Dang Gui Si Ni Tang

Dang Gui Si Ni Tang's main function is to warm the channels to dispel cold, nourish the blood, promote blood circulation, invigorate pulse, and alleviate pain.

Dang Gui Si Ni Tang

Functions
Dang Gui Si Ni Tang's main function is to warm the channels to dispel cold, nourish the blood, promote blood circulation, invigorate pulse, and alleviate pain. The formula is used to treat the following symptoms: deficiency of blood due to the accumulation of pathogenic cold, cold limbs due to stagnation of blood circulation and channels, and syncope due to a faint pulse. Clinically, the formula is commonly used to treat diseases such as Raynaud's disease, thrombophlebitis, chilblain, and chronic rheumatic arthritis.(1)
Dosage Info
Internal administration, 5:1 concentrated extracts: 9 grams/day.
Ingredients
Precautions
The formula is appropriate for treating cold limbs due to blood deficiency and accumulation of pathogenic cold only; it is not appropriate for treating cold limbs due to other factors.
Pharmacology
Anticoagulation effect: Experiments have shown that when administered to mice, Dang Gui Si Ni Tang can prolong blood coagulation time, thrombin time, and plasma recalcification time. When administered to rats, the formula can inhibit thrombogenesis in arterio-venous bypasses, and reduce blood platelet aggregation. The formula can also promote absorption of subcutaneous hematoma in mice.(2)

Analgesic and anti-inflammatory effects: Fed to mice, the Dang Gui Si Ni Tang formula is shown to have antagonistic actions towards potassium antimony tartrate-induced body torsion and electric stimulation-induced pain. The formula also has an anti-inflammatory effect on croton oil-induced auricular inflammation in mice and on carrageenin-induced paw swelling and edema in rats.(3)

Vasodilation effect: When fed to rabbits, this formula has shown long-lasting effects in the dilation of auricular blood vessels.(4)

Clinical Applications
Treating Raynaud's disease
Xu treated 20 cases of Raynaud's disease with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Huang Qi (processed Astragalus Root), Gui Zhi (Cinnamon Twig), Chuan Wu (processed Sichuan Aconite Root), Dan Shen (Salvia), Tao Ren (Persica), Hong Hua (Carthamus), Di Long (processed Earthworm), Xi Xin (Wild Ginger), Gan Cao (processed Licorice), Mu Tong (Akebia), and Da Zao (Jujube). To suit the individual patients' symptoms, the formula was further modified as follows: for soreness and cold in the waist and knees, Yin Yang Huo (Epimedium) and Lu Jiao (Antler) were added; for serious dampness symptoms and edema, Qiang Huo (Notopterygium Root), Du Huo (Pubescent Angelica Root), and Hou Po (Magnolia Bark) were added; for emotional stress complicated with fullness in the chest and hypochondrium, Chai Hu (Bupleurum) and Bai Shao (White Peony Root) were added; for blood stasis complicated with pain, San Leng (Burreed Tuber) and E Zhu (Zedoaria) were added. The herbs were decocted in water and administered orally one dose per day. The results showed that after 21 to 91 days of treatment, 11 cases were resolved, 6 cases had improved, and the remaining 3 cases did not respond to the treatment.(5)

Zhuang treated 50 cases of Raynaud's disease with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Xi Xin (Wild Ginger), Tong Cao (Tetrapanax), Gan Cao (processed Licorice), Da Zao (Jujube), Huang Qi (processed Astragalus Root), and Cong Bai (Fistular Onion Bulb). The herbs were decocted in water and administered orally once a day. The results showed that the treatment had a total effectiveness rate of 86%.(6)

Liang treated 9 cases of Raynaud's disease with Dang Gui Si Ni Tang plus Mao Dong Qing (Pubescent Holly Root) and Huang Qi (processed Astragalus Root). After the herbs were decocted in water, the formula was given orally once a day. The results showed that 8 cases were resolved and the remaining case showed some improvement.(7)

Dou et al. treated 28 cases of Raynaud's disease based on the formulas Si Ni Tang (Decoction for Resuscitation) and Dang Gui Si Ni Tang. This mega-formula consisted of Fu Zi (processed Aconite Root), Gan Jiang (Rhizoma Zingiberis), Gan Cao (Licorice), Gui Zhi (Cinnamon Twig), Chi Shao (Peony Red), Huang Qi (Radix Astragali), Yan Hu Suo (Rhizoma Corydalis), Dang Gui (Dang Gui), Xi Xin (Wild Ginger), and Dan Shen (Salvia). The herbs were decocted in water and used as an oral administration once a day and one therapeutic course of treatment lasted for 20 days. The comparison group of 25 cases was treated with tolazoline (25mg) and nicotinic acid (50mg), three times a day. After this therapy, of the treatment group, 15 cases were resolved, 10 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effectiveness rate of 89.29%. Of the comparison group, the corresponding numbers were 6, 10, 9, and 64% (P<0.05).(8)

