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Dampness-Draining Formulas

當歸拈痛湯 · Dāng Guī Niān Tòng Tāng

Dang Gui Nian Tong Tang

A classical formula for damp-heat bi with red swollen painful joints, especially of the lower body.

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Last reviewed August 2026

Formula CategoryDampness-Draining Formulas

Primary PatternDamp-Heat

Primary FunctionClear heat, drain damp, dispel wind, stop pain

Primary Therapeutic PrincipleClear damp-heat and dispel wind for painful bi

Main HerbsNotopterygium Root · Ginseng Root · Sophora Root · Atractylodes Rhizome · Saposhnikovia Root · Anemarrhena Rhizome · Chinese Angelica Root · White Atractylodes Rhizome · Virgate Wormwood · Scutellaria / Baikal Skullcap · Licorice Root

Classical SourceLi Dongyuan school / classical

Why This Formula?

Traditionally selected for damp-heat bi with red swollen joints, rather than compact lower damp-heat only, chronic deficient bi, or blood-stasis bi.

Overview

What Is Dang Gui Nian Tong Tang?

1. Origin Background

Dang Gui Nian Tong Tang (当归拈痛汤), or Angelica Decoction to Ease Pain, is a classical Jin-Yuan formula from Li Dongyuan’s Lan Shi Mi Cang (Secrets from the Orchid Chamber). It belongs to the category of formulas that clear Damp-Heat, dispel Wind-Damp, and relieve painful obstruction.

This formula addresses Damp-Heat Bi, especially of the lower body, in which Damp-Heat pours downward and mixes with Wind, causing sore swollen joints. Typical signs include painful, hot, or heavy aching in the legs, knees, or feet, possible sores or damp skin eruptions, a feeling of heaviness, a yellow greasy tongue coating, and a slippery rapid pulse.

Combining Qiang Huo and Fang Feng to dispel Wind-Damp from the channels, Yin Chen Hao, Huang Qin, Ku Shen, and Zhi Mu to clear Damp-Heat, Cang Zhu and Bai Zhu to dry Dampness and strengthen the Spleen, Zhu Ling and Ze Xie to leach Dampness through the urine, Ge Gen and Sheng Ma to raise the clear and vent Heat, Dang Gui to nourish and invigorate Blood so the channels can move, Ren Shen to support Qi, and Gan Cao to harmonize, Dang Gui Nian Tong Tang eases Damp-Heat joint pain while protecting the Spleen and Blood.

2. Rheumatic Arthritis

Dang Gui Nian Tong Tang is often used by practitioners to help manage rheumatic arthritis when the core issue is damp-heat mixed with wind.
Typical Symptoms: Patients usually experience swollen, painful, and hot joints that are hard to move. They might also have a fever, feel thirsty, and have a yellow, greasy coating on their tongue.
How it works: The cooling and damp-draining herbs calm the local inflammation in the joints, the wind-dispelling herbs ease the pain, and the tonifying herbs help the body bounce back.

3. Rheumatoid Arthritis

For patients dealing with rheumatoid arthritis, this formula can be a helpful complementary option if they show signs of damp-heat and wind blocking the joints.
Typical Symptoms: This includes stiff, painful, or even deformed joints that are hard to bend, often accompanied by a bitter taste in the mouth, a dry throat, dark urine, and a yellow, greasy tongue coating.
How it works: By clearing the internal damp-heat environment and stopping the wind pathogen, the formula helps to reduce joint swelling and pain, potentially helping to slow down the progression of the discomfort.

4. Gout

During an acute gout flare-up, this formula can sometimes be used as part of the treatment plan if the symptoms align with a damp-heat and wind pattern.
Typical Symptoms: Joints that are severely red, hot, swollen, and incredibly painful to move, along with signs of internal heat like a bitter taste, intense thirst, dark urine, and a yellow, greasy tongue.
How it works: The heat-clearing and dampness-resolving herbs assist the body in processing and reducing uric acid levels, while the wind-dispelling herbs help take the edge off the intense joint pain, offering relief during sudden attacks.

