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SHEN TONG ZHU YU TANG (DRIVE OUT BLOOD STASIS FROM
A PAINFUL BODY DECOCTION)

By John Chen, L.Ac., O.M.D., Pharm.D., Ph.D.

COMPOSITION

DOSAGE / PREPARATION / ADMINISTRATION

The source text states to prepare the ingredients as a decoction.

CHINESE THERAPEUTIC ACTIONS

1. Activates qi and blood circulation
2. Dispels blood stagnation and opens the channels and collaterals
3. Unblocks bi zheng (painful obstruction syndrome) and relieves pain

CLINICAL MANIFESTATIONS

Pain due to qi and blood stagnation blocking the channels and collaterals: pain in the shoulder, elbow, waist and/or leg; and generalized pain throughout the whole body that does not heal.

CLINICAL APPLICATIONS

Arthritis, rheumatoid arthritis, sciatica, pain in the lower back and legs, lumbago, neuralgia, hyperosteogeny, and allergic purpura.

EXPLANATION

The main actions of Shen Tong Zhu Yu Tang (Drive Out Blood Stasis from a Painful Body Decoction) are to activate qi and blood circulation, dispel blood stagnation, open the channels and collaterals, and relieve pain. Clinically, it is often used for pain due to stagnation of qi and blood. Pain may be located in the shoulder, elbow, waist, leg, or throughout the whole body.

In this formula, Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) activate blood circulation and eliminate blood stasis. Dang Gui (Radicis Angelicae Sinensis) and Chuan Xiong (Rhizoma Ligustici Chuanxiong) nourish the blood and promote blood circulation. Mo Yao (Myrrha) relieves pain by invigorating blood circulation. Wu Ling Zhi (Excrementum Trogopteri seu Pteromi) and Di Long (Pheretima) dispel blood stasis and open the channels and collaterals. Qin Jiao (Radix Gentianae Macrophyllae) and Qiang Huo (Rhizoma et Radix Notopterygii) dispel wind-damp to relieve pain. Xiang Fu (Rhizoma Cyperi) activates qi to relieve pain. Niu Xi (Radix Cyathulae seu Achyranthis) strengthens bones, tendons, and soft tissues. Gan Cao (Radix Glycyrrhizae) harmonizes all the herbs in the formula.

MODIFICATIONS

• With pain in the upper body, add Ge Gen (Radix Puerariae).
• With pain the lower body, add Du Huo (Radix Angelicae Pubescentis).
• With pain in the extremities, add Sang Zhi (Ramulus Mori) and Gui Zhi (Ramulus Cinnamomi).

CAUTIONS / CONTRAINDICATIONS

Use of this formula is contraindicated during pregnancy. (i)

PHARMACOLOGICAL EFFECTS

Analgesic and anti-inflammatory: According to in vitro studies, administration of Shen Tong Zhu Yu Tang in tincture form was effective in relieving pain and reducing inflammation. (ii)

CLINICAL STUDIES AND RESEARCH

1. Bi zheng (painful obstruction syndrome): According to one study, administration of Shen Tong Zhu Yu Tang in 32 patients with bi zheng (painful obstruction syndrome) was associated with complete recovery in 12 cases, significant improvement in 10 cases, moderate improvement in 7 cases, and no effect in 3 cases. The overall effectiveness was 90.6%. The herbal formula used Shen Tong Zhu Yu Tang as the base, with the addition of Huang Qi (Radix Astragali) and Dang Shen (Radix Codonopsis) for qi deficiency; Fang Feng (Radix Saposhnikoviae) and Wei Ling Xian (Radix Clematidis) for wind; Chuan Wu (Radix Aconiti Preparata) and Xi Xin (Herba Asari) for cold; Fu Ling (Poria) and Yi Yi Ren (Semen Coicis) for damp; Gui Zhi (Ramulus Cinnamomi) and Sang Zhi (Ramulus Mori) for pain in the upper limbs; Sang Ji Sheng (Herba Taxilli), Xu Duan (Radix Dipsaci), and Gou Ji (Rhizoma Cibotii) for pain in the lower limbs; Ge Gen (Radix Puerariae) for pain in the neck; and Lu Feng Fang (Nidus Vespae), Wu Shao She (Zaocys), Quan Xie (Scorpio), and dry-fried Chuan Shan Jia (Squama Manis) for stiff joints with deformation. Furthermore, for re bi (heat painful obstruction), Jin Yin Hua (Flos Lonicerae), Cang Zhu (Rhizoma Atractylodis), and Huang Bai (Cortex Phellodendri) were added, and Qin Jiao (Radix Gentianae Macrophyllae), Qiang Huo (Rhizoma et Radix Notopterygii), and Chuan Xiong (Rhizoma Ligustici Chuanxiong) were removed. For shi-re bi (damp-heat painful obstruction), Huang Lian (Rhizoma Coptidis), Jin Yin Hua (Flos Lonicerae), and Yu Jin (Radix Curcumae) were added, and Niu Xi (Radix Cyathulae seu Achyranthis), Qin Jiao (Radix Gentianae Macrophyllae), Qiang Huo (Rhizoma et Radix Notopterygii), and Chuan Xiong (Rhizoma Ligustici Chuanxiong) were removed. (iii)


