Du Huo Ji Sheng Tang (独活寄生汤), known in English as Angelica Pubescens and Taxillus Decoction, is a classical TCM formula by Sun Si-miao for treating Wind-Cold-Damp Bi syndrome (painful obstruction) with underlying Liver and Kidney deficiency. It is particularly indicated for chronic lower back and leg pain, joint pain, stiffness, and weakness, especially in elderly or deficient patients with cold and damp signs. In modern clinical practice, Du Huo Ji Sheng Tang is widely used for chronic arthritis, sciatica, and lower back pain with deficiency when there is both pathogenic invasion (Wind-Cold-Damp) and root deficiency (Liver and Kidney). By simultaneously expelling the pathogenic factors causing pain while strengthening the deficient Liver and Kidney, it provides effective relief for chronic pain conditions in deficient patients.

I. Origins and History

1. Recorded in the Classical Literature

Duhuo Jisheng Tang originates from the *Beiji Qianjin Yaofang* (Essential Prescriptions for Urgent Need Worth a Thousand Gold), written by the Tang dynasty physician Sun Simiao. This medical classic is regarded as a brilliant gem in the treasury of Chinese medicine, containing numerous practical formulas and medical theories. Duhuo Jisheng Tang first appears in Volume 8 of the *Beiji Qianjin Yaofang*, in the chapter "Formulas for Treating Wind-Toxin Leg Weakness." The text records in detail the formula's herb composition, combination method, and indications, providing an important basis for later generations of physicians applying this formula to treat various diseases.

2. Historical Evolution

Since the Tang dynasty, Duhuo Jisheng Tang has continuously been applied and developed in clinical practice. As times changed, physicians, while inheriting the original formula, made appropriate adjustments and additions according to different conditions and clinical experience. For example, in the proportioning of herb dosages, different physicians applied more flexible approaches according to factors such as the patient's constitution and the severity of the condition. In terms of indications, beyond the original target of wind-toxin leg weakness, its application gradually expanded to treating a variety of conditions such as joint pain and soreness and weakness of the lower back and knees caused by liver-kidney deficiency, qi-blood insufficiency, and wind-cold-damp bi obstruction; its scope of application has continually broadened, and its efficacy has been further verified and recognised, making it one of the classical formulas in Chinese medicine for treating such conditions, enduring for a thousand years without decline.

II. Herb Composition (Sovereign, Minister, Assistant, Envoy)

1. Chief Herb — Duhuo

Duhuo (Angelica pubescens Root) is acrid and bitter in flavour, slightly warm in nature, and enters the kidney and bladder channels. Its acrid, dispersing, bitter, drying quality and fragrant, warming, unblocking qi make it excellent at dispelling wind, eliminating dampness, unblocking bi obstruction, and relieving pain. In Duhuo Jisheng Tang, Duhuo serves as the chief herb, bearing the important responsibility of dispelling wind, dispersing cold, overcoming dampness, and relieving pain. It can penetrate deeply into the sinews, bones, and joints, seeking out and clearing wind pathogens, and has a distinctive therapeutic effect for pain in the lower back and knees and difficulty bending and extending the limbs and joints caused by wind-cold-damp pathogens obstructing the channels. As the *Bencao Zhengyi* (Correct Meaning of the Materia Medica) states: Duhuo's qi and flavour are fierce and vigorous, its fragrance spreading in all directions, and so it can freely open the hundred vessels, harmonise the channels, unblock the sinews and bones, and benefit the joints — for all manner of migratory joint pain, wind-bi, atrophy and weakness of the legs, and leg qi, there is none that it does not effectively treat.