How It Works

Herb Composition (Sovereign / Minister / Assistant / Envoy)

1. Ruler Herbs: Qiang Huo (Notopterygium Root), Fang Feng (Saposhnikovia Root)

Qiang Huo has a strong, pungent nature. It is excellent at relieving exterior symptoms, dispelling cold, and clearing out wind and dampness. It offers strong pain relief, especially for wind-cold-dampness joint pain in the upper body.
Fang Feng excels at expelling wind, clearing dampness, and relieving muscle spasms. It works on the body's surface but also circulates through the meridians, making it a crucial herb for treating "wind" issues.
Together, these two Ruler herbs not only clear wind and dampness from the surface but also unblock the joints, allowing the pathogens to leave the body. They lead the entire formula in clearing out these negative elements.

2. Minister Herbs: Yin Chen (Capillary Artemisia), Huang Qin (Baical Skullcap Root), Zhi Mu (Anemarrhena Rhizome), Cang Zhu (Atractylodes Rhizome)

Yin Chen has a bitter profile and directs downwards. It specializes in clearing damp-heat and guiding it out through the urine, making it a key herb for jaundice-like symptoms.
Huang Qin clears heat, dries dampness, and detoxifies. It works well for various issues caused by damp-heat.
Zhi Mu clears heat, nourishes yin (cooling fluids), and moistens dryness. It supports the other herbs while preventing them from being too drying and damaging the body's natural fluids.
Cang Zhu dries dampness, strengthens the spleen, and dispels wind and cold. It’s great for dampness blocking the digestive system.
As Minister herbs, they assist the Ruler herbs in clearing and promoting the elimination of damp-heat.

3. Assistant Herbs: Dang Gui (Angelica Root), Ren Shen (Ginseng), Gan Cao (Licorice Root), Sheng Ma (Bugbane Rhizome), Ge Gen (Kudzu Root)

Dang Gui nourishes and invigorates the blood, relieves pain, and moistens the intestines. Here, it prevents the drying herbs from damaging the blood and keeps the meridians flowing smoothly to push out dampness.
Ren Shen strongly tonifies the body's core energy (qi) and supports the spleen. It boosts the body's natural defenses ("healthy qi"), helping it fight off pathogens and recover from weakness.
Gan Cao strengthens the spleen, harmonizes the other herbs, and can even reduce the harshness of certain ingredients.
Sheng Ma helps release exterior symptoms, clears heat, and raises "yang" energy. This upward lifting pushes the medicinal effects right to the affected areas.
Ge Gen relieves muscle tension, generates fluids, and helps raise clear energy to eliminate dampness.
These Assistant herbs work together to support the primary actions of the formula.

4. Guide Herbs: Ku Shen (Sophora Root), Ze Xie (Alisma Rhizome)

Ku Shen clears heat and strongly dries dampness, enhancing the overall power of the formula to completely wipe out damp-heat pathogens.
Ze Xie promotes urination and drains dampness. It acts as the Guide herb by directing the damp-heat downward and flushing it out of the body through the urine.

Symptoms Traditionally Associated

Clinical Presentation in TCM

1. Pathogenesis

Dang Gui Nian Tong Tang targets a core issue: the combination of dampness and heat accumulating and blocking the meridians.
This can happen due to external damp-heat environments or internal digestive weakness. When digestion struggles, internal "damp turbidity" builds up, stagnates, and turns into heat.
When this damp-heat settles in the meridians and joints, it blocks the smooth flow of qi and blood. This leads to symptoms like aching limbs, physical heaviness, and joint swelling.

2. Efficacy

This formula works by clearing heat, promoting urination (to drain dampness), dispelling wind, and relieving pain.
By using a synergistic mix of herbs, it clears internal damp-heat and disperses external wind from the muscles and meridians.
Once the dampness and heat are cleared and the wind is gone, the meridians naturally open up, and the pain resolves on its own.

3. Indications

It is primarily used for conditions where internal damp-heat meets external wind.
Common symptoms include: General joint and limb pain, a heavy feeling in the shoulders and back, swollen and painful legs/feet, a white and greasy or slightly yellow tongue coating, and a tight, rapid pulse.
Clinical applications: Practitioners commonly use it to help manage symptoms associated with rheumatoid arthritis, osteoarthritis, and gout, especially when presenting with joint pain, swelling, and stiffness linked to wind and damp-heat.

