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Chinese Medicinal Formulas

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Objectives

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This book is to illustrate the use of combinations of Chinese medicinal materials to treat diseases before the advent of modern medicine.

Introduction

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Chinese medicinal formulas have been used in traditional Chinese medicine for hundreds of years. Formulas consist of combinations of herbs to treat various diseases. These formulas or prescriptions may be classified according to types or symptoms of diseases.

On the other hand, individual Chinese herbs may be classified in a number of ways, including tonifying, invigorating or nourishing herbs for Yang, Yin, Qi and blood, as well as herbs to reduce or purge fire, wind or dampness. This classification may be affirmed by modern scientific studies on the effects of individual herbs, where conclusions such as the following may be drawn: "The results obtained from studies using myocardial mitochondrial fractions isolated from herb-pretreated mice suggest that 'Yang-invigorating' herbs might speed up ATP generation by increasing mitochondrial electron transport." [1]

Synergy

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The usual method to prepare a herbal formulation is to boil the herbs in a prescription together, and then consume the liquid when cooled. Boiling the herbs together sometimes have effects beyond that of boiling the herbs separately, and then mixing the solutions together.

Danggui Buxue Tang

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An example of herbal synergy is in the use of the formula Danggui Buxue Tang

The two herbs in Danggui Buxue Tang (DBT) are Radix Astragali (RA), roots of Astragalus membranaceus (Fisch.) Bunge or Astragalus membranaceus (Fisch.) Bunge var. mongholicus (Bunge) P.K. Hsiao, and Radix Angelicae Sinensis (RAS), roots of Angelica sinensis (Oliv.) Diels. These two herbs are used in the ratio of 5:1 by weight.

It was found that[2] "DBT, an ancient Chinese herbal decoction having a combination of RA and RAS in a weight ratio of 5:1, possesses much better effect in stimulating cultured T-lymphocytes as compared to that of the extracts derived from RA, or RAS, or RA + RAS (boiled separately and then mixed together in 5:1 ratio). In parallel to this effect, cytokine array analysis revealed a specific set of cytokines being stimulated to release from the cultured T-lymphocytes by DBT; the cytokine release was not triggered by RA alone, or RAS alone, or RA + RAS. In addition, the insufficient stimulating effect of RA + RAS in cultured T-lymphocytes suggests that boiling of the two herbs together is essential; this method of DBT preparation, indeed, has long been recommended by TCM practitioners. Besides the effect in T-lymphocytes, the role of the correct weight ratio of RA to RAS in making the formulation of DBT has also been demonstrated in cultured breast cancer, macrophage and osteoblast."

Zuo Jin Wan

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Other examples of synergy can be found between the herbs berberine and evodiamine, as well as in the formula Zuojinwan. "Generally, an enhancement or synergy effects are observed when different medicinal plants were used combined in TCM research. For example, the excellent pharmacological action of Zuojinwan was produced by the synergy of C. chinensis Franch and E. Fructus."[3]

Er Zhi Wan

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Synergy is sometimes interpreted as compatibility. For example, it is stated [4] with reference to Er Zhi Wan (二至丸), a traditional Chinese formulation, that "According to the law of compatibility of traditional Chinese medicines, a single herbal medicine usually exerts a limited therapeutic action. When several herbal medicines are mixed in a certain proportion, they will display their superiority over a single drug in the treatment of a disease. Therefore, for more than a millennium, traditional Chinese formulations have been extensively used, apparently safely and effectively, in Asian countries, especially in China, Japan and Korea, to alleviate various symptoms of diseases."

Types of Formulas

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  1. Prescriptions for Relieving Exterior Syndromes
  2. Prescriptions for Clearing away Heat
  3. Prescriptions for Warming the Interior
  4. Purgative Prescriptions
  5. Prescriptions for Mediation
  6. Tonic Prescriptions
  7. Prescriptions for Astringent Effects
  8. Sedative Prescriptions
  9. Prescriptions for Resuscitation
  10. Prescriptions for Regulating the Flow of Qi
  11. Prescriptions for Regulating Blood Circulation
  12. Prescriptions for Treating Wind Syndrome
  13. Prescriptions for Eliminating Dampness
  14. Prescriptions for Eliminating Phlegm
  15. Peptic Prescriptions
  16. Prescriptions for Treating Carbuncles

Notes

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  1. K.-M. Ko, T.Y.Y. Leon, D.H.F. Mak, P.-Y. Chiu, Y. Du, M.K.T. Poon. "A characteristic pharmacological action of ‘Yang-invigorating’ Chinese tonifying herbs: Enhancement of myocardial ATP-generation capacity", Phytomedicine, Volume 13, Issues 9-10, 24 November 2006, Pages 636-642.
  2. Qiu T. Gao, Jerry K.H. Cheung, Jun Li, Zhi Y. Jiang, Glanice K.Y. Chu, Ran Duan, Anna W.H. Cheung, Kui J. Zhao, Roy C.Y. Choi, Tina T.X. Dong, Karl W.K. Tsim. "A Chinese herbal decoction, Danggui Buxue Tang, activates extracellular signal-regulated kinase in cultured T-lymphocytes", FEBS Letters, Volume 581, Issue 26, 30 October 2007, Pages 5087-5093
  3. X.-N. Wang, X. Han, L.-N. Xu, L.-H. Yin, Y.-W. Xu, Y. Qi, J.-Y. Peng. "Enhancement of apoptosis of human hepatocellular carcinoma SMMC-7721 cells through synergy of berberine and evodiamine", Phytomedicine, Volume 15, Issue 12, December 2008, Pages 1062-1068
  4. Hong Zhang, Wei-Wei Xing, Yu-Shan Li, Zheng Zhu, Jin-Zhong Wu, Qiao-Yan Zhang, Wen Zhang, Lu-Ping Qin. "Effects of a traditional Chinese herbal preparation on osteoblasts and osteoclasts", Maturitas, Volume 61, Issue 4, 20 December 2008, Pages 334-339.

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