Huang Qi Formula Family With Dr Huang Huang

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1 Huang Qi Formula Family With Dr Huang Huang Huang Qi Recorded in the Shen Nong Ben Cao Jing (Divine Husbandman s Classic of Materia Medica) as being used to treat welling-abscesses and flat abscesses, sores, expel pus and relieve pain, treat leprosy, five haemorrhoids and scrofula, it tonifies deficiency, and treats paediatric diseases. Included in 8 formulas in the Jin Gui Yao Lue (Essentials from the Golden Cabinet). Huang Qi Herb Pattern Sweating (spontaneous sweating/night sweating) with aversion to wind A sense of heaviness in the body Numbness in the body and limbs Swelling / oedema Inhibited urination Chronic, non-healing sores & ulcers with clear watery discharge Huang Qi Body Type External appearance: o Tends to be overweight o Fatigue looking o Dull yellow or dull red complexion without any lustre o Skin lacks elasticity and feels moist o Muscles feel loose or weak o Abdomen is soft (no pain or resistance on palpation) and abdominal muscles feel loose with substantial adipose tissue o Face and limbs look oedematous o Tongue body is pale red or pale and fat, or dull and purplish. Common presenting symptoms: o Fatigue o Sweats easily o Light headed or feels faint easily o Chest stuffiness and shortness of breath (especially after exercise) o Big appetite and intolerant to hunger o Loose stools, or initial dry stools followed by loose stools o Easily gets oedematous, especially for lower limbs o Aversion to wind, gets nasal blockage and panting easily o Gets numbness easily in hands and feet o Gets joint pains o Difficult to heal sores and ulcers 1

2 Huang Qi Gui Zhi Wu Wu Tang Traditionally used in the Jin Gui Yao Lue to treat Xue Bi ( Blood Stroke ) as it can tonify Qi and move blood; it can improve one s immune function, improve coronary and cerebral circulation, and peripheral microvascular circulation; treat chronic diseases that present with numbness in the limbs, spontaneous sweating and oedema. Dr Huang s modifications of the formula: Huang Qi 30-60g Gui Zhi 10g Rou Gui 5g Chi Shao 15g Sheng Jiang 30g or Gan Jiang 10g Da Zao 20g Decoct herbs in 900ml of water until water reduced to 300ml. Divide into 2-3 portions to drink. Drink the formula warm. After taking the formula, advise the patient to keep warm and drink ginger tea. Applicable to patients with the following characteristics: o Yellow facial complexion and loose muscles physique tends to be overweight, muscles are loose, skin lacks elasticity and is moist, skin colour is pale or yellow or dark red and lacks lustre, may have droopy eye bags, have fat necks; commonly seen in many elderly patients o Tongue is dark purple tongue body is fat and dark purple, the tongue coating is irrelevant; lips are dark; LU10 area is shrivelled and red; finger and toe nails mostly thick and yellow o Huang Qi belly big and soft abdomen, no resistance or pain on deep palpation; has very good appetite and cannot tolerate hunger; has spontaneous sweating, palpitations and lack of energy when hungry; has fatigue or a lack of energy despite large food intake o Numbness and oedematous limbs easily feel numb; has joint pains; lower limbs often have pitting oedema; has localised skin dryness or localised skin darkness and prone to infections, ulcers and sores o Fatigue and prone to sweating easily fatigued, heavy sensation in the body, dizziness, shortness of breath, especially after exercise; prone to sweating, especially after meals o Often presents with coronary or cerebrovascular diseases prone to coronary disease, hypertension, cerebrovascular infarction, coronary infarction; joint diseases, obesity, nephritis, anaemia, etc. 2

3 Applicable to conditions and diseases that present with: o Limb numbness diabetes, coronary heart disease, angina, hypertension, cerebrovascular infarction, sequelae of stroke, cervical spondylosis, vertebrobasilar insufficiency, peripheral neuropathy, diabetic peripheral neuropathy, etc. o Joint pains lumbar disc protrusion, cervical spondylosis, bone hyperplasia, frozen shoulder, sciatica, arthritic deformations, etc. o Oedema obesity, hyperlipidaemia, chronic nephritis, nephrotic syndrome, renal dysfunction, uraemia, anaemia, etc. Dr Huang s clinical experience using this formula: o Diabetes: Recurrent hypoglycaemia increase Rou Gui and Huang Qi Diabetic peripheral neuropathy with limb numbness, pain and aversion to cold add Fu Zi Diabetic foot disease combine with Si Wei Jian Bu Tang or Gui Zhi Fu Ling Wan Excessive sweating in diabetic patients increase Huang Qi to g Diabetes with coronary/cerebrovascular disease add Ge Gen, Chuan Xiong, Dan Shen Diabetic renal disease add Gui Zhi Fu Ling Wan or Si Wei Jian Bu Tang o Dizziness in the elderly: Often due to cerebrovascular disease, hypertension, atherosclerosis, vertebrobasilar insufficiency Often accompanied by blurred vision, cognitive deterioration, facial or limb numbness Add Ge Gen, Chuan Xiong If facial complexion is dark red, add Gui Zhi Fu Ling Wan Caution in using this formula if the patient s complexion is red and oily or has abdominal bloating or has a dry mouth with bitter taste o Coronary artery disease with chest stuffiness and excessive sweating: Important formula for treating angina and for post coronary infarction rehabilitation. Applicable patients have lack lustre yellow facial complexion, significant fatigue, and bradycardia. Increase Huang Qi dose for excessive sweating. Need to increase the dose of Gui Zhi (20g or more) Patients with dark purplish tongue, add Chi Shao Patients with tight back muscles add Ge Gen Patients with headaches and chest stuffiness, add Chuan Xiong, Dan Shen Need to continue treatment with the formula for 3-6 months. o Chronic renal disease: Applicable for diabetic renal disease, hypertension induced renal disease, chronic nephritis, nephrotic syndrome. For patients who sweat easily and catch colds easily, add Yu Ping Feng San. For patients who do not have oedema but have dark red facial complexion and constipation, alternate the formula with Gui Zhi Fu Ling Wan plus Da Huang. For chronic patients with persistent proteinuria or decreasing response to the formula, add Fu Zi 5-10g, or combine the formula with Zhen Wu Tang. 3

