Dang Gui Nian Tong Tang — Tangkuei to Pinch the Pain Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Dang Gui Nian Tong Tang — the “Tangkuei to Pinch the Pain Decoction” — is from Li Dong-yuan’s Jin-Yuan-dynasty Yi Xue Fa Ming. It treats Damp-Heat painful obstruction (Bi) with Wind: severe inflammatory joint pain with prominent Damp-Heat signs (warmth, swelling) often combined with skin involvement (hot itchy lesions, weeping eczema with joint pain). Particularly used for acute gout flare, acute rheumatoid arthritis flare and acute reactive arthritis. The combination of Qiang Huo and Fang Feng (Wind-Damp expellers) with Yin Chen Hao and Huang Qin (Damp-Heat clearers) and Dang Gui (move Blood, relieve pain) addresses all three pathological factors.

I prescribe Dang Gui Nian Tong Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Dang Gui Nian Tong Tang is prescribed for Wind-Damp-Heat Bi syndrome:

• Hot, red, swollen joint pain
• Severe pain that may shift between joints (Wind)
• Heavy-bodied feeling, fatigue
• Hot itchy skin lesions, possibly weeping
• Dark urine, bitter taste
• Tongue — red with yellow-greasy coat
• Pulse — slippery, rapid, possibly wiry

Key herbs

1. Dang Gui (Rx. Angelicae Sinensis, 6–9g) — moves Blood; relieves pain
2. Qiang Huo (Rz. Notopterygii, 6–9g) — expels Wind-Damp from the upper body and joints
3. Fang Feng (Rx. Saposhnikoviae, 6–9g) — releases Wind; relieves itching
4. Yin Chen Hao (Hb. Artemisiae Scopariae, 6–9g) — clears Damp-Heat strongly
5. Huang Qin (Rx. Scutellariae, 6–9g) — clears Damp-Heat from upper burner
6. Ku Shen (Rx. Sophorae Flavescentis, 6–9g) — clears Damp-Heat; relieves itching
7. Cang Zhu (Rz. Atractylodis, 6–9g), Bai Zhu (Rz. Atractylodis Macrocephalae, 6–9g) — dry Damp
8. Zhu Ling (Polyporus, 6–9g), Ze Xie (Rz. Alismatis, 6–9g) — drain Damp through urination
9. Zhi Mu (Rx. Anemarrhenae, 6–9g) — clears Heat; nourishes Yin
10. Ren Shen (Rx. Ginseng, 3–6g) — tonifies Qi
11. Sheng Ma (Rz. Cimicifugae, 3–6g), Ge Gen (Rx. Puerariae, 6–9g) — release the exterior; lift the Yang
12. Gan Cao (Rx. Glycyrrhizae, 3–6g) — harmonises and resolves toxin

Formula actions

1. Expels Wind-Damp from the channels
2. Clears Damp-Heat
3. Moves Blood and relieves severe joint pain
4. Resolves Damp-Heat skin manifestations

Conditions treated

1. Acute gout flare with severe red hot swollen joint pain
2. Acute rheumatoid arthritis flare with prominent Damp-Heat
3. Acute reactive arthritis
4. Septic arthritis recovery phase (alongside conventional care)
5. Acute eczema flare with joint pain
6. Psoriatic arthritis flare with Damp-Heat
7. Behçet’s disease with joint and skin manifestations

Cautions

Not appropriate for cold or deficient Bi syndromes — the cold draining herbs would aggravate cold patterns.

Acute severe joint pain with high fever requires medical assessment to exclude septic arthritis.

Always consult a qualified Chinese herbalist registered with the RCHM.

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