2. Deputy Herbs — Sangjisheng, Duzhong, and Niuxi

Sangjisheng (Taxillus Stem) is sweet and bitter in flavour, neutral in nature, and enters the liver and kidney channels. It has the actions of tonifying the liver and kidney, strengthening the sinews and bones, and dispelling wind-dampness. It both assists Duhuo in dispelling wind and eliminating dampness, and tonifies the liver and kidney, so that pathogens are expelled without damaging righteous qi. Duzhong (Eucommia Bark) is sweet in flavour, warm in nature, and enters the liver and kidney channels; it has the action of tonifying the liver and kidney and strengthening the sinews and bones, strengthening the formula's power to tonify the liver and kidney. Niuxi (Achyranthes Root) is bitter, sweet, and sour in flavour, neutral in nature, and enters the liver and kidney channels; it expels stasis and unblocks the menses, tonifies the liver and kidney, strengthens the sinews and bones, and directs blood downward. These three herbs together assist Duhuo, strengthening the formula's action of tonifying the liver and kidney, strengthening the sinews and bones, and dispelling wind-dampness, and are the deputy herbs in the formula. Working together, they play a key therapeutic role in targeting the pathomechanism of liver-kidney insufficiency with wind-damp bi obstruction.

3. Assistant Herbs — Xixin, Qinjiao, Fuling, Rougui Xin, and Fangfeng

Xixin (Asarum) is acrid in flavour, warm in nature, and enters the heart, lung, and kidney channels; it has the actions of dispelling wind, dispersing cold, opening the orifices, relieving pain, and warming the lung to resolve fluid retention. It strengthens Duhuo's power to dispel wind and disperse cold, and can also relieve pain. Qinjiao (Large-Leaf Gentian Root) is acrid and bitter in flavour, neutral in nature, and enters the stomach, liver, and gallbladder channels; it excels at dispelling wind-dampness, relaxing the sinews and channels, and clearing deficiency heat. Fuling (Poria) is sweet and bland in flavour, neutral in nature, and enters the heart, lung, spleen, and kidney channels; it promotes urination and drains dampness, strengthens the spleen, and calms the heart, able to eliminate damp pathogens while also strengthening the spleen to aid in the transportation of water-dampness. Rougui Xin (Cinnamon Bark, inner layer) is acrid and sweet in flavour, intensely hot in nature, and enters the kidney, spleen, heart, and liver channels; it tonifies fire and assists yang, disperses cold and relieves pain, and warms and unblocks the channels, assisting the chief herb Duhuo in strengthening the action of warming and unblocking the channels and dispersing cold to relieve pain. Fangfeng (Siler Root) is acrid and sweet in flavour, slightly warm in nature, and enters the bladder, liver, and spleen channels; it dispels wind, releases the exterior, overcomes dampness, relieves pain, and stops spasms, working synergistically with Duhuo and the other herbs to dispel wind and eliminate dampness. These five herbs play an assisting and moderating role in the formula, assisting the chief herb in strengthening the power to expel pathogens, while moderating the other herbs to prevent excessive warming dryness or cloying richness, allowing the formula to expel pathogens without damaging righteous qi, and support righteous qi without retaining pathogens.

4. Envoy Herbs — Renshen, Gancao, Danggui, Shaoyao, and Gandihuang

Renshen (Ginseng) is sweet and slightly bitter in flavour, slightly warm in nature, and enters the spleen, lung, heart, and kidney channels; it greatly tonifies original qi, restores the pulse and stems collapse, tonifies the spleen and benefits the lung, generates fluids and nourishes blood, and calms the spirit and sharpens the intellect. Gancao (Licorice) is sweet in flavour, neutral in nature, and enters the heart, lung, spleen, and stomach channels; it tonifies the spleen and boosts qi, moistens the lung to stop coughing, clears heat and resolves toxicity, and harmonises the actions of the other herbs. Danggui (Angelica Root) is sweet and acrid in flavour, warm in nature, and enters the liver, heart, and spleen channels; it tonifies and activates blood, regulates menstruation and relieves pain, and moistens the intestines to unblock bowel movements. Shaoyao (Peony Root) is bitter and sour in flavour, slightly cold in nature, and enters the liver and spleen channels; it nourishes blood and regulates menstruation, astringes yin to stop sweating, softens the liver to relieve pain, and calms hyperactive liver yang. Gandihuang (Dried Rehmannia Root) is sweet and bitter in flavour, cold in nature, and enters the heart, liver, and kidney channels; it has the action of nourishing yin, tonifying blood, and enriching essence and marrow. These five herbs together serve as envoy herbs, with the action of nourishing qi and blood. On the one hand, they harmonise the actions of the other herbs in the formula, allowing them to work together synergistically for better therapeutic effect; on the other hand, by nourishing qi and blood, they support righteous qi and stabilise the root, ensuring righteous qi is sufficient to help expel pathogens, while also preventing the pathogen-expelling herbs from excessively damaging righteous qi — embodying the treatment principle of supporting righteous qi while expelling pathogens.

