My Proven Formula for Stroke: Xinglou Chengqi Tang
Professor Wang Xinzhi is a renowned traditional Chinese medicine physician in Henan Province, a doctoral supervisor in TCM who receives a special allowance from the State Council, and is skilled in treating brain diseases with the bowel-unblocking method. In his book Clinical Experience of Professor Wang Xinzhi in Treating Brain Diseases with the Bowel-Unblocking Method, he introduces the experienced formula he frequently uses in clinical practice, "Xinglou Chengqi Tang" (Trichosanthes-Arisaema Chengqi Decoction), which has good efficacy in treating stroke.
The specific composition of this formula is as follows: whole Fructus Trichosanthis (Gualou) 30–40 g, Arisaema cum Bile (Dannanxing) 6–10 g, raw Radix et Rhizoma Rhei (Sheng Dahuang) 10–15 g (added later), Mirabilitum (Mangxiao) 10–15 g (dissolved in the decoction). This formula was devised by Academician Wang Yongyan, following the prescribing logic of Liu Wansu's "Sanqi Tang" (composed of Rhubarb, Immature Bitter Orange, Notopterygium and Magnolia Bark), as a formula specifically for treating the bowel-repletion constipation syndrome after stroke. It is applicable to the phlegm-heat internal accumulation syndrome in the acute stage of stroke, presenting as exuberant internal phlegm-heat with toxins damaging the brain collaterals, which over time binds and transforms into heat, resulting in bowel-repletion constipation.
Professor Wang Xinzhi is skilled in modifying and adding to this formula to treat stroke and various emotional and psychiatric disorders. From his medical writings and case records, one can roughly summarize some of his modification strategies.
On the basis of this formula, he often makes additions and subtractions according to the patient's specific condition. For example, for a patient with acute cerebral infarction accompanied by constipation, he increases the dose of raw Rhubarb to 30 g, and adds Hirudo (Shuizhi) 10 g and Pheretima (Dilong) 10 g to activate blood and resolve stasis; to awaken the spirit and open the orifices he adds Rhizoma Acori Tatarinowii (Shichangpu) 12–15 g. For ischemic cerebral infarction, he adds raw Radix Astragali (Huangqi) 15–30 g, Rhizoma Chuanxiong (Chuanxiong) 10–15 g, Radix Angelicae Sinensis (Danggui) 6–10 g, Semen Persicae (Taoren) 6–10 g, Flos Carthami (Honghua) 6–10 g, Radix et Rhizoma Salviae Miltiorrhizae (Danshen) 30 g, and Rhizoma Gastrodiae (Tianma) 12 g. When it is necessary to subdue yang and quiet the spirit, he adds raw Os Draconis (Longgu) and raw Concha Ostreae (Muli), each 30 g. For accompanying hypertension, he adds Semen Cassiae (Juemingzi) 10–15 g and Ramulus Uncariae cum Uncis (Gouteng) 30–60 g. For abdominal distension, he adds raw Rhizoma Atractylodis Macrocephalae (Baizhu) 30–60 g, Cortex Magnoliae Officinalis (Houpo) 15–30 g, and stir-fried Fructus Aurantii Immaturus (Zhishi) 15 g. For scanty, rough urination with a dry mouth and foul breath, he adds raw Radix Rehmanniae (Sheng Dihuang) 30 g and Radix Scrophulariae (Xuanshen) 15 g. For emotional depression, he adds Radix Curcumae (Yujin) 15 g and Cortex Albiziae (Hehuanpi) 12 g.
Using the above approach, Professor Wang Xinzhi has treated many patients with acute cerebral thrombosis, cerebral infarction and intracerebral hemorrhage, effectively relieving their symptoms, alleviating their suffering, shortening their hospital stay, and reducing the proportion of patients developing stroke sequelae. It can be seen that this experienced formula of Academician Wang Yongyan indeed has relatively high clinical value. Of course, its use also requires a physician with rich clinical experience who can modify it according to the various symptoms that appear.