Functions
The formula mainly functions to regulate the flow of qi and blood, clear sputum and relieve liver-qi stagnation, arrest panic and tranquilize the mind. It is primarily used to treat the lingering symptoms commonly seen in febrile diseases, such as distention of the chest, restlessness, delirious verbosity and dreams, urination difficulty, general heaviness and difficulty with turning sides in bed.
Dosage Info
Decoction: 1 dose of decoction per day divided into 2 administrations. 5:1 concentrated extract: 9 grams/day.
Ingredients
Precautions
Toxicity: The original prescription of this formula contains Qian Dan, a poisonous mineral. Modern modifications of the formula have generally done away with Qian Dan. If Qian Dan is ever to be included in a preparation of the formula, especially if the formula is to be administered as a decoction, caution is strongly advised. (1)
Pharmacology
Effects on the central nervous system: The formula as a whole as well as a number of the formula’s component herbs have a bi-directional regulatory effect on the central nervous system. Administered to normal healthy mice at 200mg/kg, this formula does not affect the subject’s autonomous activity. However when administered to mice pretreated with methyl phenol, a central-excitatory drug, the same treatment decreases the subject’s autonomous activity. When administered to mice pretreated with pentobarbital sodium, a central-inhibitory drug, the treatment increases the subject’s autonomous activity. (2) Further studies show that this formula increases the level of tryptophan, while decreasing that of 5-hydroxytryptamine in the cerebral cortex, peripheral system, nuclei of median raphe, diencephalon, and cerebellum of mice. (3)
Effects on the cardiovascular system: Administered to rabbits at 20mg/day, this formula can counteract the adverse effects of adrenalin and norepinephrine on the subject’s cardiac functions. Administered to rabbits by IV injection (8.4mg/minute for seven days), the 3:1 mixture of adrenalin and norepinephrine can cause EKG irregularities; marked by a decrease in cardiac output, a significant drop in cardiac index and contraction capacity. The mixture can also cause a significant increase in peripheral resistance, central venous pressure, diastolic pressure, and even death. A pathological examination reveals pneumonedemia, pulmonary stasis, heart enlargement, thickened cardiac muscles, endocardium and cardiac muscle hemorrhage, and local necrosis of cardiac muscles. These pathological changes can be prevented or ameliorated, however, by administering this formula to the subjects three days prior to and continuing concurrently with the treatment of adrenalin and norepinephrine. (4)
Lowering the blood lipid level and preventing artherosclerosis: Administered to mice fed with fodder containing 5% cholesterol, this formula (0.4g/day) can lower the levels of cholesterol, triglycerides, and phospholipids in the subject’s liver, heart, and aorta. (5) , (6)
Promoting blood coagulation and hemostasis: Long Gu Mu Li Tang with Chai Hu can activate the alpha 2-receptors of platelets and increase the platelet aggregation induced by low-concentration adrenalin, thereby enhancing platelet’s release of coagulation factors, shortening coagulation time, and achieving hemostasis. (7)
Clinical Applications
Schizophrenia
Liang treated 126 cases of schizophrenia based on TCM’s differentiation treatment principles. For yang cases, the following modified formula of Long Gu Mu Li Tang with Chai Hu was used as the basic treatment: Chai Hu, Fa Ban Xia, Fu Ling, Da Huang, Chuan Bei Mu, Zhi Zi, Long Gu, Mu Li, and Huang Qin. For yin cases, the formula Si Ni Tang was used and consisted of processed Fu Zi, Zi He Che, Lu Jiang, Huang Qi, Dang Shen, Yin Yang Huo, Gan Jiang, Rou Gui, and processed Gan Cao. The results: 10 cases fully recovered, 41 significantly improved, 55 improved, and 20 did not respond to the treatment, with a total effective rate of 84.13%. (8)
