Chuanxiong (Ligusticum chuanxiong) is the dried rhizome of the plant from the Umbelliferae family, primarily containing ferulic acid, ligustrazine, phenolic acids, organic acids, alkaloids, and volatile oils. Clinically, both raw Chuanxiong and wine-prepared Chuanxiong are commonly used. Chuanxiong has a pungent taste, a warm nature, and is associated with the liver, gallbladder, and pericardium meridians. It is known for its ability to invigorate blood circulation, promote qi flow, dispel wind, and alleviate pain. This article discusses the reasonable and effective dosages of Chuanxiong based on classic formulas, experiences from renowned TCM practitioners, and modern medical applications, providing a reference for clinical practice.
1 Classic Formula Dosages and Combinations
Ancient physicians often combined Chuanxiong with various herbs to treat gynecological diseases, depression, stroke, and headaches. Dosage conversions varied across dynasties; for example, during the Eastern Han dynasty, 1 tael was approximately 13.8g, while in the Song, Jin, and Yuan dynasties, it was about 41.4g, and in the Ming and Qing dynasties, it was around 37g. For instance, in the Shang Han Za Bing Lun (Han dynasty), the formula Jiao Ai Si Wu Decoction includes Chuanxiong (2 taels, approximately 27.6g) combined with Danggui (Angelica sinensis) to treat blood stasis and deficiency; Chai Hu Shu Gan San (Ming dynasty, Zheng Zhi Zhun Sheng) includes Chuanxiong (1.5 qian, approximately 5.6g) combined with Chai Hu (Bupleurum) to treat liver qi stagnation and hypochondriac pain; Bu Yang Huan Wu Decoction (Qing dynasty, Yi Lin Gai Cuo) includes Chuanxiong (1 qian, approximately 3.8g) combined with Huangqi (Astragalus) to treat qi deficiency and blood stasis in stroke; Tong Qiao Huo Xue Decoction (Qing dynasty, Yi Lin Gai Cuo) includes Chuanxiong (1 qian, approximately 3.8g) combined with Tao Ren (Peach kernel) and Hong Hua (Carthamus) to treat blood stasis headaches; and Suan Zao Ren Decoction (Han dynasty, Shang Han Za Bing Lun) includes Chuanxiong (2 taels, approximately 27.6g) combined with Suan Zao Ren (Sour Jujube Seed) to treat insomnia due to liver blood deficiency and internal heat.
2 Experiences of Renowned TCM Practitioners with Chuanxiong Dosages and Combinations
2.1 Yan Zhenghua: Chuanxiong is often combined with Tao Ren, Hong Hua, Chi Shao, and Dan Shen to invigorate blood circulation, or with Chai Hu, Xiang Fu, Yu Jin, and Huangqi to regulate qi and tonify qi for treating diseases with blood stasis. The typical dosage is 6-10g; it is commonly combined with Qiang Huo, Du Huo, and Fang Feng to dispel wind and dampness for treating colds, usually at 10g.
2.2 Deng Tietao: Chuanxiong is combined with San Qi, Dan Shen, Danggui, Tao Ren, and Hong Hua to nourish blood and invigorate circulation, treating coronary heart disease, stroke, amyotrophic lateral sclerosis, and post-operative paraplegia from cavernous hemangioma. The dosage of Chuanxiong is typically 3-15g, and can reach 20g in medicinal baths; when combined with Huai Niu Xi, it invigorates blood circulation and tonifies the liver and kidneys, with Deng Tietao’s foot bath formula using 30g of Chuanxiong for treating liver yang hyperactivity hypertension.
2.3 Ren Jixue: Chuanxiong is combined with insect-based medicines and blood-invigorating herbs like Tu Bie Chong, Qi She, Chi Shao, Tao Ren, and Hong Hua to invigorate blood, dispel wind, and open channels for treating cervical spondylosis, heart pain, and stroke. The typical dosage is 10-15g; when combined with Man Jing Zi, Gao Ben, Bai Zhi, and Xin Yi, it guides the medicine upward to dispel wind and open channels for treating headaches and nasal colds (wine-prepared Chuanxiong), and for treating liver-spleen disharmony type chronic diarrhea, it is combined with Danggui, with Chuanxiong dosages of 5-15g; for treating pediatric cough and wheezing, it is often used at 3g.
