Danggui Shaoyao San: Its Uses Past and Present
Danggui Shaoyao San (Dong Gui and Peony Powder) comes from Zhang Zhongjing's Jin Gui Yao Lue (Essential Prescriptions from the Golden Coffer) of the Han dynasty. Its composition: Danggui 3 liang (9 g), Shaoyao 1 jin (48 g), Fuling 4 liang (12 g), Baizhu 4 liang (12 g), Zexie 0.5 jin (24 g), Chuanxiong 0.5 jin (one source says 3 liang; 10 g). The Jin Gui Yao Lue records its main use for women during pregnancy or menstruation with abdominal cramping and lingering pain, dizziness and palpitations, or lower-limb edema and difficult urination, a pale tongue and a white greasy coating. The modern doses marked here are for prepared slices in decoction; Shaoyao is generally Baishao, with Chishao used when blood stasis is marked and the tongue is dark purple, and Baizhu used stir-fried.
According to traditional TCM theory, Danggui Shaoyao San activates blood, nourishes blood, fortifies the spleen and promotes urination, treating blood stasis, blood deficiency, spleen deficiency and damp excess. Danggui, Shaoyao and Chuanxiong are three herbs of Siwu Tang (Four-Substance Decoction), the representative formula for activating and nourishing blood; Fuling and Baizhu are two herbs of Sijunzi Tang (Four-Gentleman Decoction), both fortifying the spleen and promoting urination, and adding Zexie makes the spleen-fortifying, damp-draining effect more marked. The formula can therefore be used for edema of blood-stasis type, with good effect on common edemas such as pregnancy edema and lower-limb edema. With added Cheqiancao, Yimucao and Hanliancao (Ecliptae Herba), it has some effect on lower-limb edema due to kidney disease.
Modern research has found its uses go further. Besides treating common gynecological dysmenorrhea, abnormal fetal position, hydrosalpinx and chloasma, Danggui Shaoyao San can also treat vascular headache. It relieves headache, irritability, impatience, irascibility, depression and forgetfulness caused by brain nervous-system disease, and also has a therapeutic effect on renal hypertension.
Modern pharmacology has found that this formula fights dementia, increasing dopamine, norepinephrine and serotonin concentrations in mouse brain; it restores the function of acetylcholine- and catecholamine-containing neurons and their coexisting receptors in the brains of early-aging rats. Especially when the ratio of Danggui to Baishao is 1:1.34, the formula markedly improves passive-avoidance deficits and spatial recognition deficits in mice, showing significant intellect-enhancing function. Combined with Gouteng Tianma Yin (Uncaria and Gastrodia Beverage), it relieves headache and dementia caused by brain decline and also has antidepressant effects.
Danggui Shaoyao San also benefits elderly patients through good antioxidant and anti-aging effects. After aged mice were orally given the decoction, superoxide dismutase activity rose in the basal forebrain, myocardium and ovarian tissue, while malondialdehyde fell in the basal forebrain and myocardium, suggesting it can reduce free-radical damage in the aging body.
Danggui Shaoyao San also regulates blood lipids, lowering serum cholesterol, triglycerides and low-density lipoprotein in hyperlipidemic rabbits while raising beneficial high-density lipoprotein; it inhibits hepatic lipid deposition, fights liver fibrosis, improves hemorheology, and reduces blood viscosity and red-cell aggregation. It also has some effect on lower-limb pain caused by lower-extremity atherosclerosis and arterial thrombosis.
Danggui Shaoyao San is also an excellent TCM formula for regulating estrogen and progesterone. Modern pharmacology shows it affects the hypothalamic-pituitary-genital (ovarian) axis and uterine smooth-muscle contractility; it can induce ovulation in mice, activate ovarian function, stimulate ovarian estrogen secretion and increase uterine estrogen receptors. It treats amenorrhea in women due to progesterone and estradiol deficiency.
In clinical practice I have found that combined with Biejia Ruangan Pian and Biejia Jian Wan, this formula has some therapeutic effect on fatty liver, liver cancer and cirrhotic ascites. Prepared Danggui Shaoyao San is sold in Taiwan and Japan; taking the patent medicine is more convenient than the decoction, and in ancient times Danggui Shaoyao San was taken as a powder, not decocted as today.