Dang Gui Shao Yao San (当归芍药散) — Tangkuei & Peony Powder

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparison with related formulas
7. Cautions
8. Frequently asked questions

What is Dang Gui Shao Yao San?

Dang Gui Shao Yao San — Tangkuei and Peony Powder — is a classical Jin Gui Yao Lue formula by Zhang Zhongjing (c. 200 CE) for Liver Blood deficiency complicated by Spleen-Damp accumulation. It is one of the most widely used formulas in Chinese herbal medicine for dysmenorrhoea, female sub-fertility[21] and the threatened-miscarriage^[15] pattern of early pregnancy. It is also one of the most studied Kampo formulas in Japan, with research in pregnancy, cognitive ageing and circulation.

I prescribe Dang Gui Shao Yao San as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

Dang Gui Shao Yao San TCM pattern

Prescribed for Liver Blood deficiency with Spleen Damp: dull crampy lower abdominal pain, mild abdominal distension, fluid retention, dizziness^[22], dull complexion, mild palpitations, scanty light periods or threatened miscarriage with pulling discomfort, pale tongue with white coat and a thin pulse.

Key herbs

1. Dang Gui (Rx. Angelicae Sinensis, 3-12g) — nourishes the Blood and regulates menstruation
2. Bai Shao (Rx. Paeoniae Alba, 4-48g) — nourishes Liver Blood and relieves spasmodic pain
3. Chuan Xiong (Rz. Chuanxiong, 3-24g) — moves Qi and Blood, relieves Blood stasis
4. Bai Zhu (Rz. Atractylodis Macrocephalae, 4-12g) — tonifies Spleen Qi and dries Damp
5. Fu Ling (Poria, 4-12g) — drains Damp and quietens the Heart
6. Ze Xie (Rz. Alismatis, 4-24g) — drains Damp and clears mild heat

Formula actions

1. Nourishes the Blood and softens the Liver
2. Tonifies the Spleen and drains Damp
3. Regulates the menses and relieves abdominal pain

Conditions treated

1. Primary dysmenorrhoea with crampy dull pain and fluid retention
2. Female sub-fertility with thin endometrium and Blood-deficient picture
3. Threatened miscarriage with pulling lower-abdominal discomfort (in collaboration with obstetric care)
4. Pregnancy-related anaemia and oedema
5. Premenstrual syndrome with bloating and dull headache
6. Cognitive decline studies in Japanese Kampo (Toki-shakuyaku-san)

Comparison with related formulas

Dang Gui Shao Yao San sits at the crossroads of nourishing Blood, harmonising the Liver and Spleen, and draining Damp — which is what distinguishes it from its close relatives:

• Xiao Yao San — also harmonises Liver and Spleen, but its emphasis is on moving stagnant Liver Qi with stress, irritability and low mood. Choose Dang Gui Shao Yao San when the picture is more physical — crampy pain, fluid retention and Blood deficiency — rather than emotional tension.
• Si Wu Tang — the pure Blood tonic. Dang Gui Shao Yao San is essentially a Blood-nourishing base with Spleen-strengthening, Damp-draining herbs added, so it suits Blood deficiency with bloating, oedema or loose stools, where Si Wu Tang alone would be too rich.
• Wen Jing Tang — for cold-type period pain and infertility with Blood stasis, where warming the uterus is the priority. Dang Gui Shao Yao San is chosen instead when Damp and Blood deficiency, not cold and stasis, dominate.
• Dang Gui Bu Xue Tang — a two-herb Qi-and-Blood tonic for marked fatigue after blood loss; used when rebuilding Blood is the whole task, without the menstrual pain or fluid retention this formula addresses.

Cautions

Use under specialist supervision in pregnancy. Generally very well tolerated. Adjust seasonally and across the menstrual cycle as appropriate.

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.

References

[15] Xie H, Zhang A, Mou X, He T, Li J, Wang CC, Fan X, Li L. Chinese herbal medicine for threatened miscarriage: An updated systematic review and meta-analysis. Front Pharmacol. 2023 Feb 14;14:1083746. https://doi.org/10.3389/fphar.2023.1083746. PMID: 36865912.

[21] Ried K. Chinese herbal medicine for female infertility: an updated meta-analysis. Complement Ther Med. 2015 Feb;23(1):116-28. https://doi.org/10.1016/j.ctim.2014.12.004. PMID: 25637159.

[22] Guo Z, Su Z, Wang Z, Luo X, Lai R. The effect of Chinese herbal medicine Banxia Baizhu Tianma Decoction for the treatment of vertebrobasilar insufficiency vertigo: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2017 Apr;31:27-38. https://doi.org/10.1016/j.ctim.2017.01.004. PMID: 28434468.

Frequently asked questions

What is Dang Gui Shao Yao San used for?

Dang Gui Shao Yao San is used for the TCM pattern of Liver Blood deficiency with Spleen Damp: dull, crampy period pain with bloating and fluid retention, scanty light periods, sub-fertility with a Blood-deficient picture, and the pulling lower-abdominal discomfort of early pregnancy. It is always prescribed within a bespoke formula after individual pattern diagnosis.

Is Dang Gui Shao Yao San safe in pregnancy?

It is one of the classical formulas traditionally used in pregnancy — for cramping discomfort, mild oedema and the threatened-miscarriage pattern — and was designed with pregnancy in mind. That said, any herbal medicine in pregnancy must be prescribed and supervised by an RCHM-registered herbalist working alongside your maternity team, never self-prescribed.

What is the difference between Dang Gui Shao Yao San and Xiao Yao San?

Both harmonise the Liver and Spleen, but they treat different emphases. Xiao Yao San is for Liver Qi stagnation with stress, irritability and low mood. Dang Gui Shao Yao San is for the more physical picture of Blood deficiency with Damp — crampy pain, bloating and fluid retention — where emotional tension is not the leading feature.

Can Dang Gui Shao Yao San help period pain?

It may help when the period pain fits its pattern: a dull, crampy, dragging ache rather than sharp stabbing pain, often with bloating, tiredness and scanty pale flow. It is taken as a course across several cycles and adjusted by a practitioner, and works as a complementary therapy alongside conventional care. Severe or new period pain should always be assessed by your doctor.

Is Dang Gui Shao Yao San the same as Toki-shakuyaku-san?

Yes. Toki-shakuyaku-san (TJ-23) is the Japanese Kampo name for the same six-herb formula, and much of the modern research — in pregnancy, circulation and cognitive ageing — has been published under the Japanese name. The composition is the same.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.