Gua Lou Xie Bai Bai Jiu Tang — Chest Bi Wine Decoction

On this page

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

Overview

Gua Lou Xie Bai Bai Jiu Tang — the “Trichosanthes, Chinese Garlic and Wine Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. It is the principal classical formula for Chest Bi (xiong bi) — obstruction of Yang Qi in the chest by Phlegm-Damp, presenting as chest oppression, chest pain (often with radiation to the back), cough with thick phlegm and shortness of breath. The Western correlate is angina pectoris, particularly with prominent Phlegm signs. The classical recipe uses rice wine (Bai Jiu) to amplify the Yang-circulating action; modern usage often omits the wine or uses warm water.

I prescribe Gua Lou Xie Bai Bai Jiu Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Gua Lou Xie Bai Bai Jiu Tang is prescribed for Chest Bi from Phlegm-Damp obstructing Yang:

• Chest oppression, tightness or pain
• Pain may radiate to the upper back
• Shortness of breath
• Cough with thick white phlegm
• Sense of cold or heaviness in the chest
• Symptoms worse with damp weather, eating rich food, lying down
• Tongue — pale or pale-purple, white-greasy coat
• Pulse — deep, wiry, slippery

Key herbs

1. Gua Lou (Fr. Trichosanthis, 9–30g) — chief; clears Phlegm-Heat from chest; opens the chest; widens the diaphragm
2. Xie Bai (Bb. Allii Macrostemonis, Chinese garlic, 9–15g) — opens Yang in the chest; resolves chest stagnation
3. Bai Jiu (white wine, traditional adjunct) — carries the herbs to circulate Yang in the chest (omit in alcohol-intolerant patients)

Formula actions

1. Circulates Yang in the chest
2. Resolves Phlegm and opens the chest
3. Relieves chest oppression and pain
4. Stops cough with thick phlegm

Conditions treated

1. Stable angina pectoris with Phlegm pattern (alongside conventional cardiology care)
2. Coronary heart disease with chest oppression (adjunctive)
3. Chronic bronchitis with chest tightness and Phlegm
4. Asthma with chest tightness and Phlegm pattern
5. Costochondritis with chest tightness and Phlegm signs
6. Functional chest pain with Phlegm pattern

Cautions

New, severe or worsening chest pain is a medical emergency — call 999. This formula is for stable, investigated chest pain only, as adjunct to conventional care.

Not appropriate for Yin-deficient chest pain (use Yang-nourishing approach) or pure Blood-stasis chest pain without Phlegm (use Dan Shen Yin or Xue Fu Zhu Yu Tang).

Always consult a qualified Chinese herbalist registered with the RCHM.

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