China's 2026 Sanfu Paste Season Is Open: TCM Asthma & Allergic Rhinitis Treatment Now Booking at Top Hospitals

Published: July 14, 2026 · Sources: Natural Product Communications 2024 review (Li et al.); Journal of Ethnopharmacology 2025 (Dang et al.); INPLASY protocols 2025; Beijing University of Chinese Medicine, Shanghai University of TCM, Guangdong Provincial Hospital of TCM hospital notices, July 2026

Every summer, on the three hottest days of the Chinese agricultural calendar, the respiratory-medicine and acupuncture departments of every major Chinese TCM hospital do the same thing: they mix a paste of four herbs — Sinapis semen, Asari Radix et Rhizoma, Kansui Radix, Corydalis Rhizoma — and stick it to acupoints on patients' backs. The protocol is called Sanfutie (三伏贴), "three-fu paste," and 2026's season is now open for booking across China's leading TCM hospitals. For international patients with asthma, allergic rhinitis, chronic bronchitis, or COPD, sanfu paste is one of the few TCM protocols with a defined mechanism, a moderate peer-reviewed evidence base, and a 6-week treatment window every summer.

What sanfu paste is — and why summer

The "three fu" are the three hottest periods of the Chinese agricultural calendar: Chufu (初伏), the first 10 days of the hottest phase; Zhongfu (中伏), the middle 10 or 20 days; Weifu (末伏), the last 10 days of summer. 2026's dates are approximately July 16, July 26, and August 15 — with a possible intercalary Yifu (闰伏) at the end of August if the lunar calendar extends the season.

The theory underlying the protocol is straightforward traditional Chinese medicine: the body's yang-qi is at its annual peak in midsummer. Warming, stimulating substances applied at this window have outsized clinical effect on chronic cold-constitution diseases — the conditions that flare in winter and improve in summer. Asthma, allergic rhinitis, chronic bronchitis, COPD, chronic degenerative joint disease, and chronic gastritis are the canonical indications. Patients apply the paste once per fu period — three applications per summer — for three consecutive summers to build durable clinical effect.

The standard four-component formula has been used in this protocol for decades and is the formula reviewed in the 2024 Natural Product Communications paper (Li et al., DOI 10.1177/1934578x241266414). Each component contributes a specific pharmacological action:

Sinapis semen (芥子, white mustard seed). The primary counter-irritant in the formula. Sinapis contains allyl isothiocyanate, which produces local vasodilation and a counter-irritation effect that drives circulation to the application site. The paste-on-back sensation patients report — warmth, mild redness, occasional small blisters — is largely a Sinapis-driven pharmacological effect, not a placebo response.

Asari Radix et Rhizoma (细辛). The analgesic and warming component. Asari contains methyleugenol and safrole, which have documented anti-inflammatory and analgesic action. In the sanfu context, Asari modulates the local inflammatory response to make the counter-irritation effect tolerable while amplifying the systemic effect.

Kansui Radix (甘遂). The drainage and anti-edema component. Kansui contains kansuinine and other diterpenes with diuretic and anti-edema action — clinically used to reduce local tissue swelling and to support the respiratory-tract drainage effect that the sanfu protocol claims for asthma and bronchitis.

Corydalis Rhizoma (延胡索). The analgesic and smooth-muscle relaxant component. Corydalis contains tetrahydropalmatine and related alkaloids with documented analgesic and smooth-muscle-relaxing action. In asthma and bronchitis, this component supports bronchodilation and reduces cough-reflex sensitivity.

The paste is mixed with ginger juice and honey to form a sticky paste, portioned into 1-2 gram doses, applied to acupoints on the back (typically BL13 Feishu, BL17 Geshu, BL20 Pishu, BL23 Shenshu, and EX-HN14 or equivalent body-points depending on indication), and held in place with medical tape for 4-6 hours for adults (1-2 hours for young children).

The 2024-2025 evidence base

The sanfu paste protocol has a moderate, growing evidence base — stronger than most TCM protocols, weaker than mainstream Western respiratory pharmacotherapy. Three recent peer-reviewed and protocol-registered sources are worth knowing about:

Li et al. 2024 (Natural Product Communications, DOI 10.1177/1934578x241266414). A comprehensive review of the four-component sanfu paste formula. The paper catalogs the standard formula, the standard indication set (asthma, allergic rhinitis, chronic bronchitis, COPD, chronic degenerative joint disease, chronic gastritis), the proposed mechanisms (anti-inflammatory, antitussive, analgesic, immune-modulating), and the application protocol. For a clinician evaluating sanfu paste, this review is the starting point.

