Dang Gui Nian Tong Tang: A Classic Formula for Relieving Pain from Damp-Heat
- Health Lab
- May 22
- 6 min read
Dang Gui Nian Tong Tang comes from Yi Xue Qi Yuan (The Origin of Medicine), created by the famous Jin Dynasty physician Zhang Yuansu. This classic Chinese medicine formula is used to treat damp-heat bi syndrome, particularly conditions caused by damp-heat buildup in the body, combined with external wind or wind-dampness turning into heat.
In Yi Xue Qi Yuan, Zhang Yuansu explains that Dang Gui Nian Tong Tang treats symptoms like “damp-heat causing limb and joint pain, heavy shoulders and back, chest and rib discomfort, widespread body pain, and swollen, unbearable pain in the lower legs.”
The formula includes herbs like Dang Gui, Qiang Huo, Fang Feng, Cang Zhu, Bai Zhu, Ze Xie, Zhu Ling, Yin Chen Hao, Huang Qin, Ku Shen, Zhi Mu, Sheng Ma, Ge Gen, Ren Shen, and Gan Cao.
Formula Explanation of Dang Gui Nian Tong Tang
Dang Gui Nian Tong Tang’s herbs are organized according to the Chinese medicine principle of “monarch, minister, assistant, and envoy”:
Monarch Herb: Dang Gui. This herb nourishes and activates blood, regulates menstruation, and relieves pain. It balances qi and blood, improving circulation to ease pain, as if “plucking away” discomfort, which inspires the formula’s name.
Supporting Herbs: Qiang Huo, Fang Feng, Cang Zhu, Bai Zhu. Qiang Huo (bitter and pungent) clears dampness from joints, while Fang Feng (sweet, pungent, and warm) disperses dampness in the channels, both expelling wind-cold and relieving pain from surface dampness. Cang Zhu and Bai Zhu strengthen the spleen and dry dampness, targeting dampness trapped in the spleen.
Assistant Herbs: Yin Chen Hao, Huang Qin, Ku Shen, Zhi Mu. Yin Chen Hao clears heat, drains dampness, and treats jaundice, helping expel damp-heat through urine. Huang Qin, Ku Shen, and Zhi Mu clear heat, dry dampness, and detoxify, addressing damp-heat turning into fire.
Envoy Herbs: Sheng Ma, Ge Gen, Ren Shen, Gan Cao. Sheng Ma and Ge Gen lift clear yang and expel pathogens, aiding in clearing damp-heat. Ren Shen greatly boosts vital qi, enhancing the body’s ability to fight pathogens. Dang Gui supports blood circulation, and Gan Cao harmonizes the formula for balanced effects.
Pathogenesis Analysis of Dang Gui Nian Tong Tang
Dang Gui Nian Tong Tang targets illnesses caused by damp-heat buildup, often worsened by external wind or wind-dampness turning into heat.
Damp-heat blocks qi and blood flow, causing symptoms like limb and joint pain, heavy shoulders and back, chest and rib discomfort, and widespread body pain.
Dampness, a heavy and sticky yin pathogen, slows qi movement, leading to a heavy feeling in the shoulders and back. When damp-heat moves downward, it can cause swollen, painful lower legs or sores on the knees and feet.
A white, greasy tongue coating with a slight yellow tint and a wiry, rapid pulse indicate internal damp-heat.
Indications and Effects of Dang Gui Nian Tong Tang
Dang Gui Nian Tong Tang is primarily used for damp-heat bi syndrome, with symptoms like widespread body pain, sciatica, neck and shoulder pain, gout, ankle pain, pain in the front or outer thigh, back of the leg, outer foot, jaw, palm, index finger, thumb, or big toe, and pain on the outer sole.
Other symptoms include body heaviness, leg swelling, scrotal itching, arm or hand numbness, difficulty swallowing, diarrhea, postpartum swelling, and weak, sore legs. In modern medicine, the formula is used for conditions like herpes zoster, acne, eczema, psoriasis, gout, trigeminal neuralgia, ankylosing spondylitis, rheumatoid arthritis, beriberi, and frozen shoulder.
Main Effects: Clears heat, drains dampness, expels wind, and relieves pain.
The formula works through multiple actions: Qiang Huo, Fang Feng, Cang Zhu, Bai Zhu, Ze Xie, and Zhu Ling drain dampness. Yin Chen Hao, Huang Qin, Ku Shen, and Zhi Mu clear heat and detoxify. Sheng Ma and Ge Gen lift yang to expel pathogens, Ren Shen boosts qi, Dang Gui improves blood flow, and Gan Cao harmonizes the formula for comprehensive relief.
Modern Applications
In modern medicine, Dang Gui Nian Tong Tang is widely used for various conditions, especially herpes zoster, acne, eczema, psoriasis, gout, trigeminal neuralgia, ankylosing spondylitis, rheumatoid arthritis, beriberi, and frozen shoulder, with significant effectiveness.
Research shows it effectively relieves damp-heat bi syndrome symptoms like widespread pain, sciatica, neck and shoulder pain, and gout by clearing heat, draining dampness, and expelling wind.