In another study, Liu treated 15 cases of schizophrenia with a modification of this formula. The modified formula consisted of Chai Hu, Huang Qin, Gui Zhi, Fu Ling, Dang Shen, Sheng Jiang, Long Gu, Mu Li, Ban Xia, Da Huang, Chang Pu, Yuan Zhi, and Da Zao. The results: after 28 to 97 doses; 8 cases resolved, 5 significantly improved, and 2 did not respond to the treatment. (9)
Anxiety
A study treated 32 cases of psychoneurosis with this formula compared the effect of using this formula alone with that of combining this formula with Western medication in treating this condition. The results: this formula was found to significantly ameliorate the patient’s restlessness, insomnia, anxiety, susceptibility to fatigue, and feelings of insecurity, with a total effective rate of 81.3%. Using the formula alone was found to be superior to combining this formula and Western medication in treating anxiety. (10)
Epilepsy
Lu used this formula to treat 50 cases of epilepsy. One unit of treatment lasted 10 days. The results: 25 cases achieved short-term recovery, 19 improved, and 6 did not respond to the treatment, with a total effective rate of 88%. (11)
Zhang treated two cases of epilepsy due to abdominal pain with a combination of this formula and a modification of the classic formula Chai Hu Gui Zhi Tang. After being treated for three months, both cases fully recovered and a two-year follow-up found no relapse. (12)
Insomnia
Shen combined an herbal therapy based on this formula and behavioral therapy to treat 36 cases of insomnia. The herbal formula used consisted of Chai Hu, Long Gu, Mu Li, Huang Qin, Fu Ling, Ban Xia, Da Huang, He Huan Pi, Da Zao, and Sheng Jiang. The herbal treatment was supplemented with 1-2 daily sessions of relaxation exercise, one of which was carried out just before bedtime. One unit of treatment lasted seven days. The results: 19 cases significantly improved, 13 improved, 4 did not respond to the treatment, with a total effective rate of 88.9%. (13)
Prurigo
Mu treated 28 cases of nodular prurigo with a modification of this formula. The modified formula consisted of Chai Hu, Huang Qin, Ban Xia, Fu Ling, Sheng Long Gu, Sheng Mu Li, Chan Yi, He Huan Pi, Sheng Jiang, Da Zao, and Gan Cao. Further modifications were made to better suit individual patient’s symptoms. One unit of treatment lasted a month and in some cases appropriate herbal pastes were applied externally. The results: after 1-2 units of treatment, 18 cases resolved, 8 improved, and 2 did not respond to the treatment, with a total effective rate of 92.8%. (14)
Hyperthyroidism
Yu treated 100 cases of hyperthyroidism with a modification of this formula. The results: after 1-3 months of treatment, 50 cases fully recovered, 41 improved, and 9 did not respond to the treatment. (15)
Pelvic inflammation
Peng et al. treated 323 cases of pelvic inflammation with a modification of this formula. The modified formula consisted of Chai Hu, Huang Qin, Ban Xia, Dang Shen, Gui Zhi, San Qi, Da Huang, Jin Yin Hua, Pu Gong Ying, Fu Ling, Long Gu, and Mu Li. One unit of treatment called for six doses. The results: 178 cases resolved, 112 significantly improved, 26 improved, and 7 did not respond to the treatment, with a total effective rate of 94.7%. (16)
References
- Yan Jian Jun. Sichuan Journal of TCM. 1987;5(12):30.
- Chen Gui Ting. Foreign Medicine (TCM vol). 1986;(2):30.
- Jiang Yong Shan. Foreign Medicine (TCM vol). 1987;(4):45.
- Tang Chao Shu, et al. Journal of Chinese Materia Medica. 1985;26(1):60.
- Liu Zhi Hu. Foreign Medicine (TCM vol). 1987;(2):30.
- Ren Wei Hua. Foreign Medicine (TCM vol). 1987;(5):49.
- Sang Bing Sheng. Foreign Medicine (TCM vol). 1988;(2):21.
- Liang Kai Rong. Journal of Applied TCM. 1998;14(3):3-4.
- Yan Jian Jun. Sichuan Journal of TCM. 1987;5(12):30.
- Jiang Yong Shan. Foreign Medicine (TCM vol). 1987;(6):50.
- Lu Hua Ping. Sichuan Journal of TCM. 1998;16(7):36.
- Zhang Neng Shun. Journal of Hunan College of TCM. 1991;11(1):24.
- Shen Li. Tianjin Journal of TCM. 1999;16(2):25-26.
- Mu Xiang Qin. Tianjin Journal of TCM. 1999;16(2):39-40.
- Yu Ji Xian. Journal of Hunan College of TCM. 1986;6(2):29.
- Peng Guang Chao, et al. Henan Journal of TCM. 1999;19(1).