4 For patients with abdominal pain, constipation, lumbar back pain, lower limb oedema or amenorrhoea, add Huai Niu Xi 30g. For diabetic patients with diabetic peripheral neuropathy and vascular disease, combine with Si Wei Jian Bu Tang or Gui Zhi Fu Ling Wan. When using this formula to treat renal diseases, DO NOT add Gan Cao or Ren Shen as these herbs can exacerbate oedema and hypertension. o Cervical/lumbar spondylosis with limb numbess: E.g. cervical spondylosis, lumbar disc protrusion, bone hyperplasia (osteophytes), frozen shoulder, sciatica Add Ge Gen, Chuan Xiong, Huai Niu Xi Additional Notes: o When used in large doses, Huang Qi can suppress the patient s appetite or cause abdominal distention. In which case, decrease the dose of Huang Qi. o This formula is not suitable for numbness or paraesthesia or muscular spasms not due to an underlying vascular circulation issue. Caution when using this formula for multiple sclerosis patients. Fang Ji Huang Qi Tang Traditionally used to treat pain and swelling of the lower limbs: o Used in the Jin Gui Yao Lue to treat wind-dampness, oedema, body heaviness, sweating, aversion to wind. o Used in Wai Tai Mi Yao to treat swelling below the waist with difficulty flexing or extending the lower limbs. Clinically applicable for chronic conditions that have lower limb swelling with loose and weak muscles. Dr Huang s modifications of the formula: Fang Ji 20g Huang Qi 30g Bai Zhu 15g Sheng Gan Cao 5g (remove if patient is hypertensive or have poor renal function) Sheng Jiang 15g Da Zao 20g Decoct in 600ml of water until 300ml of water left. Divide into 2-3 portions to drink separately. Drink the formula warm. Applicable to patients with the following characteristics: o Oedematous with yellowish complexion often seen in middle age to elderly women; physique tends to be overweight; yellow skin complexion; big and soft abdomen; flabby hips and legs with a tendency for oedema o Excessive sweating and thirsty easily sweats and often have bad body odours; often symptomatic in hot and humid summer conditions; fatigue and a heavy sensation in the body; thirsty with not a lot of urination 4

5 o Pain in lower limbs pain in lumbar region to leg region; painful swelling of the knees and ankles causing difficulties in ambulation Applicable to conditions and diseases that present with: o Oedema e.g. chronic glomerulonephritis, idiopathic oedema o Painful joint swellings in the lower limbs e.g. rheumatoid arthritis, gouty arthritis, lumbar vertebral disc protrusion o Excessive sweating e.g. obesity, bad body odour, malodorous sweat, yellow sweat o Fatigue, excessive sweating, and oedema e.g. coronary/cerebrovascular disease, hypertension, diabetes, hyperlipidaemia Dr Huang s clinical experience using this formula: o Arthritic joint deformations in the elderly: With concomitant lower limb swelling and pain For patients with a sturdy built with excessive sweating and pain, add Ma Huang and Sheng Shi Gao; for extreme pain, add Fu Zi o Idiopathic oedema: Usually with whole body oedema Combine formula with Wu Ling San (Sheng Huang Qi 60g, Fang Ji 30g, bai Zhu 30g, Sheng Gan Cao 5g, Sheng Jiang 20g, Hao Zao 15g, Gui Zhi 20g, Fu Ling 20g, Ze Xie 20g, Zhu Ling 20g plus Ma Huang if patient has a sturdy build); 1 dose a day; when symptoms are alleviated 1 dose every other day. o Primary obesity: Due to affluent lifestyle and not much physical activity Accompanied by knee pain and afternoon swelling of the lower limbs Combine formula with Wu Ling San, Huai Niu Xi and Ma Huang o Excessive sweating with malodourous armpits: Need to induce diuresis after taking the formula to be effective Additional Notes: o Comparison with Yue Bi Jia Zhu Tang: Both can promote diuresis to reduce pain and swelling of joints. Yue Bi Jia Zhu Tang is used when the patient has a strong, sturdy build Fang Ji Huang Qi Tang is used when the patient has soft muscles, pale or yellow skin with excessive sweating. If unable to differentiate between the two, combine both formulas and use. 5

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