Quick-Acting Hemostatic Formula: Modified Ningxue Tang (Blood-Calming Decoction)
Ningxue Tang is a contemporary empirical formula composed of: Xianhecao (Agrimonia pilosa) 30 g, Mohanlian (Eclipta prostrata) 30 g, Shengdihuang (raw Rehmannia) 20 g, Baimaogen (Imperata cylindrica rhizome) 15 g, Baiji (Bletilla striata) 15 g, Bailian (Ampelopsis japonica) 15 g, Ejiao (Asini Corii Colla, donkey-hide gelatin) 10 g, Cebai Tan (charred Biota orientalis leaves) 10 g, Baishao (white Paeonia lactiflora) 10 g, Zhizi Tan (charred Gardenia jasminoides fruit) 8 g. This formula has the actions of nourishing yin and cooling blood, stopping bleeding and resolving stasis. Clinically it is mainly used for idiopathic thrombocytopenic purpura, retinal vein thrombosis, all kinds of intraocular hemorrhage, and early-stage vitreous hemorrhage, presenting with hemorrhagic lesions in the fundus, dizziness and tinnitus, vexation and insomnia, dry mouth and throat, and a red tongue with little coating.
This formula can be used not only for fundus hemorrhage, but also for bleeding caused by various tumors. By modifying this formula, it can treat thrombocytopenia in cancer patients, or thrombocytosis caused by bleeding, in patterns of yin deficiency with blood-heat reckless movement.
The modified formula devised by the author is as follows: Dangshen (Codonopsis pilosula) 30 g, Huangqi (Astragalus membranaceus) 30 g, Danggui (Angelica sinensis) 10 g, Xianhecao 100 g, Mohanlian 30 g, Shengdi 20 g, Baimaogen 15 g, Baiji 15 g, Bailian 15 g, Ejiao 10 g, Cebai Tan 10 g, Baishao 10 g, Zhizi Tan 10 g, Fengweicao (Pteris multifida) 50 g, Diyu Tan (charred Sanguisorba officinalis root) 10 g, Yumixu (maize silk) 15 g, Xiaoji (Cirsium setosum) 20 g, Daji (Cirsium japonicum) 20 g, Huaruishi (stalactite stone) 30 g.
Lung and stomach cancer are prone to sudden massive hemorrhage. In first-aid of massive hemorrhage, the dosage of Baiji should be increased to 30–90 g, and a separate decoction of ginseng should be taken to greatly bolster the original qi. However, for ordinary bleeding there is no need to increase the dosage of Baiji, because Baiji is expensive, and increasing the dosage may also cause cardiac discomfort; therefore, it should not be used in large doses except in emergencies. Fengweicao in the modified formula not only has a strong hemostatic effect but also relieves pain well; in patients with bleeding accompanied by cancer pain, the dosage of Fengweicao may be increased to 100 g, and fresh Fengweicao may be used from 250 g to 500 g (half a jin to one jin). This formula has a certain effect in patients with low platelets, but in patients taking strong anticoagulant Western medicines the effect is less pronounced. If the patient also has diarrhea, Wumei (smoked Prunus mume) 30 g and Shiliupi (pomegranate peel) 10 g may be added to this formula.
Most tumor patients experience bleeding during the course of their disease—for example, stomach cancer causes gastric bleeding, lung cancer causes hemoptysis, nasopharyngeal carcinoma causes epistaxis, intestinal cancer causes hematochezia, and cervical cancer causes vaginal bleeding, among others. When bleeding is not severe, most patients may take the Chinese patent medicine Yunnan Baiyao or Sanqi capsules to stop bleeding. Once the bleeding is heavy, a decoction should be considered to strengthen the hemostatic effect. If the bleeding is severe and the patient is weak, blood transfusion may also be needed. Bleeding in end-stage tumor patients is beyond what this formula can resolve; a more targeted prescription should be given according to the patient’s specific condition in order to relieve suffering.