Yangxin Tang (Heart-Nourishing Decoction) for Insomnia and Forgetfulness Due to Qi and Blood Deficiency
"Yangxin Tang" (Heart-Nourishing Decoction) is recorded in Renzhai Zhifang Lun (Renzhai's Discourse on Prescriptions). It is composed of prepared Astragalus (Zhi Huangqi), White Poria (Bai Fuling), Poria Spirit (Fushen), Pinellia Mass (Banxia Qu), Chinese Angelica (Danggui), and Sichuan Lovage Rhizome (Chuanxiong), each half a liang (15g); Polygala Root (Yuanzhi, pith removed, steeped in ginger juice), Spicy Cinnamon (Laragui, i.e., Rougui), Biota Seed (Baiziren), Sour Jujube Seed (Suanzaoren, soaked, skin removed, dry-fried between paper), Northern Schisandra (Bei Wuweizi), and Ginseng (Renshen), each one qian (3g); and prepared Licorice (Zhi Gancao), four qian (12g).
To prepare: grind the above herbs together into coarse pieces. Take three qian (12g) each time, with five slices of ginger and two jujubes, decoct in water, and take before meals. Nowadays it is often prescribed directly as a decoction at the above doses, using prepared herbal pieces decocted in water.
This formula supplements qi and blood, nourishes the heart, and calms the spirit. It treats the pattern of qi and blood deficiency with unsettled heart spirit, presenting as vagueness of spirit, palpitations and easy fright, insomnia and forgetfulness, a pale tongue with white coating, and a fine, weak pulse. In this formula, Astragalus and Ginseng supplement spleen qi; Chinese Angelica and Sichuan Lovage invigorate and nourish blood; Biota Seed, Polygala, Sour Jujube Seed, and Schisandra nourish the heart and calm the spirit; Poria, Poria Spirit, and Pinellia Mass fortify the spleen and drain dampness; Cinnamon warms the center and disperses cold; prepared Licorice harmonizes the other herbs. Used together, the herbs both supplement qi and blood and warm the center, fortify the spleen, calm the spirit, and aid sleep. The formula is therefore suitable for patients with qi and blood deficiency, spleen deficiency with phlegm obstruction, and an unsettled heart spirit.
After COVID, my teacher used this formula to treat his own post-COVID sequelae and found it somewhat effective, particularly in improving symptoms such as excessive phlegm and insomnia. I have recently also applied it to patients with advanced cancer who have symptoms of dual qi and blood deficiency, palpitations, and insomnia, and it has improved their symptoms. If the patient's illness has dragged on and treatment will take a long time, the formula may be made into pills according to the original proportions for oral use.
In addition, this formula has some effect on patients with depression who present with the pattern of dual qi and blood deficiency with forgetfulness and insomnia; it can relieve the patients' symptoms of insomnia and frequent dreaming.