Dang Gui Nian Tong Tang (当归拈痛汤) — Tangkuei to Pinch the Pain Decoction
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Overview
Dang Gui Nian Tong Tang — the “Tangkuei to Pinch the Pain Decoction” — is from Li Dong-yuan’s Jin-Yuan-dynasty Yi Xue Fa Ming. It treats Damp-Heat painful obstruction (Bi) with Wind: severe inflammatory joint pain with prominent Damp-Heat signs (warmth, swelling) often combined with skin involvement (hot itchy lesions, weeping eczema with joint pain). Particularly used for acute gout flare, acute rheumatoid arthritis[14] flare and acute reactive arthritis. The combination of Qiang Huo and Fang Feng (Wind-Damp expellers) with Yin Chen Hao and Huang Qin (Damp-Heat clearers) and Dang Gui (move Blood, relieve pain) addresses all three pathological factors.
I prescribe Dang Gui Nian Tong Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.
TCM pattern
Dang Gui Nian Tong Tang is prescribed for Wind-Damp-Heat Bi syndrome:
- Hot, red, swollen joint pain
- Severe pain that may shift between joints (Wind)
- Heavy-bodied feeling, fatigue[9]
- Hot itchy skin lesions, possibly weeping
- Dark urine, bitter taste
- Tongue — red with yellow-greasy coat
- Pulse — slippery, rapid, possibly wiry
Key herbs
- Dang Gui (Rx. Angelicae Sinensis, 6–9g) — moves Blood; relieves pain
- Qiang Huo (Rz. Notopterygii, 6–9g) — expels Wind-Damp from the upper body and joints
- Fang Feng (Rx. Saposhnikoviae, 6–9g) — releases Wind; relieves itching
- Yin Chen Hao (Hb. Artemisiae Scopariae, 6–9g) — clears Damp-Heat strongly
- Huang Qin (Rx. Scutellariae, 6–9g) — clears Damp-Heat from upper burner
- Ku Shen (Rx. Sophorae Flavescentis, 6–9g) — clears Damp-Heat; relieves itching
- Cang Zhu (Rz. Atractylodis, 6–9g), Bai Zhu (Rz. Atractylodis Macrocephalae, 6–9g) — dry Damp
- Zhu Ling (Polyporus, 6–9g), Ze Xie (Rz. Alismatis, 6–9g) — drain Damp through urination
- Zhi Mu (Rx. Anemarrhenae, 6–9g) — clears Heat; nourishes Yin
- Ren Shen (Rx. Ginseng, 3–6g) — tonifies Qi
- Sheng Ma (Rz. Cimicifugae, 3–6g), Ge Gen (Rx. Puerariae, 6–9g) — release the exterior; lift the Yang
- Gan Cao (Rx. Glycyrrhizae, 3–6g) — harmonises and resolves toxin
Formula actions
- Expels Wind-Damp from the channels
- Clears Damp-Heat
- Moves Blood and relieves severe joint pain
- Resolves Damp-Heat skin manifestations
Conditions treated
- Acute gout flare with severe red hot swollen joint pain
- Acute rheumatoid arthritis flare with prominent Damp-Heat
- Acute reactive arthritis
- Septic arthritis recovery phase (alongside conventional care)
- Acute eczema flare with joint pain
- Psoriatic arthritis flare with Damp-Heat
- Behçet’s disease with joint and skin manifestations
Cautions
Not appropriate for cold or deficient Bi syndromes — the cold draining herbs would aggravate cold patterns.
Acute severe joint pain with high fever requires medical assessment to exclude septic arthritis.
Always consult a qualified Chinese herbalist registered with the RCHM.
Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.
References
[9] Wang YY, Li XX, Liu JP, Luo H, Ma LX, Alraek T. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014 Aug;22(4):826-33. https://doi.org/10.1016/j.ctim.2014.06.004. PMID: 25146086.
[14] Han R, Ren HC, Zhou S, Gu S, Gu YY, Sze DM, Chen MH. Conventional disease-modifying anti-rheumatic drugs combined with Chinese Herbal Medicines for rheumatoid arthritis: A systematic review and meta-analysis. J Tradit Complement Med. 2022 Jan 26;12(5):437-446. https://doi.org/10.1016/j.jtcme.2022.01.005. PMID: 36081815.
