CLINICAL APPLICATIONS

* Severe blood stasis and stagnant blood circulation in upper, middle and lower jiaos (San Jiao):

§ Severe blood stasis in the upper jiao: headache, angina pectoris, rheumatic heart disease, thrombosis, embolism, cardiac ischemia, bradyarrhythmia, stroke, concussion, post-concussion syndrome, cerebral atherosclerosis, hyperlipidemia, and physical injury to the chest

§ Severe blood stasis in the middle jiao: pleural adhesion, acute and chronic hepatitis, liver cirrhosis, hepatic hemangioma, cholecystitis, jaundice, and splenomegalia

§ Severe blood stasis in the lower jiao: female infertility, male infertility, amenorrhea, dysmenorrhea, irregular menstruation, uterine bleeding, ectopic pregnancy, hysteromyoma, endometriosis, oophoritic cyst, ovarian cyst, pelvic inflammatory disease, hyperplastic tuberculosis of intestine, ulcerative colitis, and urinary stones

* Chronic traumatic injury that was not treated properly back in the acute phase and now re-exacerbates off and on

* Cardiovascular, circulatory or clotting disorders

* Chronic musculoskeletal injuries, joint injuries (such as knee, ankle, wrist, elbow, shoulder, and back)

* Post-surgical pain and adhesions

* Severe, chronic or unusual conditions that do not respond to standard herbal treatment [use Circulation (SJ) as an adjunct formula to boost the overall therapeutic effect]

 

WESTERN THERAPEUTIC ACTIONS

* Treats cardiovascular and circulatory disorders throughout the entire body

* Antiplatelet and anticoagulant effects to reduce the risk of blood clots and decrease blood viscosity

* Vasodilating action to lower blood pressure and increase blood perfusion

* Positive cardiotonic function to strengthen cardiac contraction and improve blood circulation

 

CHINESE THERAPEUTIC ACTIONS

* Invigorates blood and qi circulation in the upper, middle, and lower jiaos

* Dispels blood stasis and qi stagnation

* Unblocks meridians and relieves pain

 

DOSAGE

Take 3 to 4 capsules three times daily. For severe cases, dosage may be increased to 7 to 8 capsules three times daily to relieve pain. This formula should be taken for no more than one month continuously. As an adjunct to another formula to invigorate blood, the recommended dose is 1 to 2 capsules in addition to the regular dose of the base formula.

 

INGREDIENTS

Bai Shao (Radix Paeoniae Alba)

Chai Hu (Radix Bupleuri)

Chi Shao (Radix Paeoniae Rubra)

Chuan Niu Xi (Radix Cyathulae)

Chuan Xiong (Rhizoma Chuanxiong)

Dang Gui (Radix Angelicae Sinensis)

Di Huang (Radix Rehmanniae)

Gan Cao (Radix et Rhizoma Glycyrrhizae)

Hong Hua (Flos Carthami)

Jie Geng (Radix Platycodonis)

Mo Yao (Myrrha)

Mu Dan Pi (Cortex Moutan)

Pu Huang (Pollen Typhae)

Rou Gui (Cortex Cinnamomi)

Shui Zhi (Hirudo)

Tao Ren (Semen Persicae)

Wu Yao (Radix Linderae)

Xiang Fu (Rhizoma Cyperi)

Yan Hu Suo (Rhizoma Corydalis)

Zhi Qiao (Fructus Aurantii)

 

BACKGROUND

Cardiovascular and circulatory disorders are common and complex illnesses that affect various parts of the body. Cardiovascular and circulatory disorders include hypertension, arteriosclerosis, coronary artery disease, embolism and many others. Furthermore, cardiovascular and circulatory disorders are often complicated with other conditions, such as diabetes mellitus, obesity, dyslipidemia, etc. As the number one cause of death in the United States, prevention and treatment of cardiovascular disease simply cannot be underestimated.[1]

 

FORMULA EXPLANATION

Circulation (SJ) is an herbal formula specifically formulated with herbs that invigorate blood circulation, dispel blood stasis, unblock meridians, and relieve pain. It promotes normal blood circulation in the upper, middle, and lower jiaos. Its formulation follows the principles of three classic formulas: Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) to treat blood stasis in the upper jiao, Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction) to treat blood stasis in the middle jiao, and Shao Fu Zhu Yu Tang (Drive Out Blood Stasis in the Lower Abdomen Decoction) to treat blood stasis in the lower jiao.

        Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) are used to activate the blood circulation. These two herbs have excellent synergistic effect and are often used together. Shui Zhi (Hirudo) is one of the strongest blood stasis removing herbs, and is added to enhance the overall effect to break down blood stasis. Dang Gui (Radix Angelicae Sinensis), Chuan Xiong (Rhizoma Chuanxiong) and Di Huang (Radix Rehmanniae) nourish blood, activate blood circulation and eliminate blood stasis. Mu Dan Pi (Cortex Moutan) and Chi Shao (Radix Paeoniae Rubra) clear heat, cool blood, and dispel blood stasis. Since blood stasis and qi stagnation often occur simultaneously, Zhi Qiao (Fructus Aurantii), Wu Yao (Radix Linderae) and Xiang Fu (Rhizoma Cyperi) are used to activate and regulate qi circulation. To effectively treat qi and blood stasis in all three jiaos, Jie Geng (Radix Platycodonis), Chai Hu (Radix Bupleuri), and Chuan Niu Xi (Radix Cyathulae) are used to guide the formula to the upper, middle and lower jiaos, respectively. In addition, because pain is often associated with qi and blood stasis, Yan Hu Suo (Rhizoma Corydalis), Mo Yao (Myrrha), Pu Huang (Pollen Typhae) and Rou Gui (Cortex Cinnamomi) are used to unblock the channels and collaterals to relieve pain. Furthermore, the combination of Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix et Rhizoma Glycyrrhizae) also has great effect to relieve spasms and cramps. Lastly, Gan Cao (Radix et Rhizoma Glycyrrhizae) tonifies qi and harmonizes all the herbs in this formula.

        In summary, Circulation (SJ) is an excellent formula to treat various types of disorders characterized by blood stasis anywhere in the upper, middle, and lower jiaos of the body.

 

CAUTIONS & CONTRAINDICATIONS

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[2]^,[3],[4]

* Patients on anticoagulant drugs, such as Coumadin (warfarin), should not fluctuate their daily consumption of vitamin K, which is found in alfalfa, cauliflower, liver, and in all dark green vegetables including broccoli and spinach.

* This formula is contraindicated during pregnancy and nursing. It should be used with caution during menstruation as it may cause excessive bleeding. In such cases, discontinue use immediately and resume after menstruation is over.

* This formula is contraindicated in patients with bleeding disorders, such as hypermenorrhea, uterine bleeding, hemophilia, and others.

* This formula should be discontinued one to two weeks before surgery.

* Use with caution or add GI Tonic if the patient has a weak digestive system or Spleen qi deficiency with diarrhea.

* During the course of treatment with this formula, some patients with chronic “dead blood” might notice pain in places of past injuries. Advise the patient of this possible experience before giving the formula that it is a positive sign as it is clearing away the residual stagnation and bringing in fresh blood supply to the chronically injured place. In some cases where patients cannot tolerate the pain, reduce the dosage of the formula by 20%. After experiencing the initial pain, the patient will later experience a total clearing sensation. This is especially prevalent in those suffering from chronic headaches due to previous head injuries. Failure to advise the patient on the potential experience of pain may result in misunderstanding by the patient, who may think the herbal treatment is causing them more pain in an adverse way.

* This formula should be taken for no more than one month continuously, since the use of strong blood moving herbs may sometimes cause blood deficiency.

* Due to its potent effect, this formula is contraindicated in weak and elderly patients.

 

CLINICAL NOTES

* The sedentary lifestyle of modern society is characterized by sitting for long hours and lack of exercise. Most people spend many hours of the day sitting in their cars, office, and home. With lack of movement, blood circulation is impaired and gradually leads to a large number of illnesses. Therefore, this formula is not only an excellent formula to improve blood circulation and treat clot related disorders, it is also a wonderful formula for prevention of chronic illness. In addition, this formula can be combined with many other formulas to improve blood circulation and deliver the herbs to the affected areas that may be hard to reach.

* Circulation (SJ) has a wide range of therapeutic actions and may be used to treat many different diseases. One common presentation among all these diseases is blood stasis characterized by either a light or dark purplish tongue. There are also cases where the tongue may appear normal but the sublingual veins are distended and dark in appearance. The patient’s face may appear dark and lusterless. Lips may be dark or purplish. Axillae, transverse cubital crease and the popliteal fossa may all appear slightly darker than the rest of the skin.

