Da Qinjiao Decoction for Nourishing Blood, Dispelling Wind, Unblocking Collaterals, and Relieving Bi Obstruction

"Da Qinjiao Decoction" comes from Suwen Bingqi Yi Baoming Ji (Life-Preserving Records on Disease Mechanism According to Suwen); in Jiaozhu Furen Liangfang (Annotated Good Prescriptions for Women) it is also called "Qinjiao Decoction." Its composition is: Qinjiao (Gentianae Macrophyllae Radix), 3 liang (90 g); Shigao (Gypsum Fibrosum), 2 liang (60 g); Gancao (Glycyrrhizae Radix), 2 liang (60 g); Chuanxiong (Chuanxiong Rhizoma), 2 liang (60 g); Danggui (Angelicae Sinensis Radix), 2 liang (60 g); Chuan Qianghuo (Notopterygii Rhizoma et Radix), 1 liang (30 g); Chuan Duhuo (Angelicae Pubescentis Radix), 2 liang (60 g); Fangfeng (Saposhnikoviae Radix), 1 liang (30 g); Huangqin (Scutellariae Radix), 1 liang (30 g); Baishaoyao (white Paeoniae Radix), 2 liang (60 g); Wu Baizhi (Angelicae Dahuricae Radix), 1 liang (30 g); Shudihuang (processed Rehmanniae Radix), 1 liang (30 g); Baifuling (white Poria), 1 liang (30 g); Xixin (Asari Radix et Rhizoma), 5 qian (15 g).

Crush the above into coarse granules; take 1 liang (30 g) each time, decoct in water, strain, and take warm. Modern practice: use one-fifth of the formula, prepared as a decoction of dried herbs and taken directly.

This formula dispels wind and nourishes blood, unblocks collaterals and removes bi obstruction. It is a classical famous formula for bi (obstruction) due to blood deficiency. It treats blood deficiency with loss of nourishment of the sinews and vessels, wind striking the channels and collaterals: inability to move the hands and feet, stiff tongue and inability to speak; or hemiplegia and deviated mouth and eye. This is essentially consistent with the symptoms of cerebral hemorrhage, cerebral infarction, and their sequelae in modern medicine. Modern pharmacological research shows that Da Qinjiao Decoction not only has some efficacy against ischemic stroke, cerebral infarction, and post-stroke sequelae, but can also be used for rheumatoid arthritis and ophthalmoplegia.

The Qinjiao in this formula dispels wind-damp, clears damp-heat, stops bi pain, and clears deficiency heat; it is a commonly used TCM herb for wind-damp bi pain, hemiplegia, and persistent deficiency heat. Shigao and Huangqin clear heat and drain fire. Chuanxiong, Danggui, Baishao, and Dihuang (in this formula both raw and processed Rehmannia are used: raw Rehmannia leans toward activating blood and resolving stasis, while processed Rehmannia leans toward supplementing blood, so this formula both activates and supplements blood) together constitute Siwu Tang (the Four-Substance Decoction). Qianghuo, Duhuo, Fangfeng, Baizhi, and Xixin all warm and unblock the channels, dispel wind and stop pain. Baifuling fortifies the spleen and drains dampness; Gancao harmonizes the other herbs. Combined, they dispel wind and drain dampness, activate blood and unblock collaterals, and remove bi obstruction and stop pain; they provide symptomatic treatment for post-stroke sequelae, relieving clinical symptoms and improving quality of life.

The Xixin in this formula is hepatotoxic; long-term use may induce liver cancer. Hence this formula may be used only briefly and not long-term. If the patient has a long course, Xixin may be replaced by Shichangpu (Acori Tatarinowii Rhizoma) 30 g and Tianma (Gastrodiae Rhizoma) 30 g. Patients with post-stroke sequelae have a long course and often need to keep taking the medicine for months or even a year or more; if this formula proves effective, it may be processed into pills for oral use, taking 3–6 g of pills two to three times daily.

Many herbs in this formula are harmful to the fetus, so it is contraindicated in pregnant women.