Zhi Shi Xie Bai Gui Zhi Tang — Aurantium, Chinese Garlic & Cinnamon Twig Decoction

On this page

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

Overview

Zhi Shi Xie Bai Gui Zhi Tang is from Zhang Zhongjing’s Jin Gui Yao Lue. It addresses chest Bi syndrome from Yang deficiency with Phlegm-Qi obstruction — the classical TCM picture of angina-pectoris-like chest pain with cold pattern, Phlegm signs and Qi stagnation. In modern terms it covers many presentations of stable angina, post-MI recovery, and chronic chest tightness from a mixed pattern.

The chief pair Xie Bai (Chinese garlic, Allium macrostemon) and Gua Lou is the classical “open the chest Yang” combination. Adding Zhi Shi, Hou Po and Gui Zhi gives the formula its distinctive Qi-moving and Yang-warming action.

I prescribe Zhi Shi Xie Bai Gui Zhi Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Zhi Shi Xie Bai Gui Zhi Tang is prescribed for chest Yang deficiency with Phlegm-Qi obstruction:

• Chest pain, tightness or oppression — central or with arm/jaw radiation
• Worse with cold, exertion, emotional stress
• Shortness of breath
• Palpitations
• Cold extremities
• Fatigue
• Sticky mouth
• Tongue — pale or slightly purplish, white or slippery coat
• Pulse — wiry, possibly tight or slow

Key herbs

1. Zhi Shi — moves Qi in the chest
2. Xie Bai (Chinese garlic, Allium macrostemon) — opens chest Yang; key “heart formula” herb
3. Gua Lou — resolves Phlegm and opens the chest
4. Gui Zhi — warms Yang and harmonises
5. Hou Po — moves Qi and transforms Damp

Formula actions

1. Opens chest Yang
2. Transforms Phlegm in the chest
3. Moves stagnant Qi
4. Relieves chest pain and tightness

Conditions treated

1. Stable angina pectoris with cold-Phlegm pattern (alongside cardiology care)
2. Post-MI recovery with chronic chest oppression
3. Atypical chest pain from Phlegm-Qi stagnation
4. Costochondritis
5. Chronic obstructive pulmonary disease (COPD) with chest tightness
6. Hiatus hernia symptoms with chest pressure
7. Esophageal motility disorders
8. Anxiety with chest tightness

Cautions

Acute severe chest pain or new-onset chest pain needs emergency cardiology assessment — call 999 if chest pain is acute, severe or with sweating, breathlessness or radiation. This formula is for chronic stable chest Bi only.

Not appropriate for Heat-pattern chest pain (sticky yellow phlegm, red tongue with yellow coat).

Use cautiously in pregnancy.

Always consult a qualified Chinese herbalist registered with the RCHM.

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