Dang Gui Nian Tong Tang

Functions

This formula’s function is to clear away damp-heat, dispel wind to relieve pain, to enrich qi, and nourish the blood. It mainly treats damp-heat induced joint swelling, arthralgia of the whole body, frozen shoulder, the feeling of heaviness in the shoulders, and the feeling of fullness and suffocation in the chest.

Dosage Info

Decoction: One dose to be divided and taken once in the morning and once in the evening. Water-paste pills: Adults: 9g each time, twice a day; Children aged 7 or older: 4.5g each time; Children 3 to 7 years: 3g. 5:1 concentrated extracts: 9-12 grams/day.

Ingredients

• Bai Zhu
• Cang Zhu
• Dang Gui
• Fang Feng
• Gan Cao
• Ge Gen
• Huang Qin
• Ze Xie
• Zhi Mu
• Yin Chen
• Zhu Ling
• Ku Shen
• Qiang Huo
• Sheng Ma
• Dang Shen

Precautions

While treating gout, the patient should drink more water than usual, and refrain from consuming alcoholic beverages, and eating pungent, spicy, or greasy food or those foods containing purines.

Pharmacology

Anti-inflammatory: Adjuvant arthritic rats were treated with large, medium, and small doses of Dang Gui Nian Tong Tang. Compared to the control group, the formula could significantly inhibit the early inflammatory reaction and the recurred swelling 10 days after establishing the arthritis. It significantly reduced the swelling of the left hind paws on the contralateral side and the swelling of the forefeet as well as lessening the lesions at the tail node and auricular erythema. This formula also has a significant inhibitory effect on carrageenin-induced foot swelling in the rat, with dose-effect correlation (P

Clinical Applications

Treatment of gouty arthritis
In the treatment study of 36 gouty arthritis cases, modified Dang Gui Nian Tong Tang was used. This modified formula was composed of Dang Gui (Chinese Angelica Root), Dang Shen (Codonopsis), Bai Zhu (White Atractylodes), Fang Feng (Siler), Qiang Huo (Notopterygium Root), Ge Gen (Pueraria), Cang Zhu (Atractylodes), Ku Shen (Sophora Root), Huang Qin (Scutellaria), Zhi Mu (Anemarrhena), Yin Chen (Oriental Wormwood), Zhu Ling (Polyporus), Fu Ling (Poria), Ze Xie (Alisma), Sheng Ma (Cimicifuga), and Zhi Gan Cao (prepared Licorice). One dose of the formula in a decoction was administered daily with 5 days constituting one therapeutic course of treatment. The results showed that after 2 to 3 courses of treatment, 12 cases were resolved, 22 cases showed improvement, and 2 cases did not respond to the treatment. (1)

For the treatment of 20 cases of gouty arthritis, Qiang Huo (Notopterygium Root), Zhi Gan Cao (prepared Licorice), Yin Chen (Oriental Wormwood), Huang Qin (Scutellaria), Fang Feng (Siler), Zhu Ling (Polyporus), Ze Xie (Alisma), Zhi Mu (Anemarrhena), Dang Gui (Chinese Angelica Root), Sheng Ma (Cimicifuga), Ge Gen (Pueraria), Ku Shen (Sophora Root), Dang Shen (Codonopsis), Cang Zhu (Atractylodes), and Bai Zhu (White Atractylodes) were used. One dose of these herbs in a decoction was administered daily. The results indicated that the treatment was significantly effective in 29 cases, slightly effective in 6 cases, and ineffective in one case, with a total effectiveness rate of 95%. (2)

In another report of 40 cases of gout treated with modified Dang Gui Nian Tong Tang, 7 cases were resolved, 29 showed improvement, and 4 cases did not respond to the treatment. The total effectiveness rate was 90%. (3)

