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Tools and Resources
Raynaud's Disease
| Introduction |
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Raynaud's disease, also called Raynaud's gangrene, is a primary or idiopathic vascular disorder characterized by intermittent symmetrical ischemic attacks affecting the fingers or toes, and sometimes the ears or nose. It is marked by severe paleness, and often accompanied by paresthesia and pain. It is typically brought on by cold stimuli and relieved by heat. The disease affects women more often than men. In traditional Chinese medicine, it falls into the categories of jue ni (“cold limbs”), bi zheng (“arthralgic-syndrome”), etc.
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| Etiology/Pathogenisis |
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Raynaud's disease, also called Raynaud's gangrene, is a primary or idiopathic vascular disorder characterized by intermittent symmetrical ischemic attacks affecting the fingers or toes, and sometimes the ears or nose. It is marked by severe paleness, and often accompanied by paresthesia and pain. It is typically brought on by cold stimuli and relieved by heat. The disease affects women more often than men. In traditional Chinese medicine, it falls into the categories of jue ni (“cold limbs”), bi zheng (“arthralgic-syndrome”), etc.
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| Primary Treatments with Medicinal Herbs |
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Dang Gui Si Ni Tang
Sun et al. treated 4 cases of Raynaud's disease with modified Dang Gui Si Ni Tang (Chinese Angelica Decoction for Restoring Yang). The basic formula consisted of the following single herbs: Huang Qi (Astragalus Root), Dan Shen (Salvia), Dang Gui (Dang Gui), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Xi Xin (Wild Ginger), Gan Cao (processed Licorice), Tong Cao (Tetrapanax), Da Zao (Jujube), Milettia (Caulis Spatholobi), and Chuan Xiong (Cnidium). For patients with severe cold accumulation, Gan Jiang (Dried Ginger) and Fu Zi (Aconite) were added to the formula, and for patients with severe dampness, Fang Ji (Stephania), Cang Zhu (Atractylodes), and Bai Zhu (White Atractylodes) were added. One dose of the formula in a decoction was administered daily. In addition, the decoction of Hong Hua (Carthamus), Hua Jiao (Zanthoxylum Peel), and Ai Ye (Argy Wormwood Leaf) was used, to wash and soak the local affected areas, 30-40 minutes each time, 2-3 times a day. The results: all four cases were resolved after 30-45 doses.(1)
Wang treated 37 cases of Raynaud's disease with Dang Gui Si Ni Tang. The formula consisted of the following herbs: Dang Gui (Dang Gui), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Xi Xin (Wild Ginger), Mu Tong (Caulis Clematidis Armandii), Fu Zi (Aconite), Gan Cao (processed Licorice), and Da Zao (Jujube). One dose of the formula in a decoction was administered daily. In addition, the decoction of Du Huo (Pubescent Angelica Root), Hua Jiao (Zanthoxylum Peel), Ai Ye (Argy Wormwood Leaf), Gui Zhi (Cinnamon Twig), Sang Zhi (Mulberry Twig), Hong Hua (Carthamus), and Tou Gu Cao (Impatiens) was used to wash the local affected areas. The results: after 60-150 days of treatment, 10 cases were clinically resolved, 18 were greatly improved, and the remaining 9 cases showed some improvement.(2)
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| Other Treatments with Medicinal Herbs |
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Huang Qi Gui Zhi Wu Wu Tang
An et al. treated 26 cases of Raynaud's disease with modified Huang Qi Gui Zhi Wu Wu Tang. The formula consisted of Huang Qi (Astragalus Root), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Tao Ren (Persica), Bai Jie Zi (White Mustard Seed), Sheng Jiang (Ginger), Hong Hua (Carthamus), Ji Xue Teng (Milettia), and Da Zao (Jujube). The formula was modified to suit individual patients' symptoms. One dose of the formula in a decoction was administered daily, divided into 2 applications. The herbs were wrapped in cloth and further decocted to generate a second decoction used to wash the local affected areas (25 minutes each time, twice daily). One course of treatment lasted 10 days. The results: after 2-4 courses of treatment, 18 cases were resolved, 6 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 92.3%.(3) Bu Yang Huan Wu Tang