Formula Analysis

The Mechanism in Classical Theory

1. Clear Heat, Remove Dampness, Disperse Wind & Stop Pain

In this formula, herbs that clear heat and promote urination, like Yin Chen (Capillary Artemisia), Huang Qin (Baical Skullcap Root), Ku Shen (Sophora Root), and Ze Xie (Alisma Rhizome), are teamed up with wind-dispelling and pain-relieving herbs, such as Qiang Huo (Notopterygium Root) and Fang Feng (Saposhnikovia Root).
The Strategy: The cooling and draining herbs tackle the root cause by flushing damp-heat out of the body. Meanwhile, the wind-dispelling herbs work on the surface and in the meridians to ease the pain.
The Result: Working together, they treat both the symptoms and the root cause. By removing the damp-heat and clearing the wind, the body's qi (energy) and blood can flow smoothly again, which naturally stops the pain.

2. Balance Strengthening Healthy Qi & Eliminating Pathogenic Factors

The formula doesn't just attack the "bad guys" (pathogens); it also supports the body using tonifying herbs like Ren Shen (Ginseng), Gan Cao (Licorice Root), and Dang Gui (Angelica Root).
Ren Shen strongly boosts core energy, Gan Cao strengthens the digestion, and Dang Gui nourishes the blood.
The Strategy: Fighting off illness takes a toll on the body. By supporting the body's natural defenses (healthy qi) at the same time, the formula ensures the patient doesn't get too exhausted. Stronger healthy qi actually helps push the pathogens out faster, making the overall treatment much more effective and aiding in a smoother recovery.

3. Regulate Spleen & Stomach to Aid Digestion

Herbs like Cang Zhu (Atractylodes Rhizome) dry up dampness and strengthen the spleen, while Gan Cao (Licorice Root) boosts digestive energy. Together, they get the digestive system back on track.
The Strategy: In TCM, the spleen and stomach are the "factories" that make qi and blood. If they are working well, they can naturally process and clear out excess fluids, preventing new "dampness" from forming.
The Result: A healthy digestive system not only helps clear out existing damp-heat but also ensures the body can actually absorb and use the herbal medicine properly, making the whole formula work better.

How This Formula Compares

Clinical Comparison Table

Compare	Dang Gui Nian Tong Tang	Si Miao San	Du Huo Ji Sheng Tang	Shen Tong Zhu Yu Tang
Primary Function	Clear heat, drain damp, dispel wind, stop pain	Clear heat, dry damp, ease bi pain in the lower body	Dispel wind-damp, stop bi pain, tonify Liver and Kidney, nourish Qi and blood	Invigorate Blood, move Qi, dispel wind-damp, stop pain
Formula Category	Dampness-Draining Formulas	Dampness-Draining Formulas	Wind-Damp Dispelling Formulas	Blood-Invigorating Formulas
Typical TCM Pattern	Damp-Heat	Damp-Heat	Dampness	Blood Stasis
Main Conditions	Joint Discomfort, Low Back Pain	Joint Discomfort, Low Back Pain, Numbness in Limbs	Low Back Pain, Joint Discomfort, Numbness in Limbs	Joint Discomfort, Muscular Stiffness, Low Back Pain, Numbness in Limbs, Neck Pain
Main Herbs	Notopterygium Root · Ginseng Root · Sophora Root · Atractylodes Rhizome · Saposhnikovia Root · Anemarrhena Rhizome · Chinese Angelica Root · White Atractylodes Rhizome · Virgate Wormwood · Scutellaria / Baikal Skullcap · Licorice Root	Phellodendron Bark · Coix Seed / Job's Tears · Atractylodes Rhizome · Achyranthes Root	Pubescent Angelica Root · Taxillus / Mulberry Mistletoe · Eucommia Bark · Achyranthes Root · Asarum / Wild Ginger · Large-Leaf Gentian Root · Poria / Hoelen · Cinnamon Bark · Saposhnikovia Root · Chuanxiong Rhizome · Ginseng Root · Licorice Root · Chinese Angelica Root · White Peony Root · Prepared Rehmannia Root	Large-Leaf Gentian Root · Chuanxiong Rhizome · Peach Kernel · Safflower · Licorice Root · Notopterygium Root · Myrrh · Chinese Angelica Root · Flying Squirrel Feces · Cyperus Rhizome · Achyranthes Root · Earthworm
Classical Source	Li Dongyuan school / classical	Classical TCM formulary	Classical TCM formulary	Yi Lin Gai Cuo (Wang Qingren, Qing dynasty, 1830)

