Huang Qi Tang — Astragalus Decoction

On this page

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

Overview

Huang Qi Tang — the “Astragalus Decoction” for constipation — appears in Jin Gui Yi. It addresses constipation in elderly or weakened patients where the Qi is too depleted to propel the stool and the intestines have grown dry, but without significant interior Heat or Yang deficiency. Huang Qi tonifies the Spleen and Lung Qi to restore the propulsive drive of defecation, Chen Pi smooths the Qi dynamic, Ma Zi Ren moistens the bowel and honey both moistens and harmonises. The result is a gentle restorative remedy that resolves constipation without purging.

I prescribe Huang Qi Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Huang Qi Tang is prescribed for Qi-deficient constipation with dry Intestines:

• Chronic difficult defecation — not because stool is hard, but because of weak propulsion
• Stool may be normal in consistency but very effortful to pass
• Marked fatigue after defecation
• Shortness of breath, poor appetite
• Pale complexion
• Tongue — pale, possibly with tooth-marks; thin coat
• Pulse — weak, soft

Key herbs

1. Huang Qi — chief; tonifies Spleen and Lung Qi; restores propulsion
2. Chen Pi — regulates Qi; prevents stagnation from the tonifying herb
3. Huo Ma Ren (Ma Zi Ren) — moistens the Intestines
4. Bai Mi (honey, taken as adjunct) — moistens and harmonises

Formula actions

1. Tonifies Qi
2. Moistens the Intestines
3. Promotes bowel movement without purging

Conditions treated

1. Chronic constipation in the elderly from Qi deficiency
2. Post-partum constipation with depletion
3. Post-operative constipation with Qi depletion
4. Constipation in chronic illness with marked fatigue
5. Constipation in chemotherapy patients with Qi deficiency
6. Functional constipation in older adults with weak propulsion

Cautions

Not appropriate for Heat-accumulation constipation (red tongue, dry yellow coat, foul stool, strong odour) — use Ma Zi Ren Wan or a Cheng Qi variant.

Not appropriate for Liver Qi stagnation constipation (alternating bowels, abdominal cramping).

Constipation with weight loss, blood in stool or change in bowel habit needs urgent investigation to exclude bowel cancer.

Always consult a qualified Chinese herbalist registered with the RCHM.

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