Lan treated 38 cases of Raynaud's disease with Bu Yang Huan Wu Tang (Decoction Invigorating Yang for Recuperation). The formula consisted of: Chi Shao (Peony Red), Dang Gui Wei (Dang Gui tail), Chuan Xiong (Cnidium), Tao Ren (Persica), Hong Hua (Carthamus), Di Long (Earthworm), and Huang Qi (Astragalus Root). The formula was modified to suit the individual patients' symptoms. For yang deficiency with accumulation of pathogenic cold, the following herbs were added to the formula: Fu Zi (Aconite), Lu Jiao Jiao (Colla Cornus Cervi), Gui Zhi (Cinnamon Twig), and Xi Xin (Wild Ginger). For blood stasis, the following herbs were added: Dan Shen (Salvia), Gui Zhi (Cinnamon Twig), Ji Xue Teng (Milettia), and E Zhu (Zedoaria). One dose of the formula was administered daily. The formula was decocted three times: the first two decoctions were mixed and administered internally once in the morning and once in the evening, and the third decoction was used to soak the affected areas (25 minutes each time, twice daily). The results: 28 cases were resolved, 8 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 94.8%.(4) Yu's Raynaud's disease Formula
Yu et al. treated 80 cases of Raynaud's disease with a self-formulated decoction, which consisted of the following herbs: Huang Qi (Astragalus Root), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Sheng Jiang (Ginger), Sang Zhi (Mulberry Twig), Da Zao (Jujube), and Wu Gong (Centipede). The herbs were decocted in water twice: the first decoction was administered internally, and the second decoction was used to wash the affected areas once every hour. One course of treatment lasted 20 days. The results: after 1-3.5 courses of treatment, 60 cases were resolved, another 5 cases greatly improved, and the remaining 15 cases improved slightly, with a total effectiveness rate of 100%.(5) Lu's Raynaud's disease Formula
Lu et al. treated 71 cases of Raynaud's disease following TCM's symptom-differentiation treatment method. The treatment identified three types of patients, and administered each a different formula. For the yin-cold type, the following herbs were used: Xi Xin (Wild Ginger), Gui Zhi (Cinnamon Twig), Ge Gen (Pueraria), Bai Shao (White Peony Root), Gan Cao (Licorice), Dang Gui (Dang Gui), Dan Shen (Salvia), Quan Xie (Scorpion), Wu Gong (Centipede), Di Long (Earthworm), Wu Shao She (Garter Snake), and Chuan Xiong (Cnidium). For the blood stasis type, a modification of the same formula was used: Di Long was removed, while Chai Hu (Bupleurum), Tao Ren (Persica), and Hong Hua (Carthamus) were added. And for the blood-heat type, the following herbs were used: Jin Yin Hua (Lonicera Flower), Xuan Shen (Scrophularia), Dang Gui (Dang Gui), Gan Cao (Licorice), Ge Gen (Pueraria), Di Long (Earthworm), Bai Shao (White Peony Root), Dan Shen (Salvia), Chi Shao (Peony Red), Chuan Xiong (Cnidium), Quan Xie (Scorpion), Wu Gong (Centipede), and Wu Shao She (Garter Snake). The results of this treatment study were: 22 cases were resolved, 19 cases greatly improved, another 28 cases slightly improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 97.2%.(6) Li's Raynaud's disease Formula
Li treated 15 cases of Raynaud's disease externally with the following herbs: Chuan Wu (Sichuan Aconite Root), Cao Wu (Aconite Root), Qiang Huo (Notopterygium Root), Gui Zhi (Cinnamon Twig), Xi Xin (Wild Ginger), and San Leng (Bureed Tuber). The herbs were decocted in water, and this decoction was used to soak the affected areas. This treatment lasted for 20 minutes each time, twice a day, and one course of treatment lasted for 7 days. A comparison group of 15 cases were treated with water steam (fumigation) and guanethidine (10mg each time, three times a day). The results: after 4 courses of treatment, the treatment groups had 11 cases that were resolved, 3 cases that had shown improvement, and one case that was unchanged, with a total effectiveness rate of 93.33%. The comparison group's corresponding numbers were 2, 8, 5, and 66.67%.(7)
