The Famous Blood-Nourishing Formula: Danggui Buxue Decoction

Danggui Buxue Decoction is a classic formula by Li Dongyuan, one of the four great masters of the Jin-Yuan period. Its composition is: Huangqi (Radix Astragali) 1 liang (30 g), Danggui (Radix Angelicae Sinensis) 2 qian (6 g), with 2 slices of Shengjiang (Rhizoma Zingiberis Recens), decocted in water. Today one may use 300 ml of water, decoct down to 150 ml, strain out the dregs, and take.

The main actions of Danggui Buxue Decoction are to supplement qi and nourish blood, dispel wind and unblock the collaterals. It is indicated for deficiency of both qi and blood, with wind striking the channels and collaterals causing facial deviation and stiffness of the hands and feet. In patients with excessive blood loss or severe anemia, the dosage may be increased when using Danggui Buxue Decoction. My usual dosage is Huangqi 60 g and Danggui 12 g. For patients with even greater blood loss (such as gastric hemorrhage or hemoptysis), Danggui Buxue Decoction may be combined with Dushen Decoction, adding Shudi (Radix Rehmanniae Preparata) and Shanzhuyu (Fructus Corni) to form an emergency formula: Danggui 12 g, raw Huangqi 30 g, honey-fried Huangqi 30 g, Shudi 60 g, and Renshen (Radix Ginseng) 10-15 g. This formula can rapidly restore the strength of patients who have lost excessive blood; patients usually improve the very day they take the medicine, and show marked improvement within a week.

Danggui Buxue Decoction can markedly improve blood counts, raising hemoglobin and red blood cells and rapidly relieving the symptoms of anemic patients. In the formula, Huangqi raises blood-oxygen saturation by increasing hemoglobin, thereby significantly improving the patient's shortness of breath and fatigue. Traditional Chinese medicine holds that Huangqi has the action of "supplementing qi," and this has a scientific basis. The main function of hemoglobin is to transport oxygen to every cell throughout the body; when hemoglobin is low, patients easily experience shortness of breath and fatigue, and modern medical instruments show insufficient blood-oxygen saturation. Once Huangqi raises hemoglobin, blood-oxygen saturation rises. Danggui, too, raises the concentration of red blood cells in the blood and promotes human hematopoietic function.

If the patient also has thrombocytopenia, Xianhecao (Herba Agrimoniae) 50-100 g may be added to this formula. Xianhecao is the Chinese herb that raises platelets fastest, but it must be used in large doses; below 50 g it can hardly achieve a rapid platelet-raising effect. Cancer patients undergoing chemotherapy often experience simultaneous drops in hemoglobin, red blood cells, and platelets; at such times Danggui Buxue Decoction plus Xianhecao may be used. When white blood cells are low, Renshen (or Xiyangshen, Radix Panacis Quinquefolii, or Dangshen, Radix Codonopsis) plus Diyu (Radix Sanguisorbae) may be added, or it may be used together with the patent medicine Diyu Shengbai Pian, or with the Western drug Ubenimex capsules.

Judging from Li Dongyuan's own records, Danggui Buxue Decoction can also treat thrombotic diseases. Wind striking the channels and collaterals, facial deviation, and stiffness of the hands and feet are all related to thrombotic diseases. Modern pharmacological studies have found that Danggui Buxue Decoction has some effect on ischemic stroke, stroke sequelae, coronary heart disease, myocardial infarction, premature beats, and other thrombosis-related conditions.

In my experience, Danggui Buxue Decoction plus Dilong (Pheretima), Shuizhi (Hirudo), Danshen (Radix Salviae Miltiorrhizae), and Honghua (Flos Carthami) treats thrombosis more effectively. For lower-extremity thrombosis, Niuxi (Radix Achyranthis Bidentatae), Duzhong (Cortex Eucommiae), Xuduan (Radix Dipsaci), and Mugua (Fructus Chaenomelis) may be added; for carotid plaque formation, Baizhi (Radix Angelicae Dahuricae), Chuanxiong (Rhizoma Chuanxiong), Gegen (Radix Puerariae), Manjingzi (Fructus Viticis), Fangfeng (Radix Saposhnikoviae), and Jingjie (Herba Schizonepetae) may be added; for coronary heart disease and myocardial infarction, Gualou (Fructus Trichosanthis), Xiebai (Bulbus Allii Macrostemonis), Guizhi (Ramulus Cinnamomi), Yujin (Radix Curcumae), Danshen, Tanxiang (Lignum Santali Albi), Sharen (Fructus Amomi), and Xiangfu (Rhizoma Cyperi) may be added; for heart failure, it may be used together with Shengmai Yin; for stroke sequelae, it may be used together with Buyang Huanwu Decoction.

Danggui Buxue Decoction has some therapeutic effect on renovascular hypertension and on glomerulonephritis complicated by acute renal failure; when treating such conditions, it may be used together with Yimucao (Herba Leonuri), Zhuling (Polyporus), and Baimaogen (Rhizoma Imperatae).

Danggui Buxue Decoction has some antitumor effect; when used for this purpose, it is advisable to combine it with Xihuang Wan, Fufang Banmao Jiaonang, and Huachansu.