2. Arthritis: According to one study, use of modified Shen Tong Zhu Yu Tang in 67 patients with arthritis was associated with complete recovery in 50 patients, significant improvement in 14 cases, and no effect in 3 cases. Modifications included the addition of Fu Zi (Radix Aconiti Lateralis Praeparata), Xi Xin (Herba Asari), and Wei Ling Xian (Radix Clematidis) for arthritis due to cold; Ren Dong Teng (Caulis Lonicerae), Shi Gao (Gypsum Fibrosum), Huang Bai (Cortex Phellodendri), and Yi Yi Ren (Semen Coicis), and removal of Qiang Huo (Rhizoma et Radix Notopterygii), for arthritis due to heat; Bai Shao (Radix Paeoniae Alba) for stiffness of the tendons and ligaments; and Bai Hua She (Bungarus Parvus) and Wu Shao She (Zaocys) for “mobile” arthritis that affects multiple joints. (iv)


3. Rheumatoid arthritis: One study of 46 patients with rheumatoid arthritis reported marked success using modified Shen Tong Zhu Yu Tang. Of 46 patients, the study reported recovery in 12 cases, improvement in 25 cases, slight improvement in 7 cases, and no effect in 2 cases. The duration of treatment was 2 months per course of treatment, for 3 courses total. The study also noted that the effect of the herbs was comparable or better than the control group that received aspirin. The herbal formula contained Shen Tong Zhu Yu Tang as the base formula, and added Gui Zhi (Ramulus Cinnamomi), Fang Feng (Radix Saposhnikoviae), and Wei Ling Xian (Radix Clematidis) for wind-dampness; Gui Zhi (Ramulus Cinnamomi), Gan Jiang (Rhizoma Zingiberis), and Fu Ling (Poria) for damp-cold; addition of Cang Zhu (Rhizoma Atractylodis), Huang Bai (Cortex Phellodendri), and Fang Feng (Radix Saposhnikoviae), and removal of Qiang Huo (Rhizoma et Radix Notopterygii), for damp-heat; the addition of Sheng Di Huang (Radix Rehmanniae), Gou Qi Zi (Fructus Lycii), and Nu Zhen Zi (Fructus Ligustri Lucidi), and removal of Qiang Huo (Rhizoma et Radix Notopterygii) and Qin Jiao (Radix Gentianae Macrophyllae), for Kidney yin deficiency; and the addition of Rou Gui (Cortex Cinnamomi) and Shan Zhu Yu (Fructus Corni), and removal of Qiang Huo (Rhizoma et Radix Notopterygii) and Qin Jiao (Radix Gentianae Macrophyllae), for Kidney yang deficiency. (v)


4. Sciatica: According to one study, administration of Shen Tong Zhu Yu Tang for 7-45 days (average of 17.4 days) in 36 patients with sciatica was associated with complete recovery in 29 cases, significant improvement in 6 cases, and no effect in 1 case. The overall effectiveness was 97.2%. Furthermore, of 24 patients who returned for follow-up one year later, only 1 had recurrence. (vi)


5. Pain in the lower back and legs: Administration of Shen Tong Zhu Yu Tang has been shown in 2 studies to effectively treat pain in the lower back and legs. Of 67 patients, the first study reported complete recovery in 53 cases, improvement in 9 cases, and no effect in 5 cases. (vii) Of 52 patients in the second study, 12 had complete recovery, 26 had significant improvement, 9 had moderate improvement, and 5 had no effect. (viii)


