Taoren 12g
Niuxi 9g
Honghua 9g
Shengdi 99g
Chishao 6g
Danggui 9g
Chuanxiong 4.59g
Zhike 6g
Jiegeng 4.59g
Chaihu 3g
Gancao 6g
Function: Promotes blood circulation and removes blood stasis, regulates Qi and relieves pain.
Formula Explanation (Fang Jie):
This formula is derived from the principal combinations of Taohong Siwu Tang and Sini San, with the addition of Niuxi (Achyranthes bidentata) to promote downward action and Jiegeng (Platycodon grandiflorus) to guide herbs upward.
In this formula:
- Taoren (Semen Persicae) breaks up blood stasis, promotes circulation, and moistens dryness;
- Honghua (Flos Carthami) activates blood, removes stasis, and relieves pain.
These two serve as the chief (monarch) herbs. - Chishao (Radix Paeoniae Rubra) and Chuanxiong (Rhizoma Chuanxiong) assist the chief herbs in activating blood and dispelling stasis;
- Niuxi enters the blood level and has a strong downward-directing property. It removes blood stasis, promotes blood flow, and guides stagnant blood downward, preventing it from accumulating in the chest and disturbing the upper body.
These act as the deputy (minister) herbs. - Sheng Dihuang (Radix Rehmanniae) is sweet and cold in nature, clears heat, cools the blood, nourishes Yin, and enriches the blood;
- Danggui (Radix Angelicae Sinensis) nourishes the blood to support the removal of stasis without harming healthy Qi;
- Chishao also clears heat and cools the blood to eliminate stasis-related heat.
These three herbs work together to nourish blood and Yin, clear heat, and promote circulation, and thus serve as the assistant (adjuvant) herbs. - Jiegeng (Platycodon Root) and Zhike (Fructus Aurantii) regulate Qi with their ascending and descending properties, helping to open the chest and promote the flow of Qi. Jiegeng also acts as a guiding herb to carry other ingredients upward;
- Chaihu (Radix Bupleuri) soothes the liver, relieves stagnation, and lifts clear Yang. Together with Jiegeng and Zhike, it effectively regulates Qi and resolves stagnation, enhancing blood circulation through promoting Qi flow. These also function as assistant herbs.
- Gancao (Radix Glycyrrhizae) harmonizes all the ingredients and serves as the envoy (courier) herb.
Together, the formula works to invigorate blood, remove stasis, regulate Qi, and harmonize the interior. When blood stasis is resolved and Qi flows smoothly, the related symptoms will subside.
Indications
This formula is primarily indicated for blood stasis in the chest (Xiong Zhong Xue Yu Zheng). Clinical manifestations include:
- Chest pain and persistent headache with fixed, stabbing sensations;
- Chronic hiccups or persistent retching when drinking water;
- Internal heat with dizziness or chest oppression;
- Palpitations, restlessness, insomnia with excessive dreaming, irritability, tidal fever in the evening;
- Darkened lips or dark circles around the eyes;
- Dark-red tongue with petechiae or ecchymoses;
- Pulse that is choppy (se) or taut and tight (xian jin).
Clinical Application
Xuefu Zhuyu Decoction is a representative prescription for treating blood stasis in the chest. The key diagnostic signs for syndrome differentiation include:
- Fixed chest or head pain;
- Dark-red tongue with stasis spots or ecchymoses;
- Choppy or taut-tight pulse.
Pathophysiological Mechanism
The symptoms treated by this formula all stem from blood stasis obstructing the chest and stagnating the Qi dynamics, corresponding to the syndrome described by Wang Qingren as “blood stasis in the mansion of blood” (Xue Fu).
- When blood stasis obstructs the chest, Qi fails to circulate freely, resulting in sharp, fixed chest pain;
- If the stasis ascends to the upper burner and obstructs the rising of clear Yang, the head lacks nourishment, causing headache;
- If blood stasis affects the stomach, the reversal of stomach Qi leads to hiccups, dry retching, or even choking upon drinking;
- Prolonged stasis transforms into heat, giving rise to internal heat, dizziness, and tidal fever in the evening;
- Stagnant blood with heat disturbs the Heart, leading to palpitations, insomnia, and vivid dreaming;
- Chronic stagnation impairs the Liver’s function of regulating emotions, resulting in irritability and a short temper.
- Additionally, dark lips, dark eyes, a dusky tongue with stasis marks, and a choppy or wiry-tight pulse are all classic signs of blood stasis.
Treatment principle: Invigorate the blood, dispel blood stasis, regulate Qi, and relieve pain.