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| Other Treatments |
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Treatment with Herbs, Electro Acupuncture, and Moxibustion
Pan et al. treated 24 cases of Raynaud's disease with herbs, electro acupuncture and moxibustion. The treatment used an herbal formula called Huang Qi Gui Zhi Wu Wu Tang, which consisted of Huang Qi (Astragalus Root), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Di Long (Earthworm), Hong Hua (Carthamus), Yan Hu Suo (Rhizoma Corrydalis), Sheng Jiang (Dried Ginger), and Da Zao (Jujube). The formula was modified to suit individual patients' symptoms, and one dose in a decoction was administered daily. In addition, patients with affected upper extremities received electro acupuncture and moxibustion treatment at Qu Chi (LI 11), Shou San Li (LI 10), Wai Guan (TE 5), and He Gu (LI 4); and patients with affected lower extremities received electro acupuncture and moxibustion treatment at Zu San Li (ST36), San Yin Jiao (SP 6), Jie Xi (ST 41), and Tai Chong (LR 3). After insertion, the needles were retained for 30 minutes, followed by moxibustion (30 minutes). The electro acupuncture and moxibustion treatments were conducted once daily, and one course of treatment lasted 15 days. The results: 15 cases illustrated great improvement, and the remaining 9 cases improved slightly.(8)
Massage Therapy
Yang et al. treated 72 cases of Raynaud's disease with massage. Methods: The acupoints on the affected extremities were selected for treatment (such as Feng Chi (GB 20), Jian Zhong Shu (SI 15), Que Pen (St 12), and Tian Zong (SI 11)). First, working downward from acupoints located higher up, a kneading-pressing manipulation was performed until a sensation of soreness and distention was felt. Then, the shoulders and the upper arms were pushed and pressed using the palm and fingers for a duration of five minutes. And finally, plucking, finger pressing, pulling, rotating, and kneading were performed for half an hour. The results: 25 cases were resolved, 34 were greatly improved, and the remaining 13 cases improved somewhat, with a total effectiveness rate of 100%.(9)
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| Acupuncture & Acupressure |
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Zhang treated 31 cases of Raynaud's disease with acupuncture. All patients with affected fingers were treated at acupoints Que Pen (ST12) and Shi Xuan (EX-UE 11). Depending on which fingers were primarily affected, patients received the additional treatment as follows: patients primarily with the thumb and index finger affected were treated at Shou Wu Li (LI 13); patients primarily with the middle finger affected were treated at Nei Guan; and patients primarily with the ring and little finger affected were treated at Xiao Hai (SI 8). Patients with affected toes were treated at acupoints San Yin Jiao (SP 6) and Zhao Hai (KI 6), with supplemental treatment at Zu Shi Xuan (EX-UE 11), Huan Tiao (GB 30), or Zhi Bian (BL 54). After insertion, the needles were retained for 20 minutes. The treatment was conducted once daily, and one course of treatment lasted 18 days. The results: after 2-4 courses of treatment, 21 cases were resolved, and the remaining 10 cases had greatly improved, with a total effectiveness rate of 100%.(10)
Jin treated 32 cases of Raynaud's disease with electro acupuncture. Patients with affected upper extremities were treated at acupoints Qu Chi (LI 11), Shou San Li (LI 10), Wai Guan (TE 5), He Gu (LI 4), Ba Xie (EX-UE 9), and Shi Xuan (EX-UE 11) by blood-letting; and patients with affected lower extremities were treated at acupoints Zu San Li (ST 36), San Yin Jiao (SP 6), Jie Xi (ST 41), Tai Chong (LR 3), Ba Feng (EX-LE 10), and Shi Xuan (EX-UE 11) by blood-letting. After insertion, the needles were retained for 30 minutes. The treatment was conducted once daily, and one course of treatment lasted 10 days. The results: after 1-4 courses of treatment, 13 cases were resolved, 12 cases demonstrated great improvement, another 6 cases slightly improved, and the remaining 1 case did not respond to the treatment.(11)