III. Pathomechanism, Actions, and Indications

1. Pathomechanism

The pathomechanism targeted by Duhuo Jisheng Tang is mainly liver-kidney insufficiency, qi-blood deficiency, and wind-cold-damp pathogens obstructing the channels. The liver and kidney are important organs of the body — the liver stores blood, and the kidney stores essence; when the liver and kidney are deficient, essence and blood become insufficient, and the sinews and bones lose nourishment. Qi and blood are the important material foundation of the body's life activities; when qi and blood are insufficient, the limbs and body lose nourishment. Wind-cold-damp pathogens take advantage of this weakness to invade, obstructing the channels and joints, causing sluggish movement of qi and blood, and giving rise to symptoms such as pain in the lower back and knees and difficulty bending and extending the limbs and joints. As the *Suwen: Bi Lun* (Basic Questions: Treatise on Bi Syndrome) states: when wind, cold, and dampness arrive together, they combine to form bi syndrome — where wind predominates, it is migratory bi; where cold predominates, it is painful bi; where dampness predominates, it is fixed bi. Duhuo Jisheng Tang addresses precisely this pathomechanism, achieving the goal of treating both the branch and the root through tonifying the liver and kidney, boosting qi and blood, dispelling wind-dampness, and unblocking the channels.

2. Actions

Duhuo Jisheng Tang has the actions of dispelling wind-dampness, relieving bi pain, benefiting the liver and kidney, and tonifying qi and blood. In the formula, wind-dampness-dispelling herbs such as Duhuo, Xixin, Qinjiao, and Fangfeng effectively dispel wind-cold-damp pathogens and relieve joint pain; Sangjisheng, Duzhong, and Niuxi tonify the liver and kidney and strengthen the sinews and bones, enhancing the body's strength; Renshen, Gancao, Danggui, Shaoyao, and Gandihuang nourish qi and blood, ensuring qi and blood are sufficient to nourish the organs and channels; Fuling strengthens the spleen and drains dampness, while Rougui Xin warms and unblocks the channels, together regulating the body and supporting righteous qi while expelling pathogens. The whole formula's combination is exquisitely crafted, dispelling wind-dampness without damaging righteous qi, and tonifying the liver, kidney, qi, and blood without retaining pathogens, achieving the effect of treating both the branch and the root together.

3. Indications

Duhuo Jisheng Tang mainly treats the pattern of long-standing bi syndrome with liver-kidney insufficiency and qi-blood deficiency. Symptoms include pain in the lower back and knees, difficulty bending and extending the limbs and joints, or numbness, aversion to cold with a preference for warmth, palpitations and shortness of breath, a pale tongue with a white coating, and a thin, weak pulse. Clinically, it is commonly used to treat rheumatoid arthritis, osteoarthritis, sciatica, and lumbar disc herniation attributable to liver-kidney deficiency with wind-cold-damp bi obstruction. For patients who have suffered prolonged exposure to wind-cold-damp pathogens, resulting in joint pain and restricted movement, accompanied by symptoms of liver-kidney and qi-blood insufficiency such as soreness and weakness of the lower back and knees, dizziness, and a lacklustre complexion, Duhuo Jisheng Tang often provides good therapeutic effect.

IV. Formula Analysis

1. Equal Emphasis on Dispelling Wind-Dampness and Tonifying the Liver, Kidney, Qi, and Blood

In the formula, wind-dampness-dispelling herbs such as Duhuo, Xixin, Qinjiao, and Fangfeng work together with liver-kidney-tonifying herbs such as Sangjisheng, Duzhong, and Niuxi, embodying the characteristic of placing equal emphasis on dispelling wind-dampness and tonifying the liver and kidney. The wind-dampness-dispelling herbs rapidly expel wind-cold-damp pathogens and relieve pain symptoms; the liver-kidney-tonifying herbs address the root of liver-kidney insufficiency, strengthening the body's resistance and preventing recurrence of the condition. At the same time, qi-blood-nourishing herbs such as Renshen, Gancao, Danggui, Shaoyao, and Gandihuang provide the body with sufficient nourishment, allowing qi and blood to become abundant, helping to expel pathogens, while also nourishing the liver and kidney and further consolidating the therapeutic effect. This combined approach of expelling pathogens and supporting righteous qi accords with the Chinese medicine principle of "treating disease by addressing the root," and provides good therapeutic effect for long-standing bi syndrome with a mixture of deficiency and excess.