* Patients with intermittent claudication, chronic pain in the calf when walking, should be checked for cardiovascular disorders.

* Circulation (SJ) works similarly like the “restart” function on the computer. When too many programs are open and running, the computer may freeze. The body works the same way in that it breaks down when there are too many aggravating factors or symptoms. This formula works like the “restart” function on the computer to clear away stagnation so the body has a chance to start new again. In breaking down the blood clot, it then should become clear what condition needs to be addressed instead of being confused with multiple symptoms that may not point to any clear diagnosis.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Dispersing or scattered pulse found in the pulse position corresponding to the location of the blood stasis. Dispersing and scattered pulses are shapeless pulses in which their borders are hard to perceive and are thick, weak, and deep. A scattered pulse is weaker than a dispersing pulse, indicating a more chronic injury with blood stasis.

 

SUPPLEMENTARY FORMULAS

Circulation (SJ) can be used individually, or in combination with any other formulas that treat disorders of the zang fu organs or diseases of the body.

* Cardiovascular disorders:

§ Angina, atherosclerosis: add Circulation.

§ High cholesterol: add Cholisma or Cholisma (ES).

§ Hypertension with dizziness or vertigo: add Gastrodia Complex.

§ Hypertension with anger or flushed face: add Gentiana Complex.

* Gynecological disorders:

§ Dysmenorrhea: add Mense-Ease.

§ Fibrocystic disorder in the breast: add Resolve (Upper).

§ Endometriosis, fibroids or cysts in the uterus or other mass: add Resolve (Lower).

* Musculoskeletal disorders:

§ Pain of arm, elbow, wrist or hand: add Arm Support.

§ Neck, shoulder and upper back pain: add Neck & Shoulder (AC) or Neck & Shoulder (CR).

§ Back pain: add Back Support (AC) or Back Support (CR).

§ Headache: add Corydalin (AC) or Corydalin (CR).

§ Neuropathy: add Flex (NP).

§ Bi zheng (painful obstruction syndrome) due to cold: add Flex (CD).

§ Bi zheng (painful obstruction syndrome) due to heat: add Flex (Heat).

§ Muscle stiffness, cramps and spasms: add Flex (SC).

§ For excruciating pain: add Herbal ANG.

§ Bone spurs: add Flex (SPR).

§ Knee pain: add Knee & Ankle (AC) or Knee & Ankle (CR).

§ Gout: add Flex (GT).

§ Trauma, post-surgical recovery: add Flex (TMX).

* Others:

§ For extreme anxiety, stress, emotional or psychological issues: add Calm or Calm (ES). If heat is evident from the tongue, use Circulation (SJ) with Gardenia Complex first until heat is purged. Then follow up with Calm or Calm (ES).

§ Insomnia: add Calm (ES), Calm ZZZ, or Schisandra ZZZ.

§ Depression: add Shine or Shine (DS).

§ Post-stroke care: add Neuro +.

§ For nodules or swelling: add Resolve (AI).

§ With excess heat or fever: add Gardenia Complex.

§ Psoriasis or chronic skin condition: add Dermatrol (PS).

§ For weepy skin conditions: add Dermatrol (Damp).

§ For dry skin conditions: add Dermatrol (Dry).

§ For edema or swelling: add Herbal DRX.

§ Varicose veins: add Shan Zha (Fructus Crataegi).

§ For forgetfulness: add Enhance Memory.

§ With cold extremities: add Kidney Tonic (Yang).

§ Hair loss: add Polygonum 14.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* For varicose veins, bleeding technique should be performed once a week on the small, distended vein while taking Circulation (SJ) and Shan Zha (Fructus Crataegi).

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* Blood stasis: Needle and moxa Huofuhai (T 33.07).