2.4 Zhu Liangchun: Qi Zhi San is used to invigorate qi and blood circulation to prevent recurrence of stubborn coronary heart disease after thrombolysis (Huangqi, Water Leech, Chuanxiong each 90g, Gui Zhi 30g, ground into fine powder, taken 5g, twice daily, for 6 months post-thrombolysis); Chuanxiong is used to dispel wind and alleviate pain for treating headaches, dizziness, and forgetfulness, typically at 10-15g.
2.5 Xu Jingshi: Chuanxiong is combined with Xiang Fu and Chai Hu to soothe the liver and relieve depression, invigorate blood circulation, and treat gynecological diseases; when combined with Suan Zao Ren, it nourishes blood and invigorates circulation for treating heart vessel obstruction and insomnia due to lack of nourishment, and in cases of severe stasis, it can be combined with Dan Shen and Amber, with Chuanxiong dosages of 10-15g.
2.6 Zhang Zhiyuan: Combined with Tao Ren, Hong Hua, Danggui, Chi Shao, Bai Shao, and Huangqi for blood-invigorating and tonifying purposes, it is used to treat blood stasis type diabetic peripheral neuropathy, depression, gynecological diseases, stroke, and atrophy syndrome, with Chuanxiong dosages of 6-30g; when combined with Fu Zi to open channels and alleviate pain (such as in the Xiong Fu Quan Wu Gan Jiang Decoction), it treats stubborn trigeminal neuralgia, with Chuanxiong typically used at 6-30g.
2.7 Zhang Xuewen: Combined with Dan Shen and Huangqi to tonify qi, invigorate blood, and dispel stasis, it treats blood obstruction type headaches, dizziness, and stroke, with Chuanxiong dosages typically at 10-30g; when combined with Niu Xi for treating liver yang hyperactivity hypertension, unstable headaches, numbness of the head, and fatigue in the limbs, the dosage is 10-12g.
2.8 Zhang Qi: Combined with Dan Shen, Chi Shao, and Danggui for blood-invigorating purposes, it treats blood stasis type heart diseases, chronic renal failure, gout, carotid atherosclerosis, dementia, diabetes, stroke, fatty liver, impotence, and oral lichen planus. When combined with Chai Hu and Xiang Fu, it treats stubborn insomnia and neurological diseases, with Chuanxiong typically used at 6-20g, most commonly at 15g; when combined with Ju Hua, Bai Zhi, Ge Gen, Quan Xie, and Jiang Can, it invigorates blood, dispels wind, and opens channels for treating stubborn headaches or migraines and chronic sinusitis, with Chuanxiong dosages of 10-30g.
2.9 Tang Youzhi: The main pathogenesis of dry eyes includes three aspects: deficiency of yin, deficiency of yang, and obstruction of pathways. Chuanxiong is commonly combined with Dan Shen and Chi Shao to clear heat and cool blood, helping to dispel wind evil from the eye surface and alleviate symptoms of redness and irritation. It is also combined with Niu Xi and San Leng to treat diabetic retinopathy and age-related macular degeneration, with typical dosages of 5-12g, most commonly at 10g.
2.10 Yan Dexin: Qi is the root of all diseases, and blood is the source of all diseases; chronic and strange diseases often involve stasis. Chuanxiong is combined with Danggui and Chi Shao to invigorate blood and dispel stasis, as in the Wu Zhu Yu Decoction, treating long-term enuresis, stubborn abdominal pain, chronic pharyngitis, persistent hiccups, gynecological diseases, breast cancer, and peripheral vascular diseases with blood stasis pathogenesis. When combined with Huangqi, Ge Gen, Tao Ren, Hong Hua, and Dan Shen, it tonifies qi and invigorates blood, raising clear yang to treat coronary heart disease, hyperlipidemia, brain diseases, and prevent stroke, with typical dosages of 3-15g, generally using 4.5-6g as a guiding herb; when combined with Qiang Huo to dispel wind, invigorate blood, and alleviate pain for treating headaches, Chuanxiong is often used at 9-20g, with higher dosages reaching 30-60g.