2. Synergistic Enhancement Through Herb Combination

The herbs in Duhuo Jisheng Tang are rigorously combined to enhance each other synergistically. Duhuo combined with wind-dispelling herbs such as Xixin, Qinjiao, and Fangfeng strengthens the actions of dispelling wind, dispersing cold, eliminating dampness, and relieving pain; Sangjisheng, Duzhong, and Niuxi combined with the liver-kidney-tonifying, qi-blood-nourishing herbs make the actions of tonifying the liver and kidney, strengthening the sinews and bones, and nourishing qi and blood more pronounced. Fuling, combined with the other herbs, both eliminates the damp pathogen and strengthens the spleen to aid transportation, preventing the tonifying herbs from being too cloying and obstructing the stomach. Rougui Xin warms and unblocks the channels, working synergistically with the wind-dampness-dispelling and tonifying herbs, allowing qi and blood to move smoothly and the channels to be unblocked. The various herbs complement one another, working together to exert the comprehensive actions of dispelling wind-dampness, relieving bi pain, benefiting the liver and kidney, and tonifying qi and blood, embodying the exquisite craft of Chinese medicine formula combination.

V. Comparison with Related Formulas

1. Comparison with Qianghuo Shengshi Tang

Qianghuo Shengshi Tang originates from the *Neiwaishang Bianhuo Lun* (Discrimination on the Damage of Internal and External Diseases), mainly composed of Qianghuo (Notopterygium Rhizome), Duhuo, Gaoben (Ligusticum Rhizome), Fangfeng, Gancao, Chuanxiong (Szechuan Lovage Rhizome), and Manjingzi (Vitex Fruit). Both formulas have the action of dispelling wind-dampness and can be used to treat wind-damp bi syndrome. However, Qianghuo Shengshi Tang uses Qianghuo and Duhuo as chief herbs, emphasising dispelling wind and overcoming dampness, and mainly treats bi syndrome with wind-dampness at the exterior, presenting mainly with heavy, aching pain in the head and body, and shoulder and back pain. Duhuo Jisheng Tang, besides dispelling wind-dampness, places greater emphasis on tonifying the liver and kidney and nourishing qi and blood, mainly treating long-standing bi syndrome with liver-kidney insufficiency and qi-blood deficiency, presenting not only with limb and joint pain but also accompanied by symptoms such as soreness and weakness of the lower back and knees, and palpitations with shortness of breath.

2. Comparison with Juanbi Tang

Juanbi Tang originates from the *Yangshi Jiacang Fang* (Prescriptions from the Yang Family Collection), composed of Qianghuo, Duhuo, Danggui, Chuanxiong, Huangqi (Astragalus Root), Fangfeng, Sangjisheng, Qinjiao, Guizhi (Cinnamon Twig), and Gancao. Juanbi Tang also has the actions of dispelling wind-dampness, nourishing qi and blood, and unblocking the channels to relieve pain. Compared with Duhuo Jisheng Tang, Juanbi Tang has a stronger action for dispelling wind-dampness and places greater emphasis on unblocking the channels to relieve pain, making it suitable for conditions with more severe wind-cold-damp obstruction of the channels and more intense pain. Duhuo Jisheng Tang, building on dispelling wind-dampness, places greater emphasis on tonifying the liver and kidney and nourishing qi and blood, making it more suitable for bi syndrome of longer duration with more pronounced liver-kidney and qi-blood deficiency.