 

Balance Method by Dr. Richard Tan:

* Left side: Shaoshang (LU 11), Zhongchong (PC 9), Shaochong (HT 9), Zusanli (ST 36), Yanglingquan (GB 34), Weizhong (BL 40)

* Right side: Hegu (LI 4), Houxi (SI 3), Zhongzhu (TH 3), Sanyinjiao (SP 6), Zhongfeng (LR 4), Taixi (KI 3)

* Alternate sides from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Invigorating blood circulation: Heart, Liver, Hot Point, Lung, Coronary Vascular Subcortex, Sympathetic, Large Auricular Nerve, Lesser Occipital Nerve, corresponding points (to the area affected)

* Thromboangiitis obliterans: corresponding point (to the area affected), Sympathetic, Coronary Vascular Subcortex, Lesser Occipital Nerve, Large Auricular Nerve, Hot Point, Heart

§ Supplementary points: Lung, Liver, Spleen, Endocrine

* Thrombophlebitis: corresponding point (to the area affected), Sympathetic, Endocrine, San Jiao, Heart, Lung, Liver, Kidney, Spleen, Hot Point, Coronary Vascular Subcortex. Bleed Ear Apex.

* Phantom limb pain: Sympathetic, Shenmen, Occiput, Lesser Occipital Nerve, Large Auricular Nerve, Nervous Subcortex. Bleed Ear Apex.

 

NUTRITION

* L-carnitine is helpful to strengthen the heart muscle and to promote circulation.

* Coenzyme Q10 improves tissue oxygenation.

* A multienzyme complex supplement helps enhance use of oxygen in body tissue.

* Multivitamins are very beneficial for various aspects of proper circulation, such as formation of red blood cells, restoration of normal blood viscosity, and prevention of blood clots.

* Minerals, such as calcium, magnesium, and potassium, are essential for normal heartbeat.

* Drink warm or hot liquids with meals. Putting cold and ice on any part of the body will immediately constrict the flow of blood to that region. Similarly, drinking cold or iced drinks with meals will hinder the natural peristaltic movements of the digestive system.

* Avoid any and all foods that contain sugar, such as cake, dessert, candy, chocolate, canned juice, soft drinks, caffeinated drinks, stevia, sugar substitutes, agave, xylitol, and corn syrup.

* Avoid raw or uncooked meats, such as sashimi, sushi, steak tartar, and seared meat. Minimize consumption of foods that are cooling in nature, including tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, eggplant, winter melon, watermelon, honeydew, citrus, oranges, guava, grapefruit, pineapple, plums, pear, banana, papaya, white radish, mustard leaf, potherb mustard, Chinese kale, napa, and bamboo sprout. Do not eat foods straight from the refrigerator.

* Avoid fried or greasy foods.

* Warm and hot natured foods that damage qi and yin should be avoided, such as:

§ certain fruits like mango and durian that produce heat.

§ stimulants like coffee, alcohol, and energy drinks.

§ spicy/pungent/aromatic vegetables such as pepper, garlic, onions, basil, rosemary, cumin, funnel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid food and drinks with artificial coloring.

* Consume as few meat products as possible. Do not eat processed meats, such as lunch meats, hot dogs and sausages, as they contain nitrites that are associated with inflammation and chronic disease.

 

LIFESTYLE INSTRUCTIONS

* Exercise helps blood circulation and is the key to keeping the blood vessels elastic, flexible and unclogged.

* Avoid the consumption of alcohol and exposure to tobacco. They increase cholesterol buildup and hardening of arteries.

* Healthy diet and lifestyle changes can reverse arteriosclerosis and its complications. However, they must be practiced daily and continuously for a long time without interruptions.

 

CASE STUDIES

* L.P., a 28-year-old female, presented with severe sharp and stabbing headaches. After a few years, they have become more frequent and intense, described as her whole head getting sore and unable to function. Upon palpation, pain and tenderness was found on the trapezius, occipital, and temporal areas. Her Western diagnosis was migraines, and the TCM diagnosis was Liver yang rising with blood stasis. Circulation (SJ) was prescribed at four capsules three times a day. The headaches immediately decreased, the frequency of the pain was a major difference in tolerance, and she was able to function more. Circulation (SJ) was used to address the symptoms initially before addressing the root of the condition and it made a great difference. Submitted by A.I., Hilo, Hawaii.

* An 81-year-old female patient presented with pain and numbness in her feet. The condition is affected by the patient’s blood sugar level, for which the patient was taking medication. The symptoms were reported as chronic; however, it still only comes and goes. Her Western diagnosis was peripheral neuropathy and the TCM diagnosis was blood stasis and Kidney deficiency. The patient was treated with Circulation (SJ), which reduced the pain and numbness until her blood sugar remained under control. Submitted by A.I., Hilo, Hawaii.