Liu Bao Ying treated 12 cases of acute gouty arthritis with modified Dang Gui Nian Tong Tang and an external application of Shang Ke Wai Fu San (a powder for the external treatment of traumatic lesions). The modified Dang Gui Nian Tong Tang formula consisted of Dang Gui (Chinese Angelica Root), Qin Pi (Fraxinus), Qiang Huo (Notopterygium Root), dried Gan Cao (Licorice), Qin Jiao (Gentian Root), Wei Ling Xian (Clematis), Fang Feng (Siler), Ge Gen (Pueraria), Dang Shen (Codonopsis), Che Qian Zi (Plantain Seed), Xi Xin Cao (Siegesbeckia), Tu Fu Ling (Smilax), dried Sheng Ma (Cimicifuga), and Cang Zhu (Atractylodes). One dose of the modified formula in a decoction was administered daily and two weeks established one course of treatment. After 1 to 2 courses of treatment, results showed that 7 cases were resolved, 3 cases had improved, and 2 cases did not respond to the treatment. (4)

23 cases of gouty arthritis were treated with Dang Gui Nian Tong Tang. The formula consisted of Dang Gui (Chinese Angelica Root), Huang Qin (Scutellaria), Ku Shen (Sophora Root), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Cang Zhu (Atractylodes), Ge Gen (Pueraria), Niu Xi (Achyranthes), Gan Cao (Licorice), Fang Ji (Stephania), Huang Bai (Phellodendron), Yin Chen (Oriental Wormwood), and Ze Xie (Alisma). The ingredients were modified according to the individuals’ symptoms. During the acute stage, 3 doses of the formula in a decoction were orally administered every other day in the morning, midday, and evening. During remission, one dose was taken every day, twice in the morning and in the evening. In addition, Jin Huang San was mixed evenly with tea and was applied to the local joint region once a day. The results indicated that 10 cases had a significant improvement, 12 had a slight improvement, and one case did not respond to the treatment. The total effectiveness rate was 95.6%. (5)

Treatment of drug-induced dermatitis
Modified Dang Gui Nian Tong Tang was used to treat 27 cases of dermatitis. The formula was composed of Qiang Huo (Notopterygium Root), Yin Chen (Oriental Wormwood), Zhi Gan Cao (prepared Licorice), Huang Qin (Scutellaria), Ren Shen (Ginseng), Ku Shen (Sophora Root), Sheng Ma (Cimicifuga), Ge Gen (Pueraria), Cang Zhu (Atractylodes), Bai Xian Pi (Dittany Bark), Di Fu Zi (Kochia), Fang Feng (Siler), Dang Gui (Chinese Angelica Root), Zhi Mu (Anemarrhena), Ze Xie (Alisma), Zhu Ling (Polyporus), and Bai Zhu (White Atractylodes). One dose of the modified formula in a decoction was administered once in the morning and again in the evening. At the same time, the patients were asked to take in more warm boiled water than usual. The results showed that after 7 to 12 days of treatment, the total effectiveness rate was 100%. (6)

Treatment of damp-heat type arthralgia
24 cases of arthralgia were treated with modified Dang Gui Nian Tong Tang. The modified formula consisted of Zhi Mu (Anemarrhena), Huang Qin (Scutellaria), Dang Gui (Chinese Angelica Root), Qiang Huo (Notopterygium Root), Zhu Ling (Polyporus), Ge Gen (Pueraria), Fang Ji (Stephania), Can Sha (Silkworm Droppings), Fang Feng (Siler), Cang Zhu (Atractylodes), Bai Zhu (White Atractylodes), Ze Xie (Alisma), and Ku Shen (Sophora Root). The ingredients were modified according to the patients’ symptoms. The results indicated that of the 24 cases, 11 were resolved, 6 had significant improvement, 5 had some improvement, and 2 cases did not respond to the treatment. The total effectiveness rate was 91.6%. (7)

Another clinical observation on the therapeutic effect of the herbal treatment was conducted in 50 cases of arthralgia. Yin Chen (Oriental Wormwood), Bai Zhu (White Atractylodes), Fu Ling (Poria), Zhu Ling (Polyporus), Qiang Huo (Notopterygium Root), Fang Ji (Stephania), Dang Gui (Chinese Angelica Root), Ku Shen (Sophora Root), Zhi Mu (Anemarrhena), Cang Zhu (Atractylodes), Ze Xie (Alisma), Sheng Ma (Cimicifuga), Huang Qin (Scutellaria), Gan Cao (Licorice), and Ge Gen (Pueraria) were used in the formula. The ingredients were modified in accordance to the individuals’ symptoms. One dose of the formula in a decoction was administered daily. After treatment, 27 cases were resolved, 13 were greatly improved, 7 had some improvement, and 3 did not respond to the treatment, with the total effectiveness rate of 94%. (8)