Treating scapulohumeral periarthritis
Hu treated 38 cases of scapulohumeral periarthritis with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Bai Shao (White Peony Root), Huang Qi (Astragalus Root), Gui Zhi (Cinnamon Twig), Bai Jie Zi (White Mustard Seed), Xi Xin (Wild Ginger), Sang Zhi (Mulberry Twig), Qiang Huo (Rhizoma seu Notopterygium Root), Zhi Qiao (Aurantium Fruit), Mu Gua (Chaenomeles), Tu Bie Chong (Eupolyphaga seu Steleophaga), Gan Cao (Licorice), and Tong Cao (Tetrapanax). The herbs were decocted in water and orally administered once a day. One therapeutic course of treatment lasted 12 days. The results demonstrated that after two courses of treatment, 9 cases were resolved, 26 cases had improved, and the remaining 3 cases did not respond to the treatment, with a total effectiveness rate of 92.2%.(9)

Similarly, Chen treated 28 cases of scapulohumeral periarthritis with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Sang Zhi (Mulberry Twig), Bai Shao (White Peony Root), Gui Zhi (Cinnamon Twig), Bai Jie Zi (Semen Sinapis Albae), Yin Yang Huo (Epimedium), Tong Cao (Tetrapanax), Pian Jiang Huang (Curcuma), Xi Xin (Wild Ginger), Huang Qi (Astragalus Root), Wei Ling Xian (Clematis), Di Long (Earthworm), and Da Zao (Jujube). The formula was modified to suit the individual patients' symptoms. The herbs were decocted in water and administered one dose per day, and one course of treatment lasted for 10 days. In addition, tendon-smoothing manipulation was performed on the patients, who also took up functional exercises. The results were, 25 cases were resolved and the remaining 3 cases had improved.(10)

Treating cold-type erythema multiforme
Zhang treated 168 cases of cold-type erythema multiforme with modified Dang Gui Si Ni Tang. The formula consisted of Gui Zhi (Cinnamon Twig), Dang Gui (Dang Gui), Bai Shao (White Peony Root), Da Zao (Jujube), Fu Zi (processed Aconite Root), and Huang Qi (Astragalus Root). For patients with blood stasis, Tao Ren (Persica), Hong Hu (Carthamus), and Dan Shen (Salvia) were added to the formula. The herbs were decocted in water and one course of treatment lasted 20 days. The results showed that after one course of treatment, 144 cases were resolved, 20 cases had improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of 97.6%.(11)

Similarly, Li treated 16 cases of cold-type erythema multiforme with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Gui Zhi (Cinnamon Twig), Fang Feng (Siler), Tong Cao (Tetrapanax), Bai Shao (White Peony Root), Chan Yi (Cicada), Chuan Wu (processed Sichuan Aconite Root), Gan Cao (Licorice), Xi Xin (Wild Ginger), Che Qian Cao (Plantaginis Herba), and Bai Xian Pi (Dittany Bark). The herbs were decocted a total of three times: the first two decoctions were administered internally and the third decoction was used topically to wash the affected extremities. After treatment, 10 cases were resolved, 4 cases showed some improvement, and the remaining 2 cases did not respond to the treatment.(12)

Treating miscellaneous diseases
Yang treated 63 cases of postoperative intestinal adhesion with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Bai Shao (White Peony Root), Gui Zhi (Cinnamon Twig), Gan Cao (processed Licorice), Xi Xin (Wild Ginger), and Tong Cao (Tetrapanax). The formula was modified to suit the individual patients' symptoms. The herbs were decocted in water to be used for oral administration once a day, and one course of treatment lasted for 5 days. After 1 to 2 courses of treatment, 34 cases were resolved, another 23 cases had some improvement, and the remaining 6 cases did not respond to the treatment, with a total effectiveness rate of 90.4%.(13)

Zhang treated 42 cases of prostatic hypertrophy with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Zhi Mu (Anemarrhena), Huang Bai (Phellodendron), Xi Xin (Wild Ginger), Tong Cao (Tetrapanax), Gan Cao (Licorice), Huai Niu Xi (Achyranthes), Che Qian Zi (Plaintain Seed), Wang Bu Liu Xing (Vaccaria), and Chuan Shan Jia (processed Anteater Scales). The formula was modified to suit the individual patient's symptoms. After decoction, the formula was administered orally once a day. After 6 to 30 days of treatment, 20 cases were resolved, another 19 cases had improved, and the remaining 3 cases did not respond to the treatment, with a total effectiveness rate of 92.6%.(14)

