Juan Bi Tang — Remove Painful Obstruction Decoction

On this page

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

Overview

Juan Bi Tang — Remove Painful Obstruction Decoction — is the principal formula in Chinese herbal medicine for Wind-Cold-Damp Bi syndrome, the TCM classification encompassing inflammatory and degenerative joint disease driven by the invasion of Wind, Cold and Damp into the channels and joints. The formula expels all three pathogenic factors simultaneously while also moving Qi and Blood to relieve pain and improve local circulation in the affected joints.

TCM pattern

Prescribed for Wind-Cold-Damp Bi syndrome (painful obstruction), characterised by: joint and muscle pain worsened by cold and damp weather and relieved by warmth, stiffness that improves with movement, heavy limbs, an absence of prominent heat or redness in the affected joints, a pale tongue with white coating, and a wiry or slow pulse. This is the “cold type” of Bi syndrome, as distinct from the “hot type” treated by Bai Hu Tang modifications.

Key herbs

1. Qiang Huo (Notopterygium incisum rhizome) — expels Wind-Cold-Damp from the upper body and channels
2. Du Huo (Angelica pubescens root) — expels Wind-Cold-Damp from the lower body, joints and sinews
3. Qin Jiao (Gentiana macrophylla root) — expels Wind-Damp and relaxes the sinews
4. Chuan Xiong (Ligusticum chuanxiong rhizome) — invigorates Blood, moves Qi and alleviates pain
5. Rou Gui (Cinnamomum cassia bark) — warms the channels and expels Cold; improves circulation to cold, painful joints
6. Ru Xiang (Boswellia carterii resin) — invigorates Blood, moves Qi and alleviates pain in the channels and joints
7. Mu Xiang (Saussurea lappa root) — moves Qi and relieves pain
8. Gan Cao (Glycyrrhiza uralensis root) — harmonises and moderates the formula

Conditions treated

1. Rheumatoid arthritis with Cold-Damp Bi pattern — cold-worsened joint pain and stiffness
2. Osteoarthritis with cold-sensitive joint pain
3. Back pain and neck pain from Wind-Cold-Damp invasion
4. Frozen shoulder with Cold-Damp obstruction
5. Sciatica with Cold-Damp obstructing the Bladder and Gallbladder channels

Contraindicated in Hot Bi syndrome (active inflammatory arthritis with hot, red, swollen joints).

Cautions

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