Common Bur-Reed Tuber Classic Formulas

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Strongly breaks Blood stasis and disperses masses - San Leng is one of the classic Blood-breaking herbs for abdominal masses, uterine fibroid-type accumulations, amenorrhea from stasis, and severe menstrual pain with clots, especially when the stasis has already hardened into palpable fullness or fixed lumps.
Moves Qi within the Blood and relieves fixed pain - unlike milder Blood movers, San Leng simultaneously attacks the congealed Blood and the stagnant Qi driving it, which is why it is chosen for stabbing or distending pain in the abdomen, flanks, chest, or lower pelvis.
Disperses chronic accumulations and food stagnation - dry-fried San Leng is used when overeating or long-standing digestive obstruction creates bloating, epigastric hardness, retained food, and abdominal distension rather than purely gynecological stasis.
Transforms chronic hepatosplenic and lower-abdominal stagnation patterns - later practice extends its use to chronic hepatitis-type enlargement, endometriosis, and other stubborn masses where Qi stagnation and Blood stasis intertwine over time.

San Zhong Kui Jian Tang (三肿溃坚汤) - classic mass-dispersing formula pattern in which San Leng helps break Blood stasis and hard swellings such as scrofulous or goiter-like accumulations.
San Leng with E Zhu (三棱配莪术) - the signature herb-pair strategy for zheng jia masses, uterine fibroid-type disorders, ovarian cyst patterns, and deeply rooted abdominal accumulations because San Leng excels at breaking Blood while E Zhu excels at moving Qi.
San Leng with Dang Gui - traditional pairing for amenorrhea or dysmenorrhea due to stasis in patients who also need protection of the normal Blood while old stagnant Blood is dispersed.
San Leng with Lai Fu Zi or other digestant Qi-movers - food-stagnation strategy for abdominal hardness, retained food, and severe post-prandial distension when the dry-fried form is preferred.

Kai Bao Ben Cao states that San Leng principally treats chronic accumulations, abdominal masses, and hardened lumps, establishing its long-standing identity as a forceful mass-dispersing herb.
Yi Xue Qi Yuan says it treats pain in the chest and diaphragm, undigested food, and stagnant Qi, but also warns that it damages true Qi and should not be used in people who are Qi deficient.
Wang Haogu described San Leng as a Liver-channel Blood-level herb that breaks the Qi within the Blood, while Zhang Xichun later emphasized that San Leng is stronger than E Zhu at transforming Blood stasis whereas E Zhu is stronger at regulating Qi.
Ben Cao Gang Mu compares its effect to Xiang Fu but notes the action is more drastic and therefore not suitable for prolonged use, a warning that remains clinically relevant whenever strong Blood-breakers are used.