skin; it is hard, brittle, easily broken, off-white, and with uneven sections, brown residue, and voids left by fermentation, with a stale odor and bitter taste.
The history of Shen Qu bridges the worlds of food fermentation and medicine. The use of fermented grain leaven (qu) in China dates back to the Shang and Zhou dynasties, when people first discovered that moldy grain could produce alcohol. The earliest agricultural text to systematically document leaven-making was Jia Sixie's Qi Min Yao Shu (齐民要术) from the Northern Dynasties period (6th century CE), which described fermentation methods that deeply influenced the later production of medicinal Shen Qu.
Shenqu was first recorded in the Yaoxing Bencao (ca. 600 CE). By the Tang Dynasty (618–907 CE), medical practitioners were using these starters medicinally as digestive aids. The name "Shen Qu" (神曲, literally "divine leaven") derives from the traditional practice of preparing it on the sixth day of the sixth lunar month, a day when the six celestial deities (liu shen) were said to gather.
Shén Qū (神曲) — Massa fermentata medicinalis — belongs to the category of "Herbs that relieve food stagnation" in the Chinese Materia Medica and is used in Chinese herbal medicine as a component of classical herbal formulas and tailored prescriptions. Its primary traditional indication is the pattern known as food stagnation (shí jī, 食积).
Traditional indications include any type of food retention — including retention by minerals, metals, or bones — presenting as fullness and distention in the epigastrium and abdomen, poor appetite, borborygmus, and diarrhea; it is also considered appropriate for overindulgence in alcohol and starches, and is especially effective for stomach cold with food stagnation.
Shen Qu is traditionally added to pills that contain mineral substances to aid in their digestion and absorption. This use as an adjuvant to formulas containing heavy or hard-to-process materials (such as magnetite or cinnabar) is a distinctive feature of its classical application.
Key classical passages describe Shen Qu as transforming grain and water, resolving overnight food, dissolving masses and accumulated stagnation, and strengthening the Spleen and warming the Stomach.
Shen Qu is also known in the Japanese Kampo medical tradition as Shinkiku, where it occupies a comparable role in digestive formulas. Published research on microbial community structure and chemical constituents in the Japanese variant confirms a closely analogous fermentation product is used in Kampo medicine. The preparation is also recognized within Korean traditional medicine, where recent published research from Dongguk University's College of Korean Medicine has characterized its pharmacological properties.
Shen Qu is used in several distinct processed forms, each carrying different therapeutic emphases according to classical TCM processing theory (pào zhì, 炮製):
In practice, Shen Qu is most commonly prepared as a water decoction, incorporated into multi-herb pill formulas, or taken as a powdered granule extract. It is normally made into pill form and used for digestion problems, diarrhea, and indigestion. Modern commercial preparations also include concentrated granules, oral liquids (such as Shenqu Xiaoshi oral liquid), and liquid tincture extracts.
Shen Qu is often combined with Shan Zha (hawthorn fruit, for meat and fat digestion) and Mai Ya (barley sprout, for starch and fruit digestion) in the classical formula Bao He Wan for comprehensive food stagnation. This combination forms the classic trio known as the "Three Charred Immortals" for comprehensive digestive support.
Shen Qu is especially effective at aiding in the processing and digestion of dietary starches and is commonly used for addressing epigastric and abdominal pain, bloating, and indigestion — as in the formulas Bao He Wan and in Curing Pills. Shen Qu also helps the Stomach to deal with "hard-to-digest" substances and is added to TCM formulas that contain medical mineral substances.
MMF contains a variety of chemical constituents, including fatty acids, amino acids, saccharides, acylglycerols, and flavonoids. Modern mass-spectrometric analyses have substantially expanded knowledge of these components. There are 62 common chemical components across different MMF preparations, including 14 flavonoids and their glycosides, 25 organic acids and their esters, 4 carbohydrates, 9 phenylpropanoids, 2 amino acids, 2 nucleotides, 2 alkaloids, 1 vitamin, 1 hydrocarbon, and 2 phenolics.
Differentially abundant metabolites are primarily categorized into lipids, amino acids and derivatives, phenolic acids, organic acids, flavonoids, lignans and coumarins, nucleotides and derivatives, and alkaloids.
Since this is a yeast preparation, its main chemical constituents include yeast, amylase, vitamin B complex, ergosterol, protein and fat, and volatile oil. The digestive enzyme content is regarded as central to its activity: the fermentation process creates amylase, protease, lipase, and other digestive enzymes alongside beneficial microorganisms, and modern analysis confirms significant digestive enzyme content that directly supports carbohydrate, protein, and fat digestion.
A key finding from biostudy research is that the initial chemical composition of the raw ingredients is not identical to the final pharmacodynamic composition. Chemical constituents in the plants such as amygdalin, benzaldehyde, and rutin — shown individually to have toxic properties — were gradually degraded during the process of fermentation so that finished Shen Qu did not contain amygdalin and benzaldehyde. At the same time, the enzyme amylase gradually increased, and the content of organic acids also increased; the authors concluded that amylase activity at least partially explains why Shen Qu is specifically, but not exclusively, effective in the digestion of grains.
The raw material chemical composition of MMF during fermentation is affected by microorganisms and various substances. The initial components of MMF are not identical to the pharmacodynamic components, and amylase activity explains the pharmacological activity of MMF to a certain extent, but it is likely not the only factor.
Two neutral polysaccharides (SMMFP-1 and CMMFP-1) have been isolated from the raw and stir-fried forms of MMF respectively, and their structural characteristics and bioactivities have been characterized. SMMFP-1 (from raw MMF) showed better trypsin inhibition activity in vitro, liver-protective activity in vivo, and stronger antioxidant activity in vivo than CMMFP-1 (from stir-fried MMF).
Twenty-four components have been identified during fermentation, and the potential strains involved include Bacillus, Burkholderia/Caballeronia/Paraburkholderia, Enterobacter, Aspergillus heterocaryoticus, Rhizopus arrhizus, and Kazachstania bulderi, which are related to the production of anti-inflammatory activity.
Structural equation modeling and correlation analysis have indicated that two bacterial species (Bacillus velezensis, Bacillus safensis) and four fungal species (Apiotrichum montevideense, Geotrichum bryndzae, f_Dipodascaceae, Saccharomycopsis fibuligera) showed significant positive correlations with five types of differential metabolites, including lipids, flavonoids, phenolic acids, lignans and coumarins, and organic acids. These differential metabolites are considered essential components responsible for the therapeutic effects of MMF, particularly those that reach peak concentrations at 72 hours of fermentation.
The most straightforward and best-supported mechanism involves the direct enzymatic activity of amylase, protease, and lipase generated during fermentation. These enzymes assist in the breakdown of dietary starch, proteins, and fats in the gastrointestinal tract. The activities of amylase in fermented MMF gradually increase during fermentation, and the content of organic acids also increases.
Animal research has explored whether MMF influences gastrointestinal motility beyond enzyme provision. Studies in rodent models have measured gastric emptying rate, intestinal propulsion rate, serum gastrin concentration, and cholinesterase activity. In preclinical studies, the constituents of Bao He Wan (which contains Shen Qu) were shown to promote gastric emptying, increase gastric acid secretion, and exert anti-ulcer effects. These findings apply to the multi-ingredient formula rather than Shen Qu in isolation.
Prebiotic compounds from the fermentation process of Shen Qu support gut microbiota diversity. Research using 16S rRNA sequencing has further detailed this effect: in mice with spleen deficiency and food accumulation, the abundance of beneficial bacteria such as Bacteroides decreased while harmful bacteria like Verrucomicrobia increased; these changes were reversed after intervention with MMF, and the intestinal microbiota structure returned to a normal state.
Based on 16S rRNA sequencing, all three formulations of MMF tested restored the relative abundance of the dominant phyla Firmicutes, which decreased in mice with spleen deficiency constipation.
MMF prevented DNA and lipid damage caused by oxidative stress, inhibited LDL oxidation, and reduced the expression of cytokines and related proteins (MAPK and NF-κB), with prominent anti-oxidative pathway (NRF2-HO-1) activation properties. The bioactive aglycone of quercetin may be contributing to the mechanisms of systemic effects.
Ancient literature and modern studies have shown that MMF has a hangover effect and ameliorates hepatic inflammation. UPLC-Q-Orbitrap HRMS was used to characterize chemical constituents in MMF; a database was utilized to collect targets for the components and diseases, and cross-targeting analysis of the targets was performed; PPI, KEGG, GO enrichment analysis, and molecular docking were performed to preliminarily validate the mechanism of action.
Preclinical evidence (animal studies):
MMF, a fermented Chinese medicine produced by the fermentation of six traditional Chinese medicines, and its charred form (CLSQ) have been used for strengthening the spleen and enhancing digestion for over a thousand years; CLSQ is commonly used in clinical practice. A study published in the Journal of Ethnopharmacology (ScienceDirect, 2024) directly compared Liu Shenqu (LSQ) and charred Liu Shenqu (CLSQ) on the digestive function of functional dyspepsia (FD) rats. This study aimed to compare the effects of LSQ and CLSQ on the digestive function of FD rats; SPF-grade SD rats were randomly divided into 6 groups: control group, model group, LSQ low-dosage group, LSQ high-dosage group, CLSQ low-dosage group, and CLSQ high-dosage group.
Another rodent study examined MMF effects on gut microbiota in dyspepsia models. Studies suggest that MMF has a variety of possible mechanisms for improving food accumulation and treating gastrointestinal dyspepsia, providing reference value for the quality evaluation and clinical application of MMF.
A further animal experiment administered MMF at doses of 1 or 3 g/kg/day by intragastric gavage for 21 days. SD rats received 0.1% iodoacetamide alone or in combination with water-platform sleep deprivation to induce functional dyspepsia and were administered MMF (1 or 3 g/kg/d, ig), mosapride citrate (2 mg/kg/d, ig), or saline for 21 days; after treatment, the sucrose preferences and gastric emptying rates of the rats were assessed, and ELISA kits were used to detect motilin (MTL) in the rat duodenum and serum contents of cytokines.
Evidence strength: The evidence base for Shen Qu's effect on dyspepsia is largely preclinical (rodent models). Key studies identify MMF as a TCM treatment for indigestion and its related disorders. No large, rigorously controlled human clinical trials specifically isolating Shen Qu from multi-herb formulas have been identified in the peer-reviewed literature. This limits conclusions about clinical efficacy.
To investigate the microecological mechanism of MMF in treating spleen deficiency constipation, researchers conducted studies in constipated mice using RT-PCR, ELISA, and other approaches to observe the effects of MMF on intestinal microecology and serum peptide human serum substance P (SP), vasoactive intestinal peptide (VIP), and calcitonin gene-related peptide (CGRP).
A 2024 Frontiers in Cellular and Infection Microbiology study examined MMF in mice with spleen-deficiency constipation. The study focused on mice with spleen-deficiency constipation to investigate the effects of different formulations of MMF on this condition, examining its impact on intestinal enzyme activity, D-xylose, VIP, 5-HT levels, and intestinal microbiota, with the aim of providing theoretical support and experimental evidence for the clinical application of MMF in treating spleen deficiency constipation.
Limited human evidence: Clinical studies have found that combining Shenqu Xiaoshi oral liquid with intestinal probiotics can effectively relieve symptoms and improve overall efficacy in treating functional constipation in children. This clinical finding, while promising, pertains to a combination product (Shenqu Xiaoshi oral liquid plus probiotics) rather than Shen Qu in isolation, limiting the ability to attribute effects solely to MMF.
Evidence strength: Primarily animal/preclinical. One clinical report involves a combination product. No randomized controlled trials (RCTs) of isolated Shen Qu in constipation have been identified.
The most widely studied clinical context for Shen Qu is as a component of the classical formula Bao He Wan (保和丸). In preclinical studies, the constituents of Bao He Wan were shown to promote gastric emptying, increase gastric acid secretion, and exert anti-ulcer effects; in mice fed a high-protein and high-fat diet, Bao He Wan conferred anti-diarrheal effects by modulating the intestinal composition of lactase-producing bacteria and by inhibiting the growth of conditionally pathogenic bacteria in the intestinal mucosa. Memorial Sloan Kettering Cancer Center notes that clinical trials are needed to determine the efficacy of Bao He Wan against digestive issues, and that side effects have not been reported for this formula in available sources.
Evidence strength: Preclinical data for Bao He Wan are encouraging. Human RCT data for Bao He Wan specifically, or for Shen Qu as a discrete ingredient, are insufficient to support clinical conclusions as of the available literature.
A 2024 study published in the journal Antioxidants (MDPI) by researchers at Dongguk University's College of Korean Medicine is among the most detailed investigations of MMF's pharmacological profile. MMF is a naturally fermented product used to treat indigestion and increase stomach activity in traditional medicine; the study examined the ability of the hydrothermal extract of MMF to scavenge free radicals corresponding to biological oxidative stresses; the anti-inflammatory effects of MMF were evaluated in LPS-induced RAW264.7 macrophages and zebrafish; and the effects of MMF on body mass index (BMI) and cholesterol accumulation in adult zebrafish fed a high-cholesterol diet (HCD) for three weeks were examined.
The key findings: MMF prevented DNA and lipid damage caused by oxidative stress, inhibited LDL oxidation, and reduced the expression of cytokines and related proteins (MAPK and NF-κB), with prominent anti-oxidative pathway (NRF2-HO-1) activation properties; LPS-induced NO production was reduced, and the increase in BMI and total cholesterol caused by the HCD diet was suppressed by MMF in zebrafish embryos or adult zebrafish.
The study concluded that MMF has excellent antioxidant properties and is useful for improving inflammation status and metabolic profile, thus highlighting its potential as a healthy, functional food.