* D.A., a 55-year-old female, presented with extreme pain in both heels, radiating up the calf area. Symptoms of night sweats, problems with staying asleep, low energy, and depression were also present. Her pulse was weak and thin and her tongue was red with thin white coating. The practitioner diagnosed this condition as Liver qi stagnation and Kidney yin deficiency. Upon diagnosis, the patient was prescribed Flex (NP) and Circulation (SJ). The patient reported less pain; however, it was still present especially in the morning and late in the day after standing a lot. Her sleep improved as well, waking up only once during the night. The patient continued to improve; however, effort on her part was necessary to improve more. Submitted by B.L., Fort Myers, Florida.

* D.D., a 72-year-old male, presented with shortness of breath and cough with frothy, clear white sputum. It was noted that this patient was diabetic, post-stroke, with a heart function of 77%, and creatinine level of 1.8 mg/dL. Objective findings included left leg hot to the touch, right leg cold to the touch, and difficulty with inhaling. He had recently taken two rounds of antibiotics. The practitioner diagnosed this condition as Kidney not grasping the qi, Lung and Spleen qi deficiencies with phlegm accumulation; his Western diagnosis was COPD. For treatment he was given a combination of Cordyceps 3, Respitrol (Deficient), Circulation (SJ) and Neuro Plus, just one bottle at a time. The patient gradually improved, getting stronger each week and continued taking the herbs for about three months. Submitted by T.W., Perrysburg, Ohio.

* After recently attending Dr. Jimmy Chang's seminar in Austin, Texas, I decided to try Circulation (SJ) with a client I had been working with since March. He was a 25-year-old who had been diagnosed with Reflex Sympathetic Dystrophy (RSD) of the right ankle. This was the result of a fall from a cliff five years ago in which he sustained extensive crushing injury to the bones of the ankle and fibula. He had three surgeries to attempt to repair the damage that were unsuccessful to the extent that amputation just below the knee was strongly encouraged by his physicians. Most of the time he could not stand anything touching his right leg so he was in shorts and barefoot, and in a wheelchair. I started working with him with acupuncture only using Dr. Tan's 12 Magic Points since he was reluctant to try herbs since he was using painkillers, even though they were not very effective. We had made some progress: he had been able to reduce his medications and sometimes he could put on a sock and loose shoe. Then two weeks ago I put him on Circulation (SJ). The first week some diminishment of pain occurred, but the second week was the miracle! He came to his appointment with shoes and socks on, and was walking with a slight limp. His face and eyes were clearer then I had ever seen, he was laughing and calm. Later that day the massage therapist who had originally referred him to me called to tell me for the first time in the two years she had been working with him she was able to touch his leg without him screaming in pain. She said his entire body was different - the tension and rigidity that was always there in the past was gone. Her statement to me was "it was like massaging a normal person." She stated that she had been contemplating discontinuing working with him because she "felt like all she was doing was grinding bone on bone and causing him pain." My client and I thank you and Dr. Chang for your continuing efforts in the field of Asian medicine. Please do not let Dr. Chang stop teaching. Thanks again!

    As an update, this week when I saw this young man, he had continued improvement. While we were talking before his treatment he was sitting there with his legs crossed as only men can do, stroking and playing with his damaged ankle and toes. When I commented on this, he said that it was just so amazing to him to be able to be touched without it causing pain for the first time in years. Submitted by A.G., Austin, Texas.

 

ADDITIONAL INFORMATION

* Circulation (SJ) is designed by Dr. Jimmy Wei-Yen Chang to treat a wide variety of disorders characterized by severe or chronic blood and qi stagnation. He calls this condition “dead blood syndrome” where there is chronic blood stasis in the body with no outlet. With this stagnation, the homeostasis of the body is disturbed and multiple symptoms may appear.

* Circulation (SJ) has three main functions:

1. It treats chronic persistent pain that is the result of previous traumatic injuries, which were not treated properly. Chronic qi and blood stagnation lead to pain which worsens with exacerbation or when the body is not in optimal health. This formula contains strong blood-moving herbs, which effectively drive away chronic blood stasis.

2. It treats multiple chronic disorders or complex patterns with no clear diagnosis. These cases have multiple symptoms and each is very severe. However, there may be conflicting signs and symptoms, which prevent clear diagnosis of the exact cause. Such cases are best treated with blood-moving herbs. By clearing away chronic “dead blood” that may be complicating the condition, the true illness will surface, which then makes it possible to diagnose and prescribe an appropriate formula.