Treatment of eczema
It was reported that 47 cases of eczema were treated with different types of modified Dang Gui Nian Tong Tang based on the individual’s symptoms and had achieved satisfactory results. For the wind-heat type, this modified formula consisted of Dang Gui (Chinese Angelica Root), Fang Feng (Siler), Huang Qin (Scutellaria), Zhi Mu (Anemarrhena), Mu Dan Pi (Moutan), Yin Chen (Oriental Wormwood), Ku Shen (Sophora Root), Ze Xie (Alisma), Sheng Ma (Cimicifuga), Ge Gen (Pueraria), dried Sheng Di (Rehmannia), Gan Cao (Licorice), and Shi Gao (Gypsum). For the damp-heat type, the herbs used were Dang Gui (Chinese Angelica Root), Fang Feng (Siler), Qiang Huo (Notopterygium Root), Cang Zhu (Atractylodes), Bai Zhu (White Atractylodes), Hou Pu (Magnolia Bark), Sheng Ma (Cimicifuga), Gan Cao (Licorice), Ge Gen (Pueraria), Yi Yi Ren (Coix), Chi Xiao Dou (Rice Bean Seed), Ku Shen (Sophora Root), Ze Xie (Alisma), Zhu Ling (Polyporus), and Yin Chen (Oriental Wormwood). For the blood-heat type, the herbs used were Dang Gui (Chinese Angelica Root), Fang Feng (Siler), Qiang Huo (Notopterygium Root), Ku Shen (Sophora Root), Huang Qin (Scutellaria), Cang Zhu (Atractylodes), Ze Xie (Alisma), Zi Cao (Lithospermum), Huai Hua (Sophora), Di Gu Pi (Lycium Bark), Ge Gen (Pueraria), Sheng Ma (Cimicifuga), and Gan Cao (Licorice). For the type of wind-dryness due to blood deficiency, the herbs used were Dang Gui (Chinese Angelica Root), Fang Feng (Siler), Bai Zhu (White Atractylodes), Ku Shen (Sophora Root), Zhu Ling (Polyporus), Wu Shao She (Garter Snake), Ze Xie (Alisma), Dang Shen (Codonopsis), He Shou Wu (Fleece-flower Root), Dan Shen (Salvia), Xuan Shen (Scrophularia), and Gan Cao (Licorice). After the administration of 5 to 32 doses of the formula, of the 47 treated cases, 38 were resolved, 5 had significant improvement, 2 had some improvement, and the remaining 2 did not respond to the treatment. (9)

Treatment of hematuria
53 cases of hematuria were treated with Dang Gui Nian Tong Tang. The formula contained the herbs of Qiang Huo (Notopterygium Root), Yin Chen (Oriental Wormwood), Huang Qin (Scutellaria), Zhi Gan Cao (prepared Licorice), Fang Feng (Siler), Zhu Ling (Polyporus), Ze Xie (Alisma), Zhi Mu (Anemarrhena), Dang Gui (Chinese Angelica Root), Sheng Ma (Cimicifuga), Ge Gen (Pueraria), Ku Shen (Sophora Root), Cang Zhu (Atractylodes), Pu Gong Ying (Dandelion), and Bai Zhu (White Atractylodes). One dose of the formula in a decoction was administered daily once in the morning and again in the evening. 1 to 2 weeks constituted one treatment course. During the treatment, other therapies were avoided. The results indicated that 30 cases had significant improvement, 19 had some improvement, and 4 did not respond to the treatment. The total effectiveness rate was above 90%. (10)

Treatment of impetigo
It was reported that 86 cases of impetigo were treated with Dang Gui Nian Tong Tang. The formula contained the following herbs: Dang Gui (Chinese Angelica Root), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Bai Zhu (White Atractylodes), Cang Zhu (Atractylodes), Zhi Mu (Anemarrhena), Sheng Ma (Cimicifuga), Dang Shen (Codonopsis), Ku Shen (Sophora Root), Huang Qin (Scutellaria), Zhu Ling (Polyporus), Ze Xie (Alisma), Ge Gen (Pueraria), Yin Chen (Oriental Wormwood), and Gan Cao (Licorice). The ingredients were modified according to the different symptoms at the early stage, pustulant stage, and scab stage. One dose of the formula in a decoction was administered once in the morning and again in the evening, and the remaining sediments were again decocted in water to wash the local area following the oral administrations. After treatment of 1 to 12 doses, all the 86 cases were resolved. (11)