Precautions
When using Dang Gui Nian Tong Tang, consider the following:
Pattern Differentiation: This formula is for damp-heat bi syndrome. Confirm the patient’s symptoms and constitution with a Chinese medicine practitioner to ensure suitability.
Contraindications: Avoid in cases of wind-cold-damp pain, as the formula is specific to damp-heat patterns.
Drug Interactions: Avoid combining with other similar-acting herbs to prevent overly strong effects or adverse reactions.
Special Populations: Pregnant women, breastfeeding mothers, children, and the elderly should use it under professional guidance for safety.
Conclusion
Dang Gui Nian Tong Tang, a time-honored formula from Yi Xue Qi Yuan, is a classic remedy for damp-heat bi syndrome. Its unique blend and proven effectiveness make it a cornerstone in Chinese medicine.
By clearing heat, draining dampness, expelling wind, and relieving pain, it addresses symptoms like body pain, sciatica, and gout, improving patient well-being. Understanding its uses and precautions ensures optimal results, blending traditional wisdom with modern care.
Chinese Name | 當歸拈痛湯 |
Phonetic | Dang Gui Nian Tong Tang |
English Name | Chinese Angelica Pain-Alleviating Decoction |
Classification | Dampclearing formulas |
Source | 《Origins of Medicine》Yi Xue Qi Yuan《醫學啟源》 |
Combination | Notopterygii Rhizoma et Radix (Qiang Huo) 0.5 liang (15g), Saposhnikoviae Radix (Fang Feng) 3 qian (9g), Cimicifugae Rhizoma (Sheng Ma) 1 qian (3g), Puerariae Lobatae Radix (Ge Gen) 2 qian (6g), Atractylodis Macrocephalae Rhizoma (Bai Zhu) 1 qian (3g), Atractylodis Rhizoma (Cang Zhu) 3 qian (9g), Angelicae Sinensis Radix (Dang Gui) 3 qian (9g), Ginseng Radix et Rhizoma (Ren Shen) 2 qian (6g), Glycyrrhizae Radix et Rhizoma (Gan Cao) 5 qian (15g), Sophorae Flavescentis Radix (Ku Shen soaked with wine) 2 qian (6g), Scutellariae Radix (Huang Qin dry-fried) 1 qian (3g), Anemarrhenae Rhizoma (Zhi Mu) 3 qian (9g), Artemisiae Scopariae Herba (Yin Chen fried with wine) 5 qian (15g), Polyporus (Zhu Ling) 3 qian (9g), Alismatis Rhizoma (Ze Xie) 3 qian (9g) |
Method | Prepare as a decoction. |
Action | Drains dampness and clears heat, scatters wind and relieves pain. |
Indication | Dang Gui Nian Tong Tang is indicated for patterns that arise due to a conflict between dampness and heat with concurrent external wind contraction. The symptoms are aching pain of limbs and joints, heavy sensation of the shoulder and back, swelling and pain of the feet, sores on the feet and knees. The tongue coating is white and greasy mixed with yellow and the pulse is wiry and rapid. |
Pathogenesis | Dang Gui Nian Tong Tang is applied to the complex pattern of wind-damp-heat with dominant dampness due to either internal damp-heat accumulation with external wind contraction or wind-dampness that has transformed into heat. Pathogenic wind, dampness, and heat accumulation in the channels block qi and blood movement. This condition manifests aching pain of limbs and joints. The heavy sensation of shoulders and back is caused by the dominant dampness. Damp-heat pouring downward gives rise to swelling and pain in the feet as well as sores on the feet and knees. Mixed white and yellow, greasy coating and the wiry and rapid pulse are signs of damp-heat. The therapeutic methods are to eliminate dampness as priority and clear heat and scatter wind to relieve pain secondarily. |
Application | 1. Essential pattern differentiation Dang Gui Nian Tong Tang is the common formula for wind-damp-heat bi and jiao qi (腳氣) due to damp-heat with excessive dampness. This clinical pattern is marked by pain, heaviness, and swelling of limbs and joints, mixed white and yellow, greasy tongue coating, rapid pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of damp-heat accumulation with exterior pattern: rheumatic arthritis and rheumatoid arthritis. |
Additonal formulae | Xuan Bi Tang (Painful Obstruction Resolving Decoction 宣痹湯) [Source]《Systematic Differentiation of Warm Diseases》Wen Bing Tiao Bian《溫病條辨》 [Ingredients] Fang ji 5 qian (15g), xing ren 5 qian (15g), hua shi 5 qian (15g), lian qiao 3 qian (9g), yi yi ren 5 qian (15g), ban xia (fried with vinegar) 3 qian (9g), can sha 3 qian (9g), chi xiao dou 3 qian (9g), zhi zi 3 qian (9g) [Preparation and Administration] Prepare it as a decoction. [Actions] Clears heat and eliminates dampness, unblocks collaterals and relieves pain. [Applicable Patterns] Bi syndrome due to damp-heat accumulation in the channels and collaterals. Symptoms include: chills and fever, aching pain of the joints, a withered-yellow complexion, and a grey tongue without luster. |
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