Dang et al. 2025 (Journal of Ethnopharmacology, DOI 10.1016/j.jep.2025.119867). A mechanistic study using TMT proteomics and molecular docking in an OVA-induced asthma mouse model. The paper documents that dorsal Sanfu Patch application modulates arachidonic-acid metabolism and tryptophan metabolism — both pathways are central to asthma inflammation. This is the strongest mechanistic evidence to date for the protocol's anti-asthma effect. The 2025 publication is also a marker that international peer-reviewed journals now accept sanfu paste studies on their methodological merits, not as a courtesy to TCM researchers.

Zhu et al. 2025 INPLASY protocol (DOI 10.37766/inplasy2025.9.0042). A registered systematic-review protocol for Chinese herbal medicine — including sanfu paste — for allergic rhinitis. The meta-analysis is supported by Shanghai Pudong New Area Pulmonary Hospital and the YC-2023-0402 Flagship TCM-Western Hospital grant. As of mid-2026 the meta-analysis is in flight; results are expected in late 2026 or early 2027.

Two additional 2025 INPLASY protocols are registered for sanfu-adjacent indications: one for acupoint herbal patching for functional dyspepsia (registered June 2025), one for the same on GERD (registered May 2025). The proliferation of registered systematic-review protocols is itself a signal: the sanfu protocol is being subjected to the same evidence-accumulation process as any mainstream therapy.

The honest evidence framing: sanfu paste is mechanistically plausible, in routine clinical use at scale in China, supported by recent peer-reviewed mechanistic work, and on the verge of stronger randomized-trial evidence. It is not at the same evidence level as inhaled corticosteroids for asthma or antihistamines for allergic rhinitis — but for patients who want adjunctive TCM protocols with a defined mechanism and a real (not nominal) clinical use, sanfu paste is among the better-evidenced options.

Where to get sanfu paste in 2026 — and how international patients access it

Sanfu paste is offered at most large TCM hospitals in China during the 6-week summer window. For international patients, the practical question is: which hospitals have English-speaking patient coordination, a sanfu program that is rigorous enough to trust, and a booking flow that doesn't require Mandarin fluency?

For patients who want a JCI-accredited experience with Western-medicine integration, Beijing United Family's TCM department and HKUMed's clinics are the cleanest options. For patients who want the deepest sanfu-paste expertise (and accept the language-coordination overhead), Dongzhimen and Yueyang are the strongest centers. For patients who are already planning a broader medical-tourism trip — for example, to Hainan Boao Lecheng for a different procedure — Hainan Medical University's program slots into the same itinerary.

How an international patient does sanfu paste

The protocol is, in practical terms, very simple:

Step 1 — Pre-arrival consultation (2-4 weeks before travel). Submit recent clinical history via email or a hospital international-coordination portal: asthma or allergic rhinitis diagnosis, current medications (especially inhaled corticosteroids, antihistamines, leukotriene modifiers), recent spirometry or skin-prick-test results if available, and any history of skin sensitivity to topical agents. The TCM physician will review and confirm the indication is appropriate for sanfu paste.

Step 2 — Travel to China timed to a fu period. The 2026 fu dates are approximately July 16, July 26, and August 15. Patients need to be in China for at least one of these dates. A common itinerary: arrive 1-2 days before the fu date, attend the application session, stay 1-2 days for any TCM follow-up consultation, and depart.

Step 3 — Application session (15-30 minutes). Brief TCM consultation to confirm indication and check for contraindications. Paste mixed fresh on the day. Application to 4-8 back acupoints by a TCM nurse or physician. Patient leaves with the paste in place and instructions to remove it after 4-6 hours (1-2 hours for children 2-6).

Step 4 — Repeat for the other fu periods. Patients aiming for the full 3-summer protocol need to return in 2027 and 2028. International patients who can only come once typically book one summer trip covering all three fu dates.