Treatment of Urticaria
In one study, 15 cases of the damp-heat type of urticaria were treated with Dang Gui Nian Tong Tang, which consisted of Dang Gui (Chinese Angelica Root), Qiang Huo (Notopterygium Root), Sheng Ma (Cimicifuga), Gan Cao (Licorice), Fang Feng (Siler), Bai Zhu (White Atractylodes), Cang Zhu (Atractylodes), Huang Qin (Scutellaria), Zhu Ling (Polyporus), Ze Xie (Alisma), Ge Gen (Pueraria), Yin Chen (Oriental Wormwood), Dang Shen (Codonopsis), and Ku Shen (Sophora Root). One dose of the formula in a decoction was administered daily. 10 days constituted one therapeutic course of treatment. The results indicated that 11 cases were resolved, 3 had some, improvement, and 1 case did not respond to the treatment. (12)

Treatment of neurodermatitis
It was reported that 30 cases of neurodermatitis were treated with Dang Gui Nian Tong Tang. The ingredients included Cang Zhu (Atractylodes), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Huang Qin (Scutellaria), Zhi Mu (Anemarrhena), Bai Shao (Radix Paeoniae Alba), Zhu Ling (Polyporus), Yin Chen (Oriental Wormwood), Ze Xie (Alisma), Dang Gui (Chinese Angelica Root), Dang Shen (Codonopsis), Ku Shen (Sophora Root), Gan Cao (Licorice), Sheng Ma (Cimicifuga), and Ge Gen (Pueraria). One dose of the formula in a decoction was administered daily. 15 days constituted one course of treatment. During the treatment, the ingestion of hot, pungent, and irritating foods was avoided. After treatment, 22 cases were resolved, 7 showed improvement, and 1 case did not respond to the treatment. (13)

Treatment of wind-damp-cold pain
It was reported that 32 cases of infantile wind-damp-cold pain were treated with Dang Gui Nian Tong Tang. The following herbs were used: Dang Gui (Chinese Angelica Root), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Cang Zhu (Atractylodes), Bai Zhu (White Atractylodes), Zhu Ling (Polyporus), Ze Xie (Alisma), Ge Gen (Pueraria), Sheng Ma (Cimicifuga), Dan Shen (Salvia), Yuan Hu (Corydalis Tuber), Qian Nian Jian (Homalomena), Niu Xi (Achyranthes), Shi Chang Pu (Grassleaved Sweetflag Rhizome), and Tian Xian Teng (Slender Dutchmanspipe Herb). The ingredients were modified according to each individual’s symptoms. One dose of the formula in a decoction was administered 3 times daily. This treatment lasted from 3 to 7 consecutive days. Also, the remaining sediments of the decoction in addition to fresh ginger and Ai Ye (Artemisia Leaves) were decocted in water to wash the affected region. A combined external application of Chu Bi Zhi Tong Plaster was applied to acupoints, which was replaced once every 4 to 5 days. After 4 to 75 days of treatment, 25 cases were resolved, 4 had significant improvement, 2 had some improvement, and 1 case did not respond to the treatment. The total effectiveness rate was 96.9%. (14)

Treatment of thrombosis in deep veins
26 cases of thrombosis of the deep veins were treated with Dang Gui Nian Tong Tang. The herbs used were Dang Gui (Chinese Angelica Root), Zhu Ling (Polyporus), Yin Chen (Oriental Wormwood), Ku Shen (Sophora Root), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Ze Xie (Alisma), Huang Qin (Scutellaria), Bai Zhu (White Atractylodes), Zhi Mu (Anemarrhena), Sheng Ma (Cimicifuga), Ge Gen (Pueraria), and Gan Cao (Licorice). One dose of the formula in a decoction was orally administered twice daily, once in the morning and again in the evening. In the control group, 10 cases of venous thrombosis were treated with an intravenous infusion of refined Agkistrodon halys (a snake venom) antithrombin of 2 to 4 ampules/day in 250ml of normal saline. After treatment, the results for the treatment group and the control group were, respectively: 15 and 6 cases were resolved, 6 and 1 cases had significant improvement, 3 and 2 had some improvement, and 2 and 1 cases did not respond to the treatment. The total effectiveness rates were 92.3% and 90%, respectively. (15)

