Zhen Gan Xi Feng Tang (镇肝熄风汤) — Sedate the Liver and Extinguish Wind

Zhen Gan Xi Feng Tang is a classical Chinese herbal formula used primarily for hypertension^[19] with liver yang rising pattern. It is prescribed for Liver and Kidney Yin deficiency with Liver Yang rising and stirring of internal Wind, characterised by: dizziness^[22] or vertigo, distending headache, blurred vision, tinnitus, flushed face, irritability, palpitations, sensation of internal Heat, occasional numbness of the extremities or facial twitching, a red tongue and a wiry, long pulse. Often seen in hypertension, particularly with prodromal stroke^[18] symptoms.

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions
7. Frequently asked questions

What is Zhen Gan Xi Feng Tang?

Zhen Gan Xi Feng Tang (“Sedate the Liver and Extinguish Wind Decoction”) is a relatively modern Chinese herbal formula devised by Zhang Xichun in the early 20th century. It targets the dangerous TCM pattern of Liver Yang rising with internal Wind — the pattern most associated in modern medicine with hypertension, hypertensive crises and the prodromal symptoms of cerebrovascular accident (stroke). The formula sedates rising Yang, extinguishes Wind, and nourishes Liver and Kidney Yin to address the underlying deficiency.

Zhen Gan Xi Feng Tang TCM pattern

Prescribed for Liver and Kidney Yin deficiency with Liver Yang rising and stirring of internal Wind, characterised by: dizziness or vertigo, distending headache, blurred vision, tinnitus, flushed face, irritability, palpitations, sensation of internal Heat, occasional numbness of the extremities or facial twitching, a red tongue and a wiry, long pulse. Often seen in hypertension, particularly with prodromal stroke symptoms.

Key herbs

1. Huai Niu Xi — directs the formula downward; nourishes Liver and Kidney
2. Dai Zhe Shi (haematite) — mineral; subdues rising Yang
3. Long Gu (dragon bone) — subdues rising Yang and calms the Shen
4. Mu Li (oyster shell) — subdues rising Yang, nourishes Yin
5. Bai Shao (Rx. Paeoniae Alba, 400g) — nourishes Liver Yin and softens the Liver
6. Gui Ban (tortoise plastron) — anchors Yang, nourishes Yin
7. Xuan Shen — nourishes Yin, clears Heat
8. Tian Men Dong — nourishes Yin
9. Chuan Lian Zi, Mai Ya, Yin Chen — small additions to smooth Liver Qi (prevent the heavy sedating herbs from causing stagnation)
10. Gan Cao — harmonises

Formula actions

1. Sedates the Liver and subdues rising Yang
2. Extinguishes internal Wind
3. Nourishes Liver and Kidney Yin

Conditions treated

1. Hypertension with Liver Yang rising pattern
2. Hypertensive headache and prodromal stroke symptoms
3. Vertigo and dizziness from Liver Yang
4. Recovery support after transient ischaemic attack (TIA) or stroke
5. Tinnitus and hearing changes from Yang rising
6. Some forms of essential tremor (Wind aspect)
7. Hypertensive nephrosclerosis

Cautions

Not a substitute for conventional blood pressure management — used alongside medical care, not instead. Stop and seek emergency care for sudden severe headache, vision changes, hemiparesis or speech difficulty — possible stroke. Contraindicated in pregnancy. Always consult a qualified Chinese herbalist registered with the RCHM. Online herbal consultations are available.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door.

Frequently asked questions about Zhen Gan Xi Feng Tang

What is Zhen Gan Xi Feng Tang used for?

Zhen Gan Xi Feng Tang is used for hypertension with liver yang rising pattern, hypertensive headache and prodromal stroke symptoms, vertigo and dizziness from liver yang, recovery support after transient ischaemic attack (tia) or stroke, tinnitus and hearing changes from yang rising. The formula targets the underlying TCM pattern producing these symptoms rather than the symptom in isolation, which is why pattern diagnosis by a qualified herbalist is essential.

How does Zhen Gan Xi Feng Tang work?

Zhen Gan Xi Feng Tang works through the combined action of its constituent herbs, each targeting a different aspect of the underlying TCM pattern.

How long does Zhen Gan Xi Feng Tang take to work?

For most patients, an improvement is typically noticed within 2–4 weeks of daily granule treatment. Full benefit usually requires 6–12 weeks, depending on how long-standing the underlying pattern is. Zhen Gan Xi Feng Tang is typically prescribed as part of an individualised treatment plan that may include other herbs or adjustments over time.

Is Zhen Gan Xi Feng Tang safe in pregnancy?

Contraindicated in pregnancy. As with any Chinese herbal formula, prescription in pregnancy should only be by a qualified RCHM herbalist with pregnancy training.

Who should not take Zhen Gan Xi Feng Tang?

Not a substitute for conventional blood pressure management — used alongside medical care, not instead. Stop and seek emergency care for sudden severe headache, vision changes, hemiparesis or speech difficulty — possible stroke. Contraindicated in pregnancy. Always consult a qualified Chinese herbalist registered with the RCHM. Online herbal consultations are available. Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door. Zhen Gan Xi Feng Tang must be prescribed only after full pattern diagnosis by a qualified RCHM herbalist; self-prescription is not appropriate.

References

[18] Shi YH, Wang Y, Fu H, Xu Z, Zeng H, Zheng GQ. Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis. Medicine (Baltimore). 2017 Dec;96(49):e9214. https://doi.org/10.1097/MD.0000000000009214. PMID: 29245245.

[19] Wang J, Xiong X, Liu W. Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:706125. https://doi.org/10.1155/2013/706125. PMID: 23710230.

[22] Guo Z, Su Z, Wang Z, Luo X, Lai R. The effect of Chinese herbal medicine Banxia Baizhu Tianma Decoction for the treatment of vertebrobasilar insufficiency vertigo: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2017 Apr;31:27-38. https://doi.org/10.1016/j.ctim.2017.01.004. PMID: 28434468.