XIAO YAO WAN (BP031) Bupleurum & Dang Gui Formula Complex

Indication

This formula is from the ‘Formulary of the Tai Ping Welfare Dispensary Bureau’ (tai ping hui min he ji ju fang), 1151, a compilation of popular and effective formulas that were used in the public dispensaries of the Song dynastic period. It is a well designed formula that addresses Liver Qi constraint – together with the associated emotional disturbances – when it occurs in the context of a deficiency syndrome, specifically Spleen Qi and Liver Blood deficiency. This condition is marked by failure of the Liver to maintain the smooth and even flow of the Qi throughout the body.

It is commonly caused by emotional strain or stress, but may also come about through invasion by pathogens, which obstruct the Qi and Blood, placing a critical strain on the Liver’s ability to adequately regulate the Qi. Thus, Liver function (i.e. the Liver Qi) becomes inhibited leading to what is essentially a deficiency type of syndrome. It manifests in a diminution of emotional responses (i.e. inability to give vent to feelings, depressed mood, crying easily), together with disturbances along the course of the Liver channel (chest, breasts and hypochondrium). In addition, disruption of the middle Jiao (i.e. Stomach and Spleen function) is usually also present.

This is because the Liver fails to regulate and promote the normal movements of Qi in the middle Jiao, leading to disturbances with digestion as described above under ‘Signs and Symptoms’. Because the Qi and the Blood form a complementary pair, Liver Qi constraint is essentially a disharmony between the Liver Qi and the Liver Blood. Thus the later may readily become deficient. Liver Blood deficiency may impact on the Heart (the Liver nourishes the Heart) as well as the uterus: in the former, the Heart receives less Blood from the Liver, leading to disturbances in cognitive function and possibly also sleep; while in the latter, the Liver’s ability to store and discharge Blood may adversely affect menstruation, e.g. irregular periods, bloating etc.

The synergistic actions of the herbs are as follows:

Bupleurum root (chai hu), Zingiber rhizome (sheng jiang), Mentha haplocalyx, herb (bo he): disperse the stagnant Liver Qi.

Paeonia root (bai shao), Angelica root (dang-gui): nourish the Liver Blood, protect the Liver Yin from the dispersing action of the above mentioned herbs (Bupleurum, Zingiber and Mentha), calm the Spirit.

Bupleurum root (chai hu), Paeonia root (bai shao), Angelica root (dang-gui): tonify the Liver and promote the Liver’s function of maintaining the normal smooth flow of the Qi.

Poria cocos (fu ling), Atractylodes rhizome (bai zhu), Glycyrrhiza root (gan cao): tonify the Spleen Qi.

Indications:

Stress

Irritability

Depressed mood

Stress-related disorders

Bruxism

Premenstrual tension

Hepatitis

Hepatic cirrhosis

Gastritis

Duodenitis

Cholecystitis

Peptic ulcer disease

Mastitis

Mammary dysplasia (fibrocystic breast disease)

Irregular menstruation

Chronic hepatitis B

Signs & Symptoms:

Sense of frustration, stress, emotional strain, depressed mood

Sense of tightness or oppressive sensation in the chest, the need to make an effort to take a deep breath, sighing

Symptoms brought on or worsened by emotional strain

Tightness of the shoulders and lower thoracic paraspinal muscles

Fatigue

Poor appetite, epigastric or abdominal bloating

Loose stools

Hypochondrial distending pain

Premenstrual tension with mastalgia

Tongue may be normal possibly with a thick tongue coat

Wiry pulse that may also be weak-thready

Combinations –

Chronic fatigue syndrome:

BA JI YIN YANG WAN

BU ZHONG YI QI WAN

SHI QUAN DA BU WAN

YU PING FENG SAN

SHEN QI DA BU WAN

ZHUANG YANG YI JING WAN

QI BAO MEI RAN DAN (Jia Wei)

TAO HONG SI WU WAN

ENERGY TONIC Formula

Insomnia or disturbed sleep due to stress:

AN SHEN DING ZHI WAN

Mammary dysplasia (fibrocystic beast disease):

JIA WEI XIAO YAO SAN

GUI ZHI FU LING WAN

TAO HONG SI WU WAN

A C Skin Formula (formerly Acne)

BLOOD MOVING 2 Formula

Menopausal syndrome:

JIA WEI XIAO YAO SAN

ER XIAN TANG

GAN MAI DA ZAO WAN (Jia Wei)

TAO HONG SI WU WAN

Mood problems:

AN SHEN DING ZHI WAN

WEN DAN TANG

GAN MAI DA ZAO WAN (Jia Wei)

Premenstrual syndrome:

CHAI HU SHU GAN WAN

JIA WEI XIAO YAO SAN

TAO HONG SI WU WAN

TCM Syndromes: Liver Qi constraint, Spleen Qi deficiency.

TCM Actions: Soothes the Liver, tonifies the Spleen Qi and nourishes the Liver Blood.