Total cost. RMB 80-200 per session at public TCM hospitals (~$11-28 at current exchange rates). Three sessions per summer: RMB 240-600 (~$33-83). Add the TCM consultation fee (RMB 50-300 depending on hospital and physician seniority) and the total per-summer cost is RMB 300-900 (~$42-125). For comparison, US allergy-immunology consultation plus a year of antihistamines plus an inhaler commonly runs $1,500-3,000.

What sanfu paste does not do

Three honest limits worth keeping in mind:

It is not a replacement for asthma or allergic-rhinitis controller medications. Sanfu paste is an adjunctive TCM protocol with a moderate evidence base. Patients with moderate-to-severe asthma should not discontinue inhaled corticosteroids. Sanfu paste can be used alongside mainstream controller medications — the protocol does not interfere with bronchodilators, inhaled steroids, or antihistamines.

The randomized-trial evidence is still maturing. Mechanistic studies and observational data are strong. Large multicenter randomized trials with hard endpoints (exacerbation rate, FEV1 change, quality-of-life scores) are fewer than Western respiratory pharmacotherapy has. The 2025 INPLASY meta-analyses will sharpen this picture over the next 12-18 months, but as of mid-2026 the evidence is moderate, not definitive.

The "three-summer rule" means durable effect takes three years. A single summer of sanfu paste produces a modest seasonal effect — patients commonly report less severe winter asthma or allergic rhinitis symptoms. The full clinical effect — comparable to a course of allergen immunotherapy — typically requires three consecutive summers. International patients who cannot commit to the three-year protocol should treat sanfu paste as a seasonal adjunct, not a cure.

What to watch in the next 12-18 months

Four concrete developments worth tracking:

1. The 2025 INPLASY meta-analyses on allergic rhinitis, functional dyspepsia, and GERD. The Zhu et al. allergic rhinitis meta-analysis is expected in late 2026 or early 2027. Positive results would significantly strengthen the sanfu evidence base; negative or null results would temper the indication. The functional dyspepsia and GERD meta-analyses will tell us whether the protocol's evidence extends beyond respiratory indications.

2. NMPA standardization of sanfu paste protocols. As of mid-2026, individual hospitals determine their own sanfu paste formulations, application points, and timing. A 2025-2026 NMPA working group on TCM standardization has signaled interest in publishing a national sanfu paste protocol. Standardization would let international patients and referring physicians rely on a defined formula rather than hospital-by-hospital variation.

3. Inclusion in international respiratory and allergy guidelines. The American Thoracic Society, European Respiratory Society, and Allergic Rhinitis and its Impact on Asthma (ARIA) guideline groups have not yet evaluated sanfu paste. A formal international-guideline review — whether positive, negative, or qualified — would give referring physicians a clear evidence-based position.

4. International sanfu paste programs at overseas TCM clinics. A growing number of TCM clinics in the US, Canada, Australia, and Europe offer sanfu paste — but the formulation is typically prepared locally rather than imported from Chinese hospitals, and the protocol variations are large. If the 2025-2026 standardization efforts move forward, expect imported Chinese-manufactured sanfu paste products and protocol manuals to become available to overseas TCM clinics, which would standardize the international experience.

Bottom line for international patients

The 2026 sanfu season is open. Patients with asthma, allergic rhinitis, chronic bronchitis, or COPD — and a tolerance for adjunctive TCM protocols alongside their main controller medications — have a 6-week window starting around July 16 to start a three-summer course at one of China's leading TCM hospitals. The protocol is non-verbal, low-cost, has a moderate and growing evidence base, and is most rigorously offered at Dongzhimen Hospital in Beijing, Yueyang Hospital in Shanghai, and Guangdong Provincial Hospital of TCM in Guangzhou.

For patients already planning a medical-tourism trip to China — for any procedure — adding the sanfu application to the itinerary is a marginal-cost addition that does not require a separate trip. For patients considering sanfu paste as the primary reason to come, a 1-2 week China trip timed to a fu period is sufficient for the first summer of the protocol, with return trips in 2027 and 2028 to complete the full three-summer course.

The honest framing: sanfu paste is not a cure, and the evidence is moderate rather than definitive. It is, however, one of the better-evidenced TCM protocols available, with a defined mechanism, a defined protocol, and a defined cost. For patients with chronic respiratory disease who have plateaued on mainstream therapy and want to add an adjunctive TCM protocol with a real evidence base, sanfu paste is one of the strongest options on the menu.