3 Expert Dosages and Combinations from the Formula and Dosage Research Committee
3.1 Tong Xiaolin: For treating diabetic peripheral neuropathy, emphasis is placed on invigorating qi and blood, harmonizing the nutrients, and promoting circulation, with a focus on warming yang, dispelling cold, and eliminating dampness, while controlling blood sugar is the primary goal. Invigorating blood and dispelling stasis is a continuous theme. When combined with Huangqi and Danggui, it nourishes qi and blood; when combined with Gui Zhi, it warms yang and invigorates blood circulation for treating diabetic peripheral neuropathy; when combined with Suan Zao Ren, it nourishes blood and regulates the liver for treating insomnia; when combined with Quan Xie and vine herbs, it invigorates blood circulation for treating eyelid ptosis, with typical dosages of 9-30g; when combined with Bai Zhi to dispel wind and alleviate pain, as in the Du Liang Wan, it is used for treating headaches, with Chuanxiong dosages typically at 10-30g, and in large doses up to 60g, often combined with Ge Gen and Tian Ma to stabilize blood pressure.
3.2 Li Saimai: The function of the organs is primarily to regulate qi and blood. Chuanxiong is combined with Danggui to nourish blood and invigorate circulation, also promoting qi for treating various conditions leading to qi stagnation and blood stasis, such as diabetic peripheral neuropathy, numbness and pain in the limbs, neck and shoulder pain, menstrual disorders, Taiyang wind rash, and Shaoyin cough. When combined with Ge Gen, it invigorates blood circulation for treating neurological diseases; when combined with Xiao Yao San, it soothes liver depression and promotes qi and blood for treating hyperthyroidism, with Chuanxiong dosages typically at 10-15g.
3.3 Huang Huang: The patient’s constitution affects the condition and treatment. The treatment model is “one formula for one disease for one person,” with the main academic thought being “formula-syndrome correspondence” and “classical formula-constitution theory.” When combined with Huangqi and Gui Zhi Wu Wu Decoction, it treats cardiovascular and cerebrovascular diseases, and when using Shanyao Wan for tumors, it combines Danggui and Bai Shao to nourish blood, invigorate circulation, and moisten dryness for treating dry syndrome, gynecological diseases, and insomnia, typically at 5-20g.
3.4 Zhang Binghou: The Chuanxiong Tea Tiao San is viewed as a whole, serving as a guiding herb, from which nine tea adjustment formulas are derived to dispel wind and alleviate pain for treating headaches, with Chuanxiong dosages of 10-20g. Emphasis is placed on folk prescriptions, with Chuanxiong combined with Danggui to adjust both qi and blood for treating bi syndrome, such as the “Pain Three Liang San” (Danggui, Chuanxiong, and Ren Dong Teng each 30g, stir-fried Pangolin 10g, San Qi 3g), a small folk prescription from Jiangnan for treating various pain syndromes; when combined with Suan Zao Ren to nourish blood and invigorate circulation, as in the Er Ren An Mei Decoction, Chuanxiong is used at 20-30g, with Suan Zao Ren and Bai Zi Ren at 30-60g.
4 Modern Medical Dosages and Combinations
4.1 Combined with Bai Shao: Chuanxiong combined with Bai Shao invigorates blood and alleviates pain for treating primary dysmenorrhea, with Bai Shao at 30g and Chuanxiong at 12g.
4.2 Combined with Chi Shao and Danggui: Chuanxiong combined with Chi Shao and Danggui invigorates blood and dispels stasis for treating blood stasis type diabetes and gynecological diseases, with dosages of 6-15g.
4.3 Combined with Huangqi: Chuanxiong combined with Huangqi benefits qi and invigorates blood circulation for treating diabetic peripheral neuropathy and autonomic neuropathy, with dosages of 6-15g.
4.4 Combined with Rou Gui: Chuanxiong combined with Rou Gui warms the meridians, dispels cold, invigorates blood, and alleviates pain for treating low back pain and diabetic peripheral neuropathy, with Rou Gui at 9-15g and Chuanxiong at 15-20g.
4.5 Combined with Tao Ren: Chuanxiong combined with Tao Ren promotes qi, invigorates blood, and dispels stasis, as in the self-formulated Tao Ren Chuanxiong Decoction combined with Western medicine for treating post-stroke sequelae, with Chuanxiong at 30g and Tao Ren at 30g.
4.6 Combined with Chai Hu: Modified Chai Hu Si Wu Decoction is used to treat headaches and facial pain, with Chuanxiong at 10g and Chai Hu at 10g.
4.7 Combined with Tian Ma: The self-formulated Chuanxiong Tian Ma Decoction treats liver wind-fire type migraines, with Chuanxiong at 50g, which is warm and heavy, good at moving blood stasis, and Tian Ma at 12g, which extinguishes wind and calms yang, opening channels and alleviating pain. These two herbs serve as the monarch herbs.