VI. Clinical Applications

1. Rheumatoid Arthritis (Rheumatic Type)

Rheumatic joint disease is often caused by wind-cold-damp pathogens invading the joints, commonly presenting with joint pain, swelling, and difficulty bending and extending, and may be accompanied by symptoms such as fever and sore throat. Duhuo Jisheng Tang can dispel wind-dampness and unblock the channels to relieve pain, while also tonifying the liver and kidney and nourishing qi and blood, strengthening the body's resistance, and provides good therapeutic effect for cases attributable to liver-kidney deficiency with wind-cold-damp bi. In clinical application, herbs may be added or removed appropriately according to the patient's specific symptoms — for example, for more severe pain, Zhi Chuanwu and Zhi Caowu may be added to strengthen the pain-relieving action; for pronounced joint swelling, Yiyiren (Job's Tears) and Fangji (Stephania Root) may be added to promote urination and reduce swelling.

2. Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, progressive, invasive autoimmune disease, presenting mainly with joint pain, deformity, and functional impairment. Duhuo Jisheng Tang has a certain therapeutic effect for the remission phase of rheumatoid arthritis, where liver-kidney insufficiency, qi-blood deficiency, and residual wind-cold-damp pathogens are present. By tonifying the liver and kidney, nourishing qi and blood, and dispelling wind-dampness, it can improve symptoms such as joint pain and stiffness, and slow disease progression. In application, it may be combined with Western anti-rheumatic medication to improve therapeutic outcomes. At the same time, the dosage and combination of herbs in the formula may be adjusted according to the patient's constitution and condition — for example, in those with a weaker constitution, the dosage of qi-tonifying herbs such as Renshen and Huangqi may be appropriately increased.

3. Sciatica

Sciatica is often caused by compression of the sciatic nerve or invasion by wind-cold-damp pathogens, presenting as pain distributed along the sciatic nerve, which may be accompanied by symptoms such as numbness and weakness of the lower limb. Duhuo Jisheng Tang can dispel wind-dampness, unblock the channels, and tonify the liver and kidney, providing good therapeutic effect for sciatica attributable to liver-kidney deficiency with wind-cold-damp bi. In clinical application, herbs may be adjusted according to the location and severity of the pain — for example, for pain mainly in the buttock and the back of the lower limb, Niuxi and Mugua (Chaenomeles Fruit) may be added to strengthen the action of unblocking the lower limb channels; for pronounced numbness of the lower limb, Quanxie (Scorpion) and Wugong (Centipede) may be added to unblock the channels and relieve pain.

4. Lumbar Disc Herniation

Lumbar disc herniation is often caused by degeneration or injury of the lumbar intervertebral disc, resulting in protrusion of the nucleus pulposus, which compresses surrounding nerve tissue, causing lower back pain and radiating pain and numbness in the lower limbs. Duhuo Jisheng Tang, through tonifying the liver and kidney, strengthening the sinews and bones, dispelling wind-dampness, and unblocking the channels, can relieve the pain and discomfort caused by lumbar disc herniation and improve lower back and lower limb function. In application, it may be combined with physical therapy methods such as traction and massage, according to the patient's specific circumstances, to improve treatment outcomes. Patients should also be advised to rest adequately and avoid excessive strain and cold exposure to the lower back.

VII. Clinical Modifications

1. Pronounced Pain

Zhi Chuanwu (prepared Aconitum carmichaelii), Zhi Caowu (prepared Aconitum kusnezoffii), Ruxiang (Frankincense), and Moyao (Myrrh) may be added to strengthen the pain-relieving action. Zhi Chuanwu and Zhi Caowu are warm in nature, with a strong action of dispelling wind-dampness and dispersing cold to relieve pain; Ruxiang and Moyao can activate blood, relieve pain, reduce swelling, and promote tissue regeneration. Adding these herbs to Duhuo Jisheng Tang can effectively relieve joint pain symptoms, but their toxicity must be noted when using them, and dosage strictly controlled to avoid toxicity.

2. Pronounced Joint Swelling

Yiyiren (Job's Tears), Fangji (Stephania Root), and Zexie (Alisma Rhizome) may be added to promote urination and reduce swelling. Yiyiren promotes urination and drains dampness, strengthens the spleen and stops diarrhoea, eliminates bi obstruction, and expels pus; Fangji promotes urination and reduces swelling, dispelling wind and relieving pain; Zexie promotes urination, drains dampness, and drains heat. They can promote the resolution of local joint oedema, reduce joint swelling, and improve joint function.

