Huangqi Guizhi Wuwu Tang for Numbness of Hands and Feet After COVID
Some patients recovered from COVID now develop numbness of the hands and feet and lower back pain as sequelae. In TCM this belongs to the bi (impediment) syndrome and can be treated with modified Huangqi Guizhi Wuwu Tang.The formula is: raw Huangqi (Astragalus) 10 g, Guizhi (cinnamon twig) 10 g, Baishao (white peony) 10 g, Danggui (Angelica sinensis) 10 g, Chuanxiong (Sichuan lovage) 10 g, Dilong (earthworm) 10 g, Shengjiang (fresh ginger) 18 g, Dazao (jujube) 4 pieces. If the patient's leg numbness is marked, add Duhuo (Angelica pubescens) 6 g, Huainiuxi (Achyranthes) 10 g, Mugua (Chaenomeles) 30 g; if arm numbness is marked, add Fangfeng (Saposhnikovia) 10 g, Qinjiao (Gentiana macrophylla) 10 g, Qianghuo (Notopterygium) 6 g; if there is lower back pain, add Duzhong (Eucommia) 10 g, Xuanduan (Dipsacus) 10 g, Gouji (Cibotium) 10 g, Rougui (cinnamon bark) 10 g.Huangqi Guizhi Wuwu Tang comes from Jin Gui Yao Lue (Essential Prescriptions of the Golden Chamber). It consists of five herbs—Huangqi, Guizhi, Shaoyao, Dazao, and Shengjiang—and has the actions of boosting qi, warming the channels, harmonizing blood, and unblocking impediment. It is the representative formula for "blood impediment" caused by cold congelation and blood stasis. This formula warms yang and activates blood, and can be used to resolve the poor circulation caused by the virus in COVID patients.But plain Huangqi Guizhi Wuwu Tang may not be strong enough, and treatment may not be fast enough, so Danggui, Chuanxiong, and Dilong should be added to strengthen the action of activating blood and resolving stasis. If a patient's limb numbness is in the upper limbs, we can add Fangfeng, Qinjiao, and Qianghuo, which work well on upper-limb numbness, to the base formula. If the numbness is in the lower limbs, we can add Huainiuxi, Mugua, and Duhuo, which work well on lower-limb numbness. If both upper and lower limbs are numb, all of the above may be added.Lower back pain is one of the more common sequelae reported by COVID-infected patients this time. The main TCM herbs for lower back pain are Duzhong, Xuduan, Gouji, and Rougui; Duzhong and Xuduan in particular have the most marked pain-relieving effect.In several previous articles I have repeatedly emphasized that COVID damages human blood vessels. In fact, among elderly people over 60 today, many have been found after COVID infection to have plaques in the coronary, cerebral, or vertebral arteries. Human capillaries are even more complex; many are blocked by these plaques in ways modern medical instruments cannot detect. All of this belongs to what TCM calls the static-blood (yu xue) syndrome and must be treated by activating and harmonizing blood. Only when circulation improves can the patient's limb numbness and lower back pain be resolved.In addition, we must observe the patient's eyelids and feet; if there is edema of both the eyelids and the feet, it means the patient's vessels contain not only static blood but also excess water, which easily leads to hypertension. In treating such patients, in addition to warming yang and activating blood, one must also promote diuresis and reduce swelling. Diuretic and detumescent herbs such as Fuling (Poria), Baizhu (Atractylodes), Zhuling (Polyporus), Sangbaipi (mulberry bark), and Digupi (Lycium bark) may be added to the base formula.I have now returned to the village for the New Year. From what I see in the village, the elderly people in the village are generally less spirited than before. Many elderly people look very much like stroke-sequelae patients: listless, vacant-eyed, slow to react, short of breath and sparing of words.My judgment is that treating COVID sequelae should follow the treatment plan for stroke sequelae. Huangqi Guizhi Wuwu Tang is also one of the commonly used regimens for stroke sequelae.