Zheng et al. treated 36 cases of post-stroke syndrome with modified Dang Gui Si Ni Tang. The formula consisted of Dang Gui (Dang Gui), Bai Shao (White Peony Root), Ma Huang (Ma-Huang), Chuang Xiong (Cnidium), Gui Zhi (Cinnamon Twig), Xi Xin (Wild Ginger), Fu Zi (processed Aconite Root), Gan Cao (processed Licorice), and Da Zao (Jujube). The formula was modified to suit the individual patients' symptoms. After an oral administration of the decoction, the results were, 14 cases were resolved, another 18 cases had improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of 89%.(15)

hives Gong et al. used Dang Gui Si Ni Tang plus Chan Yi (Cicada) and Jing Jie (Schizonepeta) to treat 55 cases of hives of the following three types: 1) Cases due to superficial invasion of pathogenic wind-cold; 2) Cases due to superficial invasion of pathogenic wind-heat; and 3) Cases due to blood deficiency-caused wind-dryness. The herbs were decocted in water to be used for an oral administration once a day. The results showed that after 10 days of treatment, 45 cases were resolved and the remaining 10 cases improved.(16) Similarly, Wang treated 55 cases of cold-type hives with Dang Gui Si Ni Tang. The herbs were decocted and administered orally once a day. Five days constituted one therapeutic course of treatment. While under treatment, the patients were advised to keep warm and avoid scratching affected areas. A comparison group of 30 cases was treated with cyproheptadinum, ketotifen, and doxal combined with scopolamine, and reserpine. The results showed that of the treatment group, 41 cases were resolved, another 13 cases improved, and the remaining case did not respond to the treatment, with a total effectiveness rate of 98.18%, and of the comparison group, the corresponding numbers were 1, 10, 19, and 36.67% (P<0.01).(17)

References
  1. Zhou Li Na. Pharmacology and clinical application of Dang Gui Si Ni Tang. Journal of Chinese Patent Medicine. 2000;22(7):518-519.
  2. Huang Fang, et al. Dang Gui Si Ni Tang's effect in invigorating the blood and removing stasis. China Journal of Experimental Recipes. 1999;5(5):31-33.
  3. Dou Chang Gui, et al. Dang Gui Si Ni Tang's analgesic and anti-inflammatory effects. China Journal of Experimental Recipes. 1999;5(5):38-39.
  4. You Guo Xiong, et al. 52 cases of migraine treated with Dang Gui Si Ni Tang. China Journal of Medicine. 1981;(1):57.
  5. Xu Yu Jian. Treating 20 cases of Raynaud's disease with modified Dang Gui Si Ni Tang. Jiangsu Journal of TCM. 1992;13(10):446-447.
  6. Zhuang Qiu Qin. Treating 50 cases of Raynaud's disease with modified Dang Gui Si Ni Tang. Shaanxi Journal of TCM. 1995;16(11):488.
  7. Liang Jin Wen. Treating 9 cases of Raynaud's disease with Dang Gui Si Ni Tang. Journal of Shaanxi Correspondence School of TCM. 1991;(1):6-7.
  8. Dou Li Gang, et al. 28 cases of Raynaud's disease treated with modified Dang Gui Si Ni Tang. China Journal of Pharmacy. 2000;28(2):21.
  9. Hu Wei Wu. Treating 38 cases of scapulohumeral periarthritis with modified Dang Gui Si Ni Tang. Guangxi Journal of Traditional Chinese Medicine. 1998;21(1):24.
  10. Chen Fei Xiong. Treating scapulohumeral periarthritis with modified Dang Gui Si Ni Tang. Xinjiang Journal of Traditional Chinese Medicine. 1999;17(3):15.
  11. Zhang Qiu Feng. Treating 168 cases of cold-type erythema multiforme with modified Dang Gui Si Ni Tang. Anhui Journal of Clinical Application of TCM. 1999;11(4):222-223.
  12. Li Huan Ming. Treating 16 cases of cold-type erythema multiforme with modified Dang Gui Si Ni Tang. Journal of Applied TCM. 1993;9(2):28.
  13. Yang De Quan. Treating 63 cases of postoperative intestinal adhesion with Dang Gui Si Ni Tang. Gansu Journal of TCM. 1998;11(4):25.
  14. Zhang Hui. Treating 42 cases of prostatic hypertrophy with modified Dang Gui Si Ni Tang. Yunnan Journal of TCM and Chinese Herbs. 1998;19(4):15.
  15. Zhen Jun Shan. Treating 36 cases of poststroke syndrome with modified Dang Gui Si Ni Tang. National Journal of Medicine Forum. 1999;14(2):11.
  16. Gong Zhi Ping, et al. Treating 55 cases of hives Dang Gui Si Ni Tang. Sichuan Journal of TCM. 2000;18(2):37.
  17. Wang Long Sheng. 55 cases of cold-type hives treated with modified Dang Gui Si Ni Tang. Journal of Applied TCM. 2000;16(6):19.
This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.
©2000-2008 ADCCG, Inc. All Rights Reserved.
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