3. Numbness

Quanxie (Scorpion), Wugong (Centipede), and Dilong (Earthworm) may be added to unblock the channels, relieve pain, dispel wind, and stop spasms. Quanxie, Wugong, and Dilong all have a strong channel-unblocking action, able to effectively improve numbness of the limbs. Quanxie extinguishes wind and stops spasms, unblocks the channels and relieves pain, and attacks toxin to disperse nodules; Wugong extinguishes wind and stops spasms, unblocks the channels and relieves pain, and attacks toxin to disperse nodules; Dilong clears heat and settles fright, unblocks the channels, calms wheezing, and promotes urination. When using these herbs, they should be combined rationally and used cautiously according to the patient's condition and constitution.

4. Pronounced Qi-Blood Deficiency

The dosages of Renshen, Huangqi (Astragalus Root), and Danggui may be increased to strengthen the action of tonifying qi and blood. Renshen greatly tonifies original qi, restores the pulse and stems collapse, tonifies the spleen and benefits the lung, generates fluids and nourishes blood, and calms the spirit and sharpens the intellect; Huangqi tonifies qi and raises yang, consolidates the exterior and stops sweating, promotes urination and reduces swelling, generates fluids and nourishes blood, moves stagnation and unblocks obstruction, expels toxin and drains pus, and promotes tissue regeneration to heal sores; Danggui tonifies and activates blood, regulates menstruation and relieves pain, and moistens the intestines to unblock bowel movements. Increasing the dosage of these herbs ensures qi and blood are sufficient, better nourishing the organs, channels, sinews, bones, and joints, and promoting recovery.

VIII. Dosage and Preparation (Traditional Method and Modern Concentrated Granules)

1. Traditional Preparation Method

The traditional method for Duhuo Jisheng Tang involves decocting the herb slices in water. Generally: Duhuo, 3 liang (9g); Sangjisheng, Duzhong, Niuxi, Xixin, Qinjiao, Fuling, Rougui Xin, and Fangfeng, 2 liang each (6g each); Renshen, Gancao, Danggui, Shaoyao, and Gandihuang, 2 liang each (6g each). The above herbs are washed and placed in a clay pot with an appropriate amount of water, soaked for around 30 minutes, then brought to a boil over high heat and simmered over a low flame for 30–40 minutes; the liquid is strained off. A second decoction is then made with added water, for a somewhat shorter time of around 20–30 minutes, and the liquid strained off. The two decoctions are combined and taken in two divided doses, one dose per day.

2. Modern Concentrated Granules

With the development of modern pharmaceutical technology, a modern concentrated granule form of Duhuo Jisheng Tang is also available. When using, simply dissolve in water according to the dosage specified on the product label. Generally, the dosage for Duhuo Jisheng Tang concentrated granules is adjusted somewhat relative to the traditional herb slices, to ensure the content of active constituents and efficacy. Specific dosages may vary slightly between products from different manufacturers, but overall this form is convenient for patients to take, particularly suiting the fast pace of modern life. Patients need only dissolve the granules in an appropriate amount of boiled water, one dose per day, taken in two divided doses, avoiding the laborious process of traditional decoction, while also ensuring the stability and efficacy of the herbs.

IX. Precautions and Contraindications

1. Herb Combination Contraindications

Duhuo Jisheng Tang contains Xixin, which should not be used together with Lilu (Veratrum), as Lilu counteracts Xixin; using the two together may produce adverse reactions, affecting efficacy or even endangering life. At the same time, the formula contains Gancao, which should not be used together with Haizao (Sargassum), Daji (Euphorbia Root), Gansui (Kansui Root), or Yuanhua (Genkwa Flower) — the so-called "eighteen incompatibilities" — to avoid drug interactions leading to increased toxicity or reduced efficacy.

2. Dietary Precautions

While taking Duhuo Jisheng Tang, raw, cold, greasy, and spicy irritating foods should be avoided. Raw and cold foods, such as cold drinks and raw fish, readily damage spleen-stomach yang qi and affect spleen-stomach transportation and transformation function, which is unfavourable for the absorption and efficacy of the herbs; greasy foods, such as fried foods and fatty meat, are difficult to digest and increase the burden on the spleen and stomach; spicy foods, such as chili peppers and Sichuan peppercorns, readily foster fire and generate heat, potentially worsening the condition or causing adverse reactions. Smoking and alcohol should also be avoided, and a light diet maintained, to help the herbs take fuller effect.

