Zhen Gan Xi Feng Tang - Clinical Application
1. Treatment of Transient Ischemic Attack (TIA)
Patient, male, 54 years old, first visit on May 4, 1998. The patient had a history of dizziness and frequently experienced dizziness, nausea, restlessness, and heat in the chest. Seven days ago, he experienced dizziness, unsteady gait, diplopia, difficulty swallowing, and heavy limbs after suddenly turning his head. The symptoms improved after half a day, but recurred multiple times, sometimes up to three times a day. A doctor diagnosed him with a transient ischemic attack. Western medicine treatment was ineffective, so he sought treatment from me. I observed that he had a flushed complexion and clear mind, with a slightly normal tongue and thin white coating, and a wiry and rapid pulse. This belonged to the category of Traditional Chinese Medicine (TCM) stroke, with the pattern of liver and kidney yin deficiency and wind and yang disturbance. The treatment plan was to nourish yin and suppress yang, using Zhen Gan Xi Feng Tang with modifications. The prescription consisted of 30g each of Achyranthes Root, Red Ochre, Herba Artemisiae Scopariae, Uncaria Rhynchophylla, Ligustrum Fruit, and Eclipta, 15g each of Raw Oyster Shell, Raw Dragon Bone, Turtle Shell, Scrophularia Root, Ophiopogon Tuber, and White Peony Root, and 10g each of Fructus Toosendan, Gastrodia Rhizome, and Malt Sprout. After taking 5 doses, the frequency of the attacks decreased. After taking 10 more doses, the attacks stopped. Follow-up for 5 years showed no recurrence.
2. Treatment of Essential Tremor Paralysis
Patient, male, 58 years old, first visit on December 10, 1999. A few days ago, he noticed slight trembling in his right upper limb, which occurred when gripping objects or when under stress, and disappeared when at rest. Recently, the tremor became more severe, and he also experienced involuntary head movements. At present, the symptoms include flushed face, limb tremors, unsteady gait, a red tongue with thin white coating, and a wiry and thin pulse. This belonged to the category of Western medicine essential tremor paralysis. TCM differentiation diagnosed it as deficiency of qi and blood, failure of tendons and vessels to be nourished, deficiency of yin in the lower part of the body, and disturbance of wind and yang. The treatment plan was to suppress liver and extinguish wind, nourish yin and suppress yang, nourish blood and promote circulation. Zhen Gan Xi Feng Tang was combined with Bu Yang Huan Wu Tang with modifications. The prescription consisted of 30g each of Achyranthes Root, Red Ochre, Raw Dragon Bone, Uncaria Rhynchophylla, and Herba Artemisiae Scopariae, 15g each of Raw Oyster Shell, Turtle Shell, White Peony Root, and Chinese Angelica Root, 10g each of Safflower, Peach Kernel, Rhizoma Dioscoreae, and Gastrodia Rhizome, 50g of Astragalus, and 20g of Malt Sprout. After taking 20 doses, the tremor stopped, and the symptoms significantly reduced. After taking Qiju Dihuang Wan for one month, all symptoms disappeared. Follow-up showed no recurrence until now.
3. Treatment of Primary Hypertension
Patient, female, 64 years old, first visit on June 20, 1998. Four days ago, she experienced dizziness, headache, tinnitus, and irritability without any obvious cause. Today, she woke up with numbness in the right side of her body. At the time of the visit, her blood pressure was 170/110mmHg, her face was flushed, her tongue was red with thin white coating, and her pulse was wiry and rapid. This belonged to the category of Western medicine primary hypertension, and TCM dizziness disease with differentiation of liver yang hyperactivity. The treatment plan was to suppress liver and extinguish wind, pacify liver and subdue yang. Zhen Gan Xi Feng Tang was combined with Tian Ma Gou Teng Yin with modifications. The prescription consisted of 30g each of Achyranthes Root, Red Ochre, Raw Dragon Bone, Uncaria Rhynchophylla, and Herba Artemisiae Scopariae, 15g each of Gastrodia Rhizome, White Peony Root, Turtle Shell, Raw Oyster Shell, Gardenia Fruit, Scutellaria Root, and Malt Sprout, and 10g of Chuan Lian. After taking 3 doses, the numbness in the limbs disappeared, and the accompanying symptoms reduced. The blood pressure was 150/90mmHg. After taking an additional 12 doses, all symptoms disappeared. Six Flavor Rehmannia Pill was prescribed for maintenance, and she has remained healthy until now.
Note: In clinical practice, we seek the cause of the disease and treat the root. Although the diseases in these three cases are different, they share the same etiology and pathogenesis, all involving excessive yang in the upper body, deficiency of yin in the lower body, and failure of tendons and vessels to be nourished. Therefore, the treatment principles are largely the same, with slight variations. The basic formula used is Zhen Gan Xi Feng Tang, with modifications based on individual symptoms. This reflects the holistic concept of Traditional Chinese Medicine and the characteristic of differential treatment.
It is important to master the main functions of this formula and flexibly combine it with other herbs. The three cases presented here all had liver and kidney yin deficiency and wind and yang disturbance, so the treatment was based on Zhen Gan Xi Feng Tang. However, the key to using this formula lies in the flexibility of combining it with other herbs according to the symptoms. For example, in case 1, because the symptoms of dizziness caused by liver and kidney yin deficiency and wind and yang disturbance recurred repeatedly, the formula was modified by adding Ligustrum Fruit and Eclipta to enhance the nourishing yin effect. In case 2, because the symptoms of head movements and limb tremors were caused by liver and kidney yin deficiency, wind and yang disturbance, deficiency of qi and blood, and failure of tendons and vessels to be nourished, the formula was modified by adding herbs that tonify qi, promote blood circulation, and activate the channels. In case 3, the symptoms were caused by liver and kidney yin deficiency, liver yang hyperactivity, and liver fire disturbing the mind and spirit, so the formula was modified by adding herbs that clear and drain liver heat. Although the symptoms were different in these three cases, the appropriate combination of herbs led to noticeable effects. However, if the formula is used stubbornly without proper modification, it may not be effective.