How to tell them apart

Dang Gui Nian Tong Tang, Si Miao San, Du Huo Ji Sheng Tang and Shen Tong Zhu Yu Tang address damp-heat or bi pain. Si Miao San is a compact lower-body damp-heat formula; Du Huo Ji Sheng Tang tonifies for chronic deficient bi; Shen Tong Zhu Yu Tang invigorates blood. Dang Gui Nian Tong Tang clears damp-heat and dispels wind for red swollen painful joints.

For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.

Clinical Modifications

Clinical Modifications for Dang Gui Nian Tong Tang

In clinical practice, practitioners often customize the formula based on a patient's specific needs. Here are some common adjustments:

1. For Severe Pain

If the joint pain is intense, practitioners might add Zhi Ru Xiang (Prepared Frankincense) and Zhi Mo Yao (Prepared Myrrh).
These two herbs are famous for their ability to invigorate blood circulation, break up stagnation, and unblock the meridians.
By improving local blood flow, they help effectively reduce joint pain, minimize swelling, and promote the natural healing of inflammation.

2. For Heavy Dampness

When a patient has a lot of fluid retention or a heavy feeling in their limbs, Yi Yi Ren (Coix Seed) and Fu Ling (Poria) are often added.
Yi Yi Ren is great at draining dampness and soothing the joints, while Fu Ling gently promotes urination and strengthens the digestion (spleen).
Together, they supercharge the formula's ability to flush out stubborn damp pathogens from the body.

3. For Severe Heat

If the joints are visibly red, hot to the touch, and swollen, cooling herbs like Shi Gao (Gypsum) and Zhi Mu (Anemarrhena Rhizome) can be included.
Shi Gao strongly clears heat and purges internal fire, while Zhi Mu cools the body and protects its natural fluids.
Adding these helps quickly cool down the "heat pathogen" and provides relief for fiery, painful joints.

4. For Obvious Joint Swelling

To tackle significant swelling and stiffness, Fang Ji (Stephania Root) and Mu Gua (Chaenomeles Fruit) are excellent additions.
Fang Ji excels at draining fluids to reduce puffiness, and Mu Gua is well-known for relaxing the tendons and unblocking the collaterals.
This combination helps naturally shrink swollen joints and restores better mobility and flexibility.

Modern Research

What the Science Suggests

1. Pharmacological Action Research

Modern science has explored how the ingredients in Dang Gui Nian Tong Tang work on a biological level:

Anti-inflammatory & Pain Relief: Wind-dispelling herbs like Qiang Huo (Notopterygium Root) and Fang Feng (Saposhnikovia Root) have been shown to inhibit the release of inflammatory chemicals in the body, which helps ease pain.
Antibacterial & Antiviral: The heat-clearing and damp-drying herbs, such as Yin Chen (Capillary Artemisia) and Huang Qin (Baical Skullcap Root), display natural antimicrobial properties that can help reduce inflammation caused by underlying infections.
Immune Regulation: The energy-boosting herbs, like Ren Shen (Ginseng) and Gan Cao (Licorice Root), help balance the body's immune system, making it stronger and more resilient during the healing process.

2. Clinical Efficacy Verification

Numerous clinical studies back up the traditional use of Dang Gui Nian Tong Tang for managing conditions like rheumatic arthritis, rheumatoid arthritis, and gout.
When observing patients' symptoms and lab results, researchers found that the formula can significantly reduce joint pain and swelling, improve range of motion, and lower inflammatory markers in the blood, ultimately leading to a better quality of life.