3. Precautions for Special Populations

Use Duhuo Jisheng Tang with caution in pregnancy. Although most of the herbs in the formula have a certain tonifying and regulating action, some herbs such as Rougui Xin have a warming, heating nature that may affect the fetus. In elderly individuals with a weak constitution, or those with spleen-stomach deficiency-cold, the dosage or combination of herbs should be appropriately adjusted when using this formula, to avoid the herbs being too fierce and causing harm to the body. Those with spleen-stomach deficiency-cold may appropriately add herbs such as Ganjiang (Dry Ginger) and Baizhu (Atractylodes Rhizome) to warm the middle and strengthen the spleen, enhancing spleen-stomach transportation and transformation function and ensuring normal absorption and utilisation of the herbs.

X. Modern Research

1. Pharmacological Research on Duhuo Jisheng Tang

Modern research shows that Duhuo Jisheng Tang has a variety of pharmacological actions, including anti-inflammatory, analgesic, and immune-regulating effects. The Duhuo and Qinjiao in the formula have anti-inflammatory actions, able to reduce inflammatory response and relieve joint pain and swelling. Sangjisheng and Duzhong have a regulatory effect on the immune system, able to strengthen the body's immune function and enhance resistance. In addition, some herbs in the formula also have actions such as improving blood circulation and inhibiting platelet aggregation, helping to improve local tissue blood supply and promote the repair of damaged tissue.

2. Observation of Clinical Efficacy

In clinical research, Duhuo Jisheng Tang has achieved certain therapeutic effects in treating conditions such as rheumatic and rheumatoid arthritis. Multiple studies have shown that combining Duhuo Jisheng Tang with Western medication for treating rheumatoid arthritis can effectively relieve symptoms such as joint pain and swelling, reduce inflammatory marker levels, and improve patients' quality of life. Compared with Western medication alone, combined treatment can reduce the adverse reactions of Western medication, leveraging the advantages of integrated Chinese-Western medicine. In treating conditions such as lumbar disc herniation, Duhuo Jisheng Tang can also improve pain and numbness in the lower back and lower limbs, enhancing lower back function, showing good prospects for clinical application.

3. Research on Dosage Form Improvement for Duhuo Jisheng Tang

To improve the clinical convenience and stability of Duhuo Jisheng Tang, researchers have conducted extensive research into dosage form improvement. Besides the modern concentrated granule form mentioned above, there are also research reports on producing it in capsule and tablet forms. These new dosage forms are convenient for patients to take and store, and can better ensure the quality and efficacy of the herbs. At the same time, some studies have also explored the use of modern pharmaceutical technologies, such as ultra-fine grinding and nanotechnology, to further improve the bioavailability of the herbs, providing more options for the clinical application of Duhuo Jisheng Tang.

As a classical Chinese medicine formula, Duhuo Jisheng Tang, having been transmitted for a thousand years, plays an important role in treating a variety of diseases. As modern research continues to deepen, its pharmacological actions and clinical efficacy have been more fully recognised, and improvements in dosage form have also brought greater convenience to its clinical application. It is believed that in the future, Duhuo Jisheng Tang will continue to demonstrate its distinctive advantages in Chinese medicine clinical practice, safeguarding the health of more patients.

Duhuo Jisheng Tang is a commonly used formula among Chinese medicine formulas, mainly treating wind-cold-damp bi syndrome and sciatica, lower back and knee pain, rheumatic arthritis, rheumatoid arthritis, and lumbar muscle strain caused by wind-cold-damp pathogens; it is suited to those with cold bi and weakness, difficulty bending and extending, and qi-blood deficiency or insufficiency, having the actions of dispelling wind-dampness, overcoming dampness, relieving bi pain, tonifying qi and blood, and boosting qi and strengthening the spleen. The formula includes herbs such as Sangjisheng and Chuanxiong, and is prepared by decoction in water, providing good therapeutic effect for bi syndrome with qi-blood insufficiency.