4.8 Combined with Ge Gen: For treating age-related dizziness, the theory of “blood stasis causing wind” is proposed, using methods to invigorate blood, dispel stasis, and soften the liver to calm wind. For example, Chuanxiong Ge Gen Decoction includes Chuanxiong at 10-20g to invigorate blood and promote qi, dispel wind and alleviate pain; Ge Gen at 30g to uplift the clear yang of the spleen and stomach, alleviating symptoms of unbeneficial menstrual flow and nourishing the channels.
4.9 Combined with Ze Xie: Chuanxiong and Ze Xie San combined with Nifedipine can be used for treating hypertension, with Chuanxiong at 10g and Ze Xie at 10g to invigorate blood and promote diuresis to lower blood pressure.
4.10 Combined with Da Huang: The self-formulated Chuanxiong Da Huang Decoction treats severe idiopathic deafness. In the first four doses, raw Da Huang is used at 30g and Chuanxiong at 100g to counteract cold and heat, invigorate blood, and dispel stasis, improving blood supply to the inner ear, with Chuanxiong gradually reduced to 20g, adhering to the principles of cautious large dosing and stopping treatment when the condition improves.
5 Conclusion
By summarizing classic formulas, historical clinical experiences, and modern medical applications, it is concluded that the clinical dosage range of Chuanxiong is 3-100g. The optimal dosage and combinations of Chuanxiong should be selected based on the type of disease, syndrome, and symptoms. When Chuanxiong exerts its effects of invigorating blood and promoting qi, it can be combined with Chai Hu, Danggui, Tao Ren, Chi Shao, Bai Shao, Huangqi, Ze Xie, Rou Gui, Ge Gen, and Da Huang to treat gynecological diseases (dysmenorrhea), cardiovascular diseases (coronary heart disease), endocrine diseases (diabetes, hyperthyroidism, etc.), stroke, atrophy syndrome, hypertension, insomnia, cancer, and peripheral vascular diseases, with dosages ranging from 3-100g; for dispelling wind and alleviating pain, it can be combined with Bai Zhi, Jing Jie, Tian Ma, Ge Gen, Qiang Huo, and insect-based medicines to treat diseases with internal and external wind evils such as colds, headaches, and dizziness, with dosages ranging from 5-60g. Although the clinical application of Chuanxiong is broad, under normal dosages (the Chinese Pharmacopoeia specifies a normal dosage of 3-10g), no significant toxic side effects have been observed. Attention should be paid to contraindicated populations: Chuanxiong is pungent and warm, and should be avoided in cases of headache due to yin deficiency and yang hyperactivity; caution is advised for those with excessive sweating, as prolonged use may harm the righteous qi; Chuanxiong invigorates blood and promotes qi, being a key herb for gynecological blood regulation, effectively treating women’s menstrual disorders, amenorrhea, and dysmenorrhea, but should be used cautiously in cases of excessive menstruation and in pregnant women due to the risk of excessive bleeding and miscarriage. There are also reports of acute toxicity and damage to the digestive tract and kidneys with high doses of Chuanxiong. Practitioners must remember that “life is of utmost importance, worth more than gold,” thus medication must be used cautiously, adhering to the principles of cautious large dosing and stopping treatment when the condition improves, ensuring safety while maximizing effectiveness.
This article aims to inherit the clinical experiences of past physicians, clarifying the optimal dosages and combinations of Chuanxiong for treating different diseases, syndromes, and symptoms, thereby guiding the rational and effective use of Chuanxiong in clinical practice to improve therapeutic efficacy. Combined with modern pharmacological research, Chuanxiong alone has pharmacological effects such as protecting the myocardium, sedative and hypnotic effects, inhibiting airway wall thickening, and protecting the liver and kidneys. When combined with different herbs, it can achieve pain relief, delay aging, and improve cerebral ischemia, aligning with the effects of Chuanxiong in invigorating blood circulation, promoting qi, and dispelling wind and alleviating pain. Therefore, studying the modern pharmacological effects of traditional Chinese medicine from the perspective of efficacy is a good starting point for promoting the integration of Chinese and Western medicine and an effective way to gain global recognition of the scientific nature of TCM. However, the treatment of diseases with traditional Chinese medicine is not merely a simple aggregation of single herb effects; the secrets of formula composition await further exploration, and modern compound pharmacological research provides another avenue for solving these issues. We must strive to inherit and promote, innovate based on tradition, and advance the modernization of traditional Chinese medicine.