3. Dosage Form Improvement Research

To make taking this classic medicine easier and more effective, modern pharmaceutical tech is stepping in.
Beyond traditional brewed teas and modern concentrated granules, researchers are developing new formats like soft capsules and dripping pills.
These new forms are designed to be more stable, easier for the body to absorb, and much more convenient for patients to take regularly.
As a time-tested TCM formula, Dang Gui Nian Tong Tang continues to prove its value. Bridging its ancient wisdom with modern research helps us better understand and utilize it for joint and autoimmune health today.

Safety

Safety Considerations

1. Dietary Precautions

During treatment, avoid spicy, greasy, raw, cold, and other irritating foods. These may promote internal heat, burden digestion, damage spleen-stomach yang, and hinder recovery from damp-heat conditions.

2. Constitution and Special-Population Precautions

People with weak constitutions or spleen-stomach deficiency-cold should use the formula cautiously, as its bitter-cold and pungent-drying ingredients may worsen their condition. Dosage adjustments or spleen-strengthening, yang-warming herbs should be considered only under medical supervision. Pregnant women should consult a doctor and use it only when the potential benefits outweigh the risks.

Available Products

Where to Get It

Hoi Tin Dang Gui Nian Tong Tang Extract Granules

HJMEDICAL Hoi Tin Dang Gui Nian Tong Tang (Angelica Pain-Relieving Decoction) 5:1 Concentrated Granules $29.10

HJMEDICAL Hoi Tin Si Miao San (Four Marvels Decoction) 5:1 Concentrated Granules $24.93

HJMEDICAL Nong's Si Miao San (Four Marvels Powder) 5:1 Concentrated Granules $44.83

HJMEDICAL Hoi Tin Du Huo Ji Sheng Tang (Angelica & Loranthus) 5:1 Concentrated Granules $24.93

Nong's Du Huo Ji Sheng Tang Extract Granules

HJMEDICAL Nong's Du Huo Ji Sheng Tang (Angelica & Taxillus) 5:1 Concentrated Granules $56.60

FAQ

Questions About Dang Gui Nian Tong Tang

Q1: What are the actions of Dang Gui Nian Tong Tang?

Dang Gui Nian Tong Tang has the actions of draining Dampness, clearing Heat, dispersing Wind, and stopping pain. Li Dongyuan designed it so the pain of Damp-Heat Bi can be “pinched away” without leaving the Blood and Qi unprotected.

Q2: Which modern diseases is Dang Gui Nian Tong Tang suited to?

Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within Damp-Heat Bi, including hot heavy aching joints or shoulders of Damp-Heat type, some gout or swollen painful feet of this pattern, and Damp-Heat sores or heaviness of the lower legs after medical causes have been assessed.

Q3: Is Dang Gui Nian Tong Tang suitable for improving vexing, heavy joint pain with Heat signs?

For presentations of aching or burning joint pain, heaviness of the shoulders and back or swollen painful feet, a greasy slightly yellow coating, and a wiry rapid or slippery pulse — in those whose pattern differentiation confirms Damp-Heat wrestling with Wind — TCM commonly applies Dang Gui Nian Tong Tang as an adjunct. A single red-hot joint with high fever needs urgent medical evaluation.

Q4: Who should not take Dang Gui Nian Tong Tang?

Those with Cold-Damp Bi, Spleen-Yang deficiency with watery swelling, or Yin-deficiency dryness without Damp-Heat are generally not suitable. The formula is bitter, cold, and leaching. Use should be assessed by a qualified TCM physician.

Q5: Why is Dang Gui in a formula that mainly drains Damp-Heat?

Li Dongyuan held that “to treat Wind, first treat Blood; when Blood moves, Wind is extinguished,” and that bitter-cold leaching can injure Blood and Qi. Dang Gui nourishes and moves Blood so pain can leave. Ren Shen, Bai Zhu, and Gan Cao protect the Spleen. Qiang Huo and Fang Feng disperse Wind; Yin Chen, Huang Qin, Ku Shen, and Zhi Mu clear Damp-Heat; Zhu Ling and Ze Xie leach Dampness; Sheng Ma and Ge Gen raise clear Qi so turbidity can descend.

Q6: How does Dang Gui Nian Tong Tang differ from Si Miao San or San Bi Tang?

Si Miao San more simply clears Lower Jiao Damp-Heat in the knees and legs. San Bi Tang warms and tonifies for Wind-Cold-Damp Bi with deficiency. Dang Gui Nian Tong Tang is chosen when Damp-Heat and Wind produce vexing whole-body or lower-limb pain and the strategy must both drain Heat-Damp and protect Qi-Blood.

Q7: What are the main ingredients of Dang Gui Nian Tong Tang?

The classical formula includes Qiang Huo and Fang Feng to disperse Wind-Damp; Yin Chen, Huang Qin, Ku Shen, and Zhi Mu to clear Damp-Heat; Zhu Ling and Ze Xie to leach Dampness; Cang Zhu and Bai Zhu to dry Dampness and support the Spleen; Sheng Ma and Ge Gen to raise clear Qi; Dang Gui and Ren Shen to protect Blood and Qi; and Gan Cao to harmonize.

Q8: Is Dang Gui Nian Tong Tang suitable for long-term use?

No. It is a short-course formula for active Damp-Heat pain. Prolonged bitter-cold leaching injures the Spleen and Yin. Once the heat and heaviness recede, the formula should be stopped or rebuilt around a milder supporting prescription.

Q9: Can this formula help both heavy aching shoulders and swollen painful feet of the same pattern?

Yes. Damp-Heat can steam through the channels and also pour downward. The same pathogen produces vexing heaviness above and swollen hot pain below. Dispersing Wind, clearing Heat, and leaching Dampness can improve both when they share one Damp-Heat Bi pattern.

Q10: What lifestyle advice supports the use of Dang Gui Nian Tong Tang?

Reducing alcohol and sweet-greasy food, keeping the joints clean and not overheated, and seeking medical care for a single red-hot joint, high fever, or inability to walk all support correct use. Acute gout or septic arthritis is not managed with this decoction alone.

FAQ

General Questions

How do I choose the right formula?

TCM formulas are traditionally selected according to individual pattern differentiation rather than by symptom alone. If you're not sure which formula fits your presentation, take our AI Assessment below for a personalized starting point, then confirm with a qualified TCM practitioner.

What are concentrated herbal granules?

Concentrated herbal granules are made by decocting raw herbs, then extracting and concentrating the resulting liquid into a fine granule or powder form. This preserves the same active compounds as a traditional decoction while making the herbs far easier to store, measure, and prepare.

How should I take these products?

Dissolve the recommended amount of granules in hot water, stir until fully dissolved, and drink while warm — following the dosage and frequency advised by your TCM practitioner or as stated on the product packaging.

Are concentrated herbal granules equivalent to traditional decoctions?

Concentrated granules are produced from the same herbs and processed to retain their active compounds, so they are traditionally regarded as a convenient alternative to decoctions rather than a different remedy. Some practitioners note subtle differences in strength or absorption between the two forms, so your TCM practitioner may adjust dosage accordingly.

Are your products authentic?

Yes. HJMEDICAL sources its concentrated granules exclusively from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry, with GMP compliance stated directly on their packaging.

Are HJMEDICAL products manufactured under GMP standards?

HJMEDICAL sources its concentrated granules from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry. GMP compliance for these products is stated directly on their packaging.

Do you ship internationally?

Yes — we ship worldwide! Every order goes out via Hong Kong Post, and your exact shipping cost and estimated delivery time for your address are calculated and shown right at checkout, so there are never any surprises. We also offer free shipping once your order reaches our free-shipping threshold, so it's easy to stock up on your favorite formulas and save.

Can I take more than one formula at the same time?

Some formulas are traditionally combined, while others overlap or counteract each other. We recommend checking with a qualified TCM practitioner before combining formulas, especially if you are already taking other medication.

Are these products suitable during pregnancy or breastfeeding?

Some TCM formulas are not suitable during pregnancy or breastfeeding. Please consult a qualified TCM practitioner or your doctor before use if you are pregnant, trying to conceive, or nursing.

Do these products replace medical treatment?

No. These products are traditional herbal supplements intended to support wellbeing according to TCM principles — they are not a replacement for professional medical diagnosis or treatment. Please consult a qualified TCM practitioner or licensed healthcare provider before starting, stopping, or combining any treatment, especially if you have a chronic condition.

Medical Disclaimer

For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.

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