Treatment of ecthyma
It was reported that 18 cases of ecthyma were treated with Dang Gui Nian Tong Tang. The herbs used were Qiang Huo (Notopterygium Root), Yin Chen (Oriental Wormwood), Huang Qin (Scutellaria), Zhi Gan Cao (Radix Glycyrrhizae Praeparata), Fang Feng (Siler), Zhu Ling (Polyporus), Ze Xie (Alisma), Zhi Mu (Anemarrhena), Dang Gui (Chinese Angelica Root), Sheng Ma (Cimicifuga), Ku Shen (Sophora Root), Cang Zhu (Atractylodes), Bai Zhu (White Atractylodes), Ren Shen (Ginseng), and Dang Shen (Codonopsis). During the treatment, the patients were asked to refrain from drinking or eating pungent, hot, and greasy foods. The results showed that 10 cases were resolved, 5 had some improvement, and the last 3 cases had not significantly changed. (16)

References

1. Wei Ai Chun, et al. Treating 36 cases of gouty arthritis with modified Dang Gui Nian Tong Tang. Sichuan Journal of TCM. 1999;17(30):23.
2. Guo Long, et al. Treating 20 cases of gouty arthritis with Dang Gui Nian Tong Tang. Journal of Applied TCM. 2000;16(11):25.
3. Xia Han, et al. Summary of treating 40 cases of gout with modified Dang Gui Nian Tong Tang. Journal of Traditional Chinese Medicine. 1987;28(2):60.
4. Liu Bao Ying. Treating 12 cases of acute gouty arthritis mainly with modified Dang Gui Nian Tong Tang. Yunnan Journal of TCM and Chinese Drug. 1997;18(2):60-61.
5. He Jian Sheng. Reports of treating 23 cases of gouty arthritis with Dang Gui Nian Tong Tang. Jiangxi Journal of TCM. 1997;28(4):21.
6. Wang Xin Ming, et al. Treatment and nursing for drug dermatitis. Journal of Traditional Chinese Medicine and Herbs. 1998;26.
7. Xu Xin Ren. Treating damp-heat type arthralgia with modified Dang Gui Nian Tong Tang. Sichuan Journal of TCM. 1986;4(1):44.
8. Li Guo Ping. Treating 50 cases of damp-heat type arthralgia with Dang Gui Nian Tong Tang. Liaoning Journal of Traditional Chinese Medicine. 1990;14(3):18-19.
9. Gong Jin Lin. Treating 47 cases eczema with modified Dang Gui Nian Tong Tang. Hubei Journal of TCM. 1986;(1)21-22.
10. Shan Cui Hua, et al. Clinical observation hematuria with Dang Gui Nian Tong Tang. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 1986;(5):17-18.
11. Shi Lin Jie. Treating 86 cases of impetigo with modified Dang Gui Nian Tong Tang. Hunan Journal of TCM. 1990;6(6):42-43.
12. Yang Shu Jie. Therapeutic observations on treating 15 cases of damp-heat type of urticaria and drug rash with Dang Gui Nian Tong Tang. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 1992;(2):38.
13. Yang Leng Ge. Treating 30 cases of neurodermatitis with Dang Gui Nian Tong Tang. Hunan Journal of TCM. 1992;8(4):42-43.
14. Chen Hou Zhong. Summary of treating 32 cases of infantile wind-damp-cold pain with Niang Tong Tang. Hunan Journal of TCM. 1993;9(3):12-13.
15. Li Jing Fang, et al. Therapeutic observation in treating thrombosis of deep veins with Dang Gui Nian Tong Tang. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 1994;(5):26.
16. Li Wen Fu, et al. Reports of treating 18 cases of ecthryma with Dang Gui Nian Tong Tang. Xinjiang Journal of Traditional Chinese Medicine. 1995;(3):25-26.