Tianma Gouteng Yin for Headache and Dizziness Due to Hypertension and Cervical Spondylosis

Tianma Gouteng Yin (Gastrodia-Uncaria Decoction) comes from the Zabing Zhengzhi Xinyi (New Meanings in the Treatment of Miscellaneous Diseases). It is composed of: tianma (gastrodia rhizome) 3 qian (9 g), gouteng (uncaria vine) 4 qian (12 g, added later), shijueming (sea-ear shell) 6 qian (18 g, decocted first), zhizi (gardenia fruit) 3 qian (9 g), huangqin (scutellaria root) 3 qian (9 g), chuanniuxi (cyathula root) 4 qian (12 g), duzhong (eucommia bark) 3 qian (9 g), yimucao (leonurus herb) 3 qian (9 g), sangjisheng (mistletoe herb) 3 qian (9 g), yejiaoteng (polygonum vine) 3 qian (9 g), and zhuling (cinnabar-fu ling) 3 qian (9 g).

This is a decoction formula, to be decocted in water for oral use. Among the herbs, shijueming is a shell mineral whose active constituents are not easily extracted, so it should be decocted first for about half an hour. Gouteng, if decocted for too long, has its active constituents easily destroyed, so it should be added only during the last three to five minutes of decocting. The herbs may be decocted twice (in the second decoction there is no longer any order of adding), combine the two decoctions, divide into 2-3 equal portions, and take one dose per day in 2-3 divided portions.

Traditional TCM holds that this formula has the actions of pacifying liver yang and subduing ascendant yang, and of clearing heat and extinguishing wind. It is indicated for headache and vertigo, insomnia and convulsion, and hemiplegia caused by ascendant liver yang and liver wind harassing upward, with a red tongue and rapid pulse. Nowadays this formula is often used to treat hypertension, high-febrile convulsions, epilepsy, Meniere's disease, neurosis, vertebral-artery-type cervical spondylosis, vascular headache, cerebral infarction, and sequelae of cerebral hemorrhage.

In this formula, tianma, gouteng, duzhong, niuxi and shijueming all have a blood-pressure-lowering effect; zhizi, yimucao and fu ling have a diuretic effect; yejiaoteng and fu ling have a spirit-calming effect. When these herbs are combined, they have a relatively strong effect on relieving the dizziness, headache and hemiplegia caused by hypertension and cervical spondylosis. As long as the indications for Tianma Gouteng Yin are firmly grasped and the herbs are used appropriately, the clinical results are very good.

After taking this formula, patients will notice increased urination, and their symptoms will also ease along with the excretion of urine. However, hypertension is difficult to cure radically and requires long-term maintenance treatment. Once the symptoms are relieved, one may consider grinding all the herbs in this formula into a powder, using refined honey as an excipient, and making into pills to take; take 6 g each time, twice daily.

Gouteng, yimucao, yejiaoteng and zhuling in this formula have a certain degree of toxicity; during long-term use, liver and kidney function should be monitored. If a patient has pre-existing liver or kidney insufficiency, professional guidance from a physician should be sought before using the herbs.