3. It treats complex conditions where the diagnosis is clear but after using the correct herbs following differentiation principles, the condition still does not improve. For example, a patient may suffer from insomnia and appropriate shen (spirit) calming herbs are given but the patient shows no result after several treatments. Alternatively, a patient suffers from high fever and Bai Hu Tang (White Tiger Decoction) is given but the high fever persists. In such cases where the diagnostic signs clearly match the herbal prescription but the patient shows no result, then one might consider that there is underlying “dead blood” disrupting the balance of the body. “Dead blood” might be blocking the blood flow and preventing it from nourishing the Heart shen (spirit) in the first case. It might also be the “dead blood” that is creating so much stagnation that the fever persists because there is a lack of proper circulation. In any case, removing the root cause is the only long-term solution to the problem.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Circulation (SJ) is designed to treat various types of illnesses characterized by cardiovascular and circulatory disorders. Pharmacologically, many herbs in this formula have marked antiplatelet, anticoagulant and thrombolytic effects, and are excellent for treating clotting disorders. Furthermore, these herbs also have vasodilating effects to lower blood pressure and increase blood perfusion, and cardiotonic action to strengthen cardiac contraction and improve blood circulation. Clinically, the herbs in the formula have been shown to treat cardiovascular, circulatory, clotting disorders, and many other illnesses.

        Circulation (SJ) incorporates many herbs with antiplatelet and anticoagulant effects to inhibit thrombus formation and treat clotting disorders. Herbs with antiplatelet effects include Dang Gui (Radix Angelicae Sinensis),[5] Hong Hua (Flos Carthami),[6] and Chi Shao (Radix Paeoniae Rubra).[7] Herbs with anticoagulant effects include Shui Zhi (Hirudo) and Tao Ren (Semen Persicae).[8]^,[9] There are many herbs in this formula that also have a marked influence on the cardiovascular system. For example, Dang Gui (Radix Angelicae Sinensis) has a positive inotropic and a negative chronotropic effect.[10] Furthermore, it has been shown to improve overall blood circulation by decreasing the whole blood specific viscosity, or improving the hemorrheological changes in "blood stasis."[11] Use of Zhi Qiao (Fructus Aurantii) showed a marked ability to lower the oxygen requirement of cardiac muscle.[12] Jie Geng (Radix Platycodonis) has been shown to dilate blood vessels and increase blood perfusion to peripheral parts of the body.[13] Lastly, Chuan Xiong (Rhizoma Chuanxiong) dilates blood vessels to lower blood pressure, increases blood perfusion to coronary arteries, and decreases oxygen consumption by the cardiac muscle.[14]

        Clinically, Circulation (SJ) may be used individually, or as an adjunct to other formulas to treat a wide variety of cardiovascular, circulatory, clotting, and related disorders. Dang Gui (Radix Angelicae Sinensis) has been used in formulas with good success to treat 40 patients with cerebral vascular accident.[15] Hong Hua (Flos Carthami) has been used in formulas with a 94.7% rate of effectiveness to treat 137 patients with cerebral thrombosis,[16] and an 80.8% rate of effectiveness in relieving chest pain in 100 patients with coronary artery disease.[17] Chi Shao (Radix Paeoniae Rubra) has been used with a 92.01% rate of effectiveness for prevention of thrombus formation in 263 patients.[18] Chuan Xiong (Rhizoma Chuanxiong), when given via injection, was associated with relief of pain in 92.5% of patients with angina,[19] a 94.5% rate of effectiveness among 400 patients with cerebral thrombosis,[20] and a 90% rate of effectiveness for 50 patients with acute cerebral embolisms.[21] Lastly, coronary artery disorder may be effectively treated with formulas that contain Yan Hu Suo (Rhizoma Corydalis) or Pu Huang (Pollen Typhae).[22]^,[23]

        Circulation (SJ) is formulated following the principles of three classic formulas: Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction), Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction), and Shao Fu Zhu Yu Tang (Drive Out Blood Stasis in the Lower Abdomen Decoction). Because of this formulation strategy, Circulation (SJ) can also be explained from the perspective of how it is used to treat disorders of the upper, middle, and lower jiaos.

        Circulