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Erchen Decoction (also known as Erchen Tang or ECD) is a classic traditional Chinese medicine (TCM) herbal formula first recorded in the *Tai Ping Hui Min He Ji Ju Fang* (Prescriptions of the Peaceful Benevolent Dispensary). It is traditionally composed of *Pinellia ternata* (Banxia), *Citrus reticulata* (tangerine peel or Chenpi), *Poria cocos* (Fuling), and *Glycyrrhiza glabra* or *Glycyrrhiza uralensis* (licorice or Gancao), often prepared with fresh ginger (*Zingiber officinale*) and Chinese plum (*Prunus mume*). Erchen Decoction is widely used to treat conditions associated with 'phlegm-dampness' retention, including chronic obstructive pulmonary disease (COPD), hyperlipidemia, non-alcoholic fatty liver disease (NAFLD), obesity, and metabolic syndrome. Pharmacologically, it has been shown to regulate lipid metabolism, alleviate mucus hypersecretion and airway inflammation, and modulate the gut-lung and gut-liver axes, potentially through pathways involving AMPK, PPARα, and gut microbiota-derived short-chain fatty acids (SCFAs) that activate free fatty acid receptor 2 (FFAR2/GPR43).
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