Yang Xin Tang — Nourish the Heart Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Modifications
8. Cautions

Overview

Yang Xin Tang — Nourish the Heart Decoction — is a Song-dynasty formula from Ren Zhai Zhi Zhi Fang (Yan Yong-he, 1253). It is one of the principal formulas for the combined pattern of Heart Qi and Heart Blood deficiency that produces palpitations, anxiety, insomnia and the foggy, depleted state of nervous-system exhaustion.

The formula is built around the dual principle of tonifying Heart Qi and Heart Blood while calming the Heart Shen. It combines the Qi-tonifying virtues of Huang Qi and Ren Shen with Blood-nourishing herbs (Dang Gui, Chuan Xiong), Shen-calming herbs (Suan Zao Ren, Bai Zi Ren, Yuan Zhi) and a small amount of warming Yang (Rou Gui) to assist circulation.

Classical versions of Yang Xin Tang sometimes included Zhu Sha (cinnabar / mercury sulfide) as a Shen-calming mineral. We use only the modern cinnabar-free version. Modern Chinese pharmacopoeia and the granulated preparations from Sun Ten in Taiwan do not contain Zhu Sha.

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

TCM pattern

Yang Xin Tang is prescribed for Heart Qi and Heart Blood deficiency with restless Shen:

• Palpitations — awareness of the heartbeat, especially at rest or on stress
• Anxiety with a sense of fragility or jumpiness
• Insomnia — particularly difficulty falling asleep, light unrestful sleep with vivid dreaming, waking often
• Poor memory and concentration — the Heart governs the Shen which directs memory
• Easily startled
• Fatigue, especially mental fatigue
• Pale complexion
• Lassitude and low motivation
• Dizziness on standing in some cases
• Tongue — pale, possibly slightly red at the tip, thin white coat
• Pulse — thin, weak, possibly irregular or skipping

The pattern is very common in modern life: chronic overwork, prolonged stress, postpartum depletion, after significant blood loss, after long illness, in chronic fatigue, in anxiety disorders, and in those who run on caffeine and adrenaline.

Key herbs

1. Huang Qi (Astragalus membranaceus) — tonifies Spleen and Lung Qi; supports Heart Qi
2. Fu Ling and Fu Shen — tonify Spleen, transform Damp, calm the Heart Shen
3. Ban Xia (qu, prepared) — transforms Phlegm to clear the chest
4. Dang Gui — nourishes and moves Heart Blood
5. Chuan Xiong — moves Blood; opens the Heart channel
6. Bai Zi Ren (Platycladus orientalis seed) — nourishes Heart Blood and calms the Shen
7. Suan Zao Ren (Ziziphus spinosa) — nourishes Heart Blood and Liver; the most important single herb for insomnia in TCM
8. Yuan Zhi (Polygala tenuifolia) — calms the Shen and reconnects Heart and Kidney
9. Wu Wei Zi (Schisandra chinensis) — astringes Heart Qi and calms the Shen
10. Ren Shen — powerfully tonifies Yuan Qi and Heart Qi
11. Rou Gui (small dose) — assists Yang to warm the Heart and circulate Blood
12. Zhi Gan Cao — harmonises and tonifies Heart Qi

Formula actions

1. Tonifies Heart Qi
2. Nourishes Heart Blood
3. Calms the Heart Shen
4. Transforms Phlegm-Damp from the chest
5. Promotes Heart-Kidney communication

Conditions treated

1. Heart Qi and Blood deficiency — the foundational pattern
2. Insomnia — particularly difficulty falling asleep, light sleep, dream-disturbed sleep
3. Anxiety with palpitations and feeling fragile
4. Palpitations from emotional stress, post-viral, or postpartum — alongside cardiology investigation
5. Generalised anxiety disorder with prominent fatigue and depletion
6. Burnout with mental fatigue and emotional flatness
7. Postpartum anxiety and insomnia — see postpartum depression
8. Chronic fatigue syndrome with prominent palpitations and brain fog
9. Mild depression with anxiety — see depression
10. Memory problems and brain fog in middle age or recovery
11. Perimenopausal anxiety and palpitations — see menopausal symptoms
12. Recovery after significant blood loss, surgery or childbirth

Comparisons with related formulas

• Gui Pi Tang — the most commonly compared formula. Both treat Heart and Spleen deficiency with insomnia and palpitations. Gui Pi Tang emphasises Spleen Qi tonification (better when poor appetite, easy bruising and loose stools are prominent). Yang Xin Tang emphasises Heart-calming and includes Phlegm-resolving herbs (better when palpitations, anxiety and chest tightness dominate).
• Suan Zao Ren Tang — for Liver Blood deficiency insomnia with irritability; uses Suan Zao Ren as the chief herb. Often combined with Yang Xin Tang in mixed presentations.
• Tian Wang Bu Xin Dan — for Heart and Kidney Yin deficiency with empty-Heat; better when night sweats, dry mouth and severe insomnia are prominent.
• Gan Mai Da Zao Tang — for Heart Yin deficiency with emotional restlessness; a much simpler three-herb formula.
• Zhi Gan Cao Tang — for Heart Qi and Yin deficiency with arrhythmia (irregular pulse).

Modifications

• For prominent insomnia, increase Suan Zao Ren and add Long Gu and Mu Li
• For prominent anxiety with chest oppression, add Hou Po and Su Geng
• For Heart Yin deficiency overlay (night sweats, dry mouth), combine with Tian Wang Bu Xin Dan principles
• For postpartum recovery, add Yi Mu Cao and increase Dang Gui
• For perimenopausal palpitations, combine with Er Xian Tang principles
• For prominent dream-disturbed sleep, add Lian Zi Xin (Lotus heart) and Bai Shao
• For arrhythmia or irregular pulse, combine with Zhi Gan Cao Tang

Cautions

The modern version of this formula does not contain Zhu Sha (cinnabar/mercury). Some older preparations did; verify the formulation with your supplier.

Not appropriate for excess patterns (high fever, vigorous Yang, full Heat).

Persistent palpitations and irregular heartbeats must be investigated medically — ECG and cardiology review — before assuming a TCM cause. Yang Xin Tang complements but does not replace cardiac assessment.

If significant anxiety or insomnia persists, particularly with low mood or suicidal thoughts, seek medical and psychological support promptly; herbs are an adjunct, not a replacement for mental-health care.

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.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door.