Wu used warm-needle acupuncture in treating 20 cases of Raynaud's disease. Patients received treatment at the following acupoints: He Gu (LI 4), Wai Guan (TE 5), Shou San Li (LI 10), San Yin Jiao (SP 6), Zu San Li (ST 36), and Guan Yuan (CV 4). After insertion, the needles were manipulated using the reinforcing method, while 3-5 moxa cones were applied to the needles to deliver heat. The treatment was conducted once daily, and one course of treatment lasted 10 days. The results: 11 cases had greatly improved, and the remaining 9 cases improved slightly.(12)
Treatment with Acupuncture and Acupoint Injection
Han et al. treated 42 cases of Raynaud's disease with acupuncture combined with acupoint injection. Acupoint injection: 0.2ml of a scopolamine injection was injected at each of the following points: Zhong Zhu (TE 3), He Gu (LI 4), Wai Guan (TE 5), Qu Chi (LI 11), and Jian Yu (LI 15). In addition, acupuncture treatment was applied at Bai Hui (GV 20), Feng Chi (GB 20), Da Zhui (GV 14), Ji Quan (HT 1), Qu Chi (LI 11), Chi Ze (LU 5), Nei Guan (PC 6), and Shen Men (HT 7). The treatment alternated the use of acupuncture and acupoint injection, and one course of treatment lasted 20 days. The results: after 2-4 courses of treatment, 26 cases were resolved, 11 had greatly improved, another 4 cases slightly improved, and the remaining 1 case did not respond to the treatment.(13)
Acupoint He-Ne Laser Therapy
Sun et al. treated 40 cases of Raynaud's disease with acupoint He-Ne laser therapy. Calibrated for 8mW and 6328 A (angstrom), the He-Ne laser was applied to the Jing acupoints of the affected fingers or toes (for instance, if the little finger was affected, Shao Chong (H 9) was treated; likewise, if the ring finger was affected, Guan Chong (SJ 1) was treated) for 10 minutes each. The treatment was conducted once daily, and one course of treatment lasted for a month. The results: after two courses of treatment, 26 cases were resolved, another 10 cases significantly improved, and the remaining
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| Footnotes |
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1 Sun Jin Chang, et al. Treating Raynaud's disease with Chinese herbs. Sichuan Journal of TCM. 1989;7(2):28.
2 Wang Jing Chun. 37 cases of Raynaud's disease treated with Dang Gui Si Ni Tang. Liaoning Journal of Traditional Chinese Medicine. 1991;18(3):31.
3 An Jing Zhi, et al. Treating 26 cases of Raynaud's disease with modified Huang Qi Gui Zhi Wu Wu Tang. Journal of Folk Chinese Medical Treatment. 1999;7(7):33-34.
4 Lan Mei Cheng. Treating 38 cases Raynaud's disease with Bu Yang Huan Wu Tang. Guangxi Journal of Traditional Chinese Medicine. 2000;23(3):17-18.
5 Yu Xian Zhang, et al. Treating 80 cases of Raynaud's disease with Chinese herbs. China Journal of TCM Science and Technology. 2000;7(1):63.
6 Lu Li Ran, et al. Treating 71 cases of Raynaud's disease. Hebei Journal of TCM. 1989;11(5): 27.
7 Li Zhi Liang. 15 cases Raynaud's disease treated externally with Chinese herbs. Journal of External Application of TCM. 1999;8(2):22.
8 Pan Guang Jun, et al. Treating 24 cases of Raynaud's disease with acupuncture and Chinese herbs. China Journal of Integrated External Medicine. 1998;4(3):134.
9 Yang Yong Qian, et al. Treating Raynaud's disease with massage. Journal of Massage and Physical Excercise Therapy. 1995;(6):16.
10 Zhang Ji Wu. Treating 31 cases of Raynaud's disease with acupuncture. China Journal of Acupuncture. 1988;8(4):25.
11 Jin Ming Yue. Treating 32 cases of Raynaud's disease with electroacupuncture. China Journal of Acupuncture. 1996;16(5):32.
12 Wu Jie. Treating 20 cases of Raynaud's disease with warm-needle acupuncture. Shanghai Journal of Acupuncture. 1999;18(1):7.
13 Han De Long, et al. Treating 42 cases of Raynaud's disease with combination of acupuncture and acupoint injection. Journal of Acupuncture Clinical Application. 1999;15(2):43-44.
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