Evidence strength: In vitro and non-mammalian in vivo (zebrafish) only. No human clinical data. These findings are preliminary and exploratory.
A PubMed-indexed study (PMID 38299285, 2024) explored the potential role of MMF in alcoholic liver injury disease (ALD) using network pharmacology and animal experiments. ALD is a chronic liver disease caused by chronic excessive alcohol consumption for which there are no drugs with better efficacy; ancient literature and modern studies have shown that MMF has a hangover effect and ameliorates hepatic inflammation. PPI, KEGG, GO enrichment analysis, and molecular docking were performed to validate the mechanism of action, followed by animal validation using male KM mice of the alcoholic liver injury model. The study serves as a rationale to support MMF in the treatment of ALD and broadens the scope of clinical application of MMF.
Evidence strength: Preclinical (rodent model) and in silico (network pharmacology) only. The traditional use in treating the aftermath of alcohol overindulgence has historical documentation, but modern clinical evidence in humans is absent.
A study published in Evidence-Based Complementary and Alternative Medicine (PMC7530502, 2020) analyzed the effect of MMF on intestinal microorganisms in dyspepsia mice using 16S rRNA technology. MMF is a TCM for treating indigestion and its related disorders; this study analyzed the effect of MMF on intestinal microorganisms in dyspepsia mice based on 16S rRNA technology. The study found broad changes in microbiome composition following MMF administration. Additionally, the 2024 Frontiers in Cellular and Infection Microbiology study found that all three formulations of MMF restored the relative abundance of the dominant phyla Firmicutes, which had decreased in mice with spleen deficiency constipation.
Evidence strength: Animal studies only; no human microbiome trial data for Shen Qu as an isolated intervention has been identified.
A key open question in the scientific literature is whether raw versus charred Shen Qu produces meaningfully different effects. It is unclear whether there is a difference in the spleen-strengthening and digestion effects between LSQ and CLSQ, as well as their mechanisms of action. There are 62 common chemical components in the three kinds of MMF, but comparative analysis shows that the chemical composition types obtained by different fermentation methods are not exactly the same. Research using metabolomics and microbiome analysis is ongoing to characterize these differences.
The following dosages are reported in the cited sources and reflect traditional reference ranges and animal study doses:
For digestive purposes, it is recommended to use Shen Qu after roasting; people with Spleen Yin deficiency, excessive Stomach Fire, or who are pregnant should use it cautiously.
In the classical Chinese pharmacopoeia, Shen Qu is classified as non-toxic and is 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 Qu with Shan Dou Gen (Sophora subprostrata root) produced symptoms of palpitations, nausea, fatigue, and sweating, so this combination should be avoided.
Shen Qu (Shén Qū) is not listed in either of the two classical incompatibility texts — Shi Ba Fan (Eighteen Antagonisms) or Shi Jiu Wei (Nineteen Mutual Inhibitions). This indicates it has no recognized classical contraindications with other traditional herbs, though modern clinical reports require consideration.
People with wheat or gluten allergies should not use Shen Qu. This caution is further supported by the clinical context of Bao He Wan, where the formula should not be taken by those with gluten allergy because it contains wheat and barley sprouts.
People with Spleen Yin deficiency, excessive Stomach Fire, or pregnant women should use Shen Qu cautiously, and it is likely contraindicated for those with an allergy to wheat. Caution in pregnancy reflects classical TCM practice; no modern pharmacovigilance or teratogenicity studies on Shen Qu specifically have been identified.
An important safety-relevant finding from biostudy research concerns the fate of potentially toxic precursor compounds: chemical constituents in the plants such as amygdalin, benzaldehyde, and rutin — shown individually to have toxic properties — were gradually degraded during the process of fermentation so that finished Shen Qu did not contain amygdalin and benzaldehyde. This suggests that the fermentation process itself is a detoxification step, and that improperly fermented or adulterated products could present different safety profiles.
No toxic components have been identified in properly prepared Shen Qu. However, quality control across commercial preparations may vary, and general cautions applicable to Chinese herbal products — including potential heavy metal contamination in poorly regulated supply chains — apply to any traditional medicine product.
The scientific literature on Shen Qu / MMF has grown substantially in the 2020–2025 period, with multiple peer-reviewed studies appearing in journals indexed on PubMed and PubMed Central, including Frontiers in Pharmacology, Frontiers in Cellular and Infection Microbiology, Antioxidants, Journal of Ethnopharmacology, and others. Liu Shenqu (MMF) is one of the most widely used fermented medicines, yet its potential processing mechanism is still unclear.
Several important evidence limitations apply to the current body of research:
Health conditions that Shen qu may help support.
Body systems that Shen qu may help support.
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