6. Lumbago: One study reported good results using modified Shen Tong Zhu Yu Tang to treat acute low back pain. Modifications included the addition of Dang Shen (Radix Codonopsis) and Huang Qi (Radix Astragali) for qi deficiency; and Yan Hu Suo (Rhizoma Corydalis) and Qi Ye Lian (Radix Schefflerae) for severe pain. Furthermore, the herbal treatment also was applied topically to the affected area. Of 15 patients, the study reported complete recovery in 8 cases, significant improvement in 3 cases, moderate improvement in 3 cases, and no effect in 1 case. (ix)


7. Hyperosteogeny: According to one study, hyperosteogeny of the lumbar spine was treated with modified Shen Tong Zhu Yu Tang with good results. Of 25 patients, the study reported complete relief in 18 cases, significant relief in 4 cases, and no effect in 3 cases. (x)


8. Allergic purpura: According to one study, use of modified Shen Tong Zhu Yu Tang for treatment of allergic purpura was associated with marked success in 30 patients (between 11-59 years of age with 2 days to 3 years history of illness). The herbal treatment contained Dang Gui (Radicis Angelicae Sinensis) 15g, Hong Hua (Flos Carthami) 12g, Mo Yao (Myrrha) 12g, Wu Ling Zhi (Excrementum Trogopteri seu Pteromi) 12g, Xiang Fu (Rhizoma Cyperi) 12g, Chuan Xiong (Rhizoma Ligustici Chuanxiong) 10g, Tao Ren (Semen Persicae) 10g, Niu Xi (Radix Cyathulae seu Achyranthis) 9g, Qin Jiao (Radix Gentianae Macrophyllae) 9g, Di Long (Pheretima) 9g, Qiang Huo (Rhizoma et Radix Notopterygii) 9g, and Gan Cao (Radix Glycyrrhizae) 6g. Other modifications were made as needed based on the condition of the individual patients. The herbs were given in decoction daily for duration of 5-32 days. Of 30 patients, the study reported complete recovery in 26 cases, significant improvement in 3 cases, and no effect in one case. (xi)

References
(i) Chen, Q., Zhong Yao Ming Fang Yao Li Yu Ying Yong (Pharmacology and Applications of Famous Herbal Formulas), 1989; 466-468
(ii) Zhong Yao Yan Jiu (Research of Chinese Herbology), 1993, 6(4):15
(iii) Xin Zhong Yi (New Chinese Medicine), 1995, 9:42
(iv) Yun Nan Zhong Yao Zhi (Yunan Journal of Chinese Herbal Medicine), 1989, 3:46
(v) Bei Jing Zhong Yi Za Zhi (Beijing Journal of Chinese Medicine), 1988, 6:35
(vi) Si Chuan Zhong Yi (Sichuan Chinese Medicine), 1985, 11:50
(vii) Hu Nan Zhong Yi Za Zhi (Hunan Journal of Chinese Medicine), 1987, 1:12
(viii) Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), 1987, 10:452
(ix) Guang Xi Zhong Yi Yao (Guangxi Chinese Medicine and Herbology), 1987, 2:47
(x) Gan Su Zhong Yi (Gansu Chinese Medicine), 1993, 9:46
(xi) Bei Jing Zhong Yi (Beijing Chinese Medicine), 1995, 4:43

ABOUT THE AUTHOR

John K. Chen, L.Ac., Pharm.D., O.M.D., Ph.D.

Dr. John Chen is a recognized authority in both western pharmacology and Chinese Herbal Medicine.  He teaches at the USC School of Pharmacy, Emperor’s College, Yo San University of TCM, OCOM, Five Branches, AOMA and ACTCM. Dr. Chen’s most recent published work is Chinese Medical Herbology and Pharmacology (2003, AOM Press) and Chinese Herbal Formulas and Applications (2008, AOM Press) for which he was lead author.

This article was taken out of Dr. Chen’s book Chinese Herbal Formulas and Applications.
To order a copy, click here.

To learn more about herbs, John Chen is speaking on the following topic for Lotus Institute. This class is approved for 8 CEUs/PDAs by the California Acupuncture Board and NCCAOM.

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