Zixue Tang: A Formula That Both Nourishes Blood and Resists Thrombosis

Zixue Tang (Blood-Nourishing Decoction) comes from Yuyuan Yao Fang (Formulas from the Imperial Pharmacy). It consists of Renshen (Radix Ginseng), Huaishanyao (Rhizoma Dioscoreae), Zhi Huangqi (Radix Astragali Preparata), Fuling (Poria), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), and Shudihuang (Radix Rehmanniae Preparata), each 1 liang (about 30g today), decocted in water for oral use.

This formula nourishes blood and regulates menstruation and supplements the middle qi. It is commonly used for women with disharmony of the Chong and Conception vessels and deficiency of construction blood: scanty, pale, thin menses, or even amenorrhea; a bearing-down sensation in the lower abdomen; dizziness and blurred vision; palpitations and insomnia; sallow complexion; pale-red tongue; and a fine pulse—patterns of Chong-Conception deficiency. It is now also used to treat various anemias, congenital ovarian hypoplasia, and male gonadal hypofunction, as well as construction-blood deficiency after childbirth or after family-planning procedures.

This is a famous blood-nourishing formula, made by taking Bazhen Tang (Eight-Treasure Decoction), removing Gancao (Radix Glycyrrhizae) and Baizhu (Rhizoma Atractylodis Macrocephalae), and adding Huaishanyao and Zhi Huangqi. Although Baizhu supplements qi, it irritates the gastric mucosa and is unsuitable for those with weak stomach; Gancao has the side effect of stagnating qi. Removing these two and adding Huaishanyao—which also fortifies the spleen without irritating the gastric mucosa—and Zhi Huangqi, which supplements qi and nourishes blood, improves the blood-nourishing effect.

This formula may be used for various anemias, including anemia after chemotherapy or radiotherapy in cancer patients, but today Renshen is mostly replaced by Dangshen (Radix Codonopsis), also at 30g, with Huangjing (Rhizoma Polygonati) 30g possibly added. For patients very weak from excessive blood loss, Renshen 30g may be used; other patients using Renshen should keep the dose around 10g, because 30g of Renshen is too large and risks ginseng-abuse syndrome.

Modern pharmacological experiments show that this formula promotes the generation and development of bone-marrow hematopoietic cells, significantly raises red-cell count and hemoglobin concentration in normal mice, and has anti-anemic effects against different types of anemia. In addition, it inhibits thrombosis in vivo, has anticoagulant action, and may promote gonadal development.

Using this formula at its stated dosage gives rapid blood-nourishing results. Once the patient's stamina clearly improves, the decoction may be switched to a pill: honey pills made to this formula's proportions for gradual, long-term supplementation. Chronic consumptive diseases require long courses and patient, persistent effort over time.