Chai Hu Jia Long Gu Mu Li Tang (柴胡加龙骨牡蛎汤) — Bupleurum, Dragon Bone & Oyster

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions where it is used
6. Common modifications
7. Modern research
8. How I use it in clinic
9. Frequently asked questions
10. Cautions
11. References

What is Chai Hu Jia Long Gu Mu Li Tang?

Chai Hu Jia Long Gu Mu Li Tang — Bupleurum with Dragon Bone and Oyster Shell — is a classical Shang Han Lun formula that builds on Xiao Chai Hu Tang by adding heavy mineral substances to anchor a disturbed Shen. It is one of the most useful formulas in Chinese herbal medicine for anxiety, palpitations, irritability and insomnia rooted in Liver-Gallbladder constraint and stuck heat.

I prescribe Chai Hu Jia Long Gu Mu Li Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

Chai Hu Jia Long Gu Mu Li Tang TCM pattern

Prescribed for Shao Yang disharmony with disturbed Shen and stuck heat: irritability, anxiety, palpitations, easy startling, broken sleep, chest oppression, restlessness, possible mild fever or hot flushes, a sticky white or yellow tongue coat and a wiry pulse.

Key herbs

1. Chai Hu (Rx. Bupleuri, 5-20g), Huang Qin (Rx. Scutellariae, 2.5-15g) — release Shao Yang and clear heat
2. Long Gu (Fossilia Ossis Mastodi, 2.5-30g), Mu Li (Concha Ostreae, 2.5-30g) — anchor the Shen and settle the Liver Yang
3. Gui Zhi (Ram. Cinnamomi, 2.5-8g) — warms the channels and supports the harmonisation
4. Ren Shen (Rx. Ginseng, 2.5-8g) — tonifies Qi and steadies the upright
5. Ban Xia (Rz. Pinelliae Preparatum, 4-15g) — transforms phlegm and descends rebellious Qi
6. Fu Ling (Poria, 3-15g) — quietens the Heart and drains Damp
7. Da Huang (Rx. et Rz. Rhei, 1-10g), Sheng Jiang (Rz. Zingiberis Recens, 2.5-8g), Da Zao (Fr. Zizyphi Jujube, 2.5-8g) — drain stuck heat and harmonise

Formula actions

1. Harmonises Shao Yang and clears stuck heat
2. Calms the Shen and settles palpitations
3. Transforms Phlegm and unblocks the Gallbladder

TCM patterns and conditions where it is used

The formula is used for the TCM pattern of Shao Yang disharmony with disturbed Shen. The presentations within that pattern include:

1. Anxiety with palpitations, easy startling and disturbed sleep — systematic review evidence supports Xiao Yao family formulas in anxiety^[1]
2. Stress-related insomnia with irritability and a wiry pulse — meta-analysis evidence supports Xiao Yao San in insomnia with anxiety^[2]
3. Tinnitus and dizziness from Liver-Gallbladder constraint — in TCM, these are the head-and-ear manifestations of Liver Yang rising with disturbed Shen
4. Liver wind manifesting as tic-pattern movements; agitated stress patterns in TCM hyperthyroid presentations (used alongside, not instead of, conventional thyroid management)^[3]
5. Disturbed Shen patterns presenting with episodes of agitation, panic or stress-driven cardiovascular irritability

Common modifications

In clinical practice Chai Hu Jia Long Gu Mu Li Tang is rarely prescribed unmodified. Common adjustments to the base formula:

• For more pronounced anxiety and panic — increase the dose of Long Gu and Mu Li; sometimes add Suan Zao Ren and He Huan Pi to deepen the Shen-calming action.
• For prominent insomnia — add Yuan Zhi, Bai Zi Ren or combine with Suan Zao Ren Tang for Liver Blood deficiency overlap.
• For palpitations with chest constriction — add Dan Shen, Yu Jin to move Blood and ease the chest.
• For perimenopausal hot flushes with anxiety — combine with Gan Mai Da Zao Tang or add Sheng Di Huang and Mai Men Dong to nourish Heart Yin.
• For irritability with menstrual cycle worsening (PMS) — consider adding Xiang Fu, Yu Jin and Bai Shao; combines well with Xiao Yao San.
• For damp-phlegm overlay (greasy tongue coat, chest oppression) — emphasise the Ban Xia, Fu Ling and consider Wen Dan Tang in alternation.
• If pregnancy is established — Da Huang must be removed; the modified formula remains useful for anxiety in early pregnancy when other patterns are excluded.

Modern research

Most of the modern literature on Chai Hu Jia Long Gu Mu Li Tang specifically is Chinese-language and Japanese-language (where it is known as Saiko-ka-Ryukotsu-Borei-To) and remains preliminary. Where the formula is described as part of the broader Xiao Yao / Bupleurum family of stress-pattern formulas, published English-language systematic reviews include:

• Anxiety — systematic review and meta-analysis of 14 RCTs (n=1,256) of Xiao Yao San reported symptom-rating-scale improvements when used as monotherapy or adjunct to anxiolytics^[1]
• Insomnia with anxiety — meta-analysis of 9 RCTs (n=681) reported reductions in Pittsburgh Sleep Quality Index and anxiety scores with Xiao Yao San as monotherapy or adjunct^[2]
• Hyperthyroidism — systematic review of 13 RCTs (n=979) reported that Jia Wei Xiao Yao San as adjunct to anti-thyroid drugs improved symptom relief and thyroid enlargement compared with anti-thyroid drugs alone^[3]
• Mechanistic studies — preclinical studies of constituents (notably saikosaponins from Chai Hu) have reported effects on stress-response signalling, consistent with the formula's traditional use in stress patterns

Quality of CHLGMLT-specific trials varies widely and most are small-cohort. Chai Hu Jia Long Gu Mu Li Tang is used as a complementary therapy alongside conventional medical and psychological care, not as a replacement for them.

How I use it in clinic

Chai Hu Jia Long Gu Mu Li Tang is one of the formulas I most commonly reach for in my Wokingham clinic when a patient presents with the combination of stress-driven irritability, sleep-onset insomnia, palpitations or chest constriction, and easy startling. The tongue is usually wider on the sides with a sticky white or thin yellow coat; the pulse is wiry, often slightly slippery in the middle position. Modern patients with this picture frequently report long-running work stress, perimenopausal hormonal shifts, post-COVID anxiety, or stimulant overload (caffeine, late screens, poor sleep architecture).

Treatment is typically 3–6 weeks of the modified formula at granule strength, reviewed monthly. The Shen-calming effect — reduced startling, better sleep onset, less mid-night waking — usually precedes the broader irritability and chest-constriction improvements by a week or two. Where insomnia is the dominant complaint I will often combine it with cycle-phase support (in women) and Spleen-tonifying support (where digestive symptoms accompany the picture).

Frequently asked questions

What is Chai Hu Jia Long Gu Mu Li Tang used for?

It is a classical Chinese herbal formula used in TCM practice for stress-driven anxiety, palpitations, irritability and insomnia where the underlying pattern is Shao Yang disharmony with disturbed Shen. It is used as a complementary therapy alongside conventional medical care, not as a replacement.

What is the difference between Chai Hu Jia Long Gu Mu Li Tang and Xiao Chai Hu Tang?

Chai Hu Jia Long Gu Mu Li Tang is essentially Xiao Chai Hu Tang plus heavy mineral substances (Long Gu, Mu Li) and a small amount of Da Huang. The mineral additions anchor the Shen and settle the Liver Yang; Da Huang drains stuck heat through the bowel. The result is a formula that simultaneously harmonises Shao Yang, calms the Shen and drains downward.

Can I take Chai Hu Jia Long Gu Mu Li Tang during pregnancy?

The base formula contains Da Huang, which is contraindicated in pregnancy. A modified version with Da Huang removed is sometimes used for stress and anxiety in early pregnancy, but only under the supervision of a qualified RCHM-registered Chinese herbalist with experience in pregnancy prescribing.

How long does it take to work?

Patients commonly report initial improvement in sleep onset and the startle response within the first 1–2 weeks, with broader improvements in irritability, chest constriction and palpitations developing over 4–6 weeks. Individual responses vary and no individual outcome can be guaranteed.

Can I take it alongside antidepressants or anti-anxiety medication?

Many of my patients use Chai Hu Jia Long Gu Mu Li Tang alongside prescribed antidepressants, anxiolytics or beta-blockers. The formula is generally well tolerated alongside conventional medication; however, this is a decision to be made with your doctor and Chinese herbalist together, and any change to prescribed medication must always be made with the prescribing doctor.

Cautions

Use with caution in pregnancy (Da Huang) and in patients with marked Yin deficiency without constraint. Long Gu and Mu Li are best taken in granule form to ensure even extraction.

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.

References

[1] Lin Y, Cai S, Wang T, Zhuang T, Huang T, Yu X, et al. Evaluation of the Safety and Efficacy of Xiao Yao San as a Treatment for Anxiety: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2022;2022:1319592. https://doi.org/10.1155/2022/1319592. PMID: 35432568.

[2] Hu J, Teng J, Wang W, Yang N, Tian H, Zhang W, Peng X, Zhang J. Clinical efficacy and safety of traditional Chinese medicine Xiao Yao San in insomnia combined with anxiety. Medicine (Baltimore). 2021 Oct 29;100(43):e27608. https://doi.org/10.1097/MD.0000000000027608. PMID: 34713840.

[3] Liu Y, Cheng L, Yan G, Gu J, Lyu Z, Ding J. Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review. Front Endocrinol (Lausanne). 2023 Sep 18;14:1241962. https://doi.org/10.3389/fendo.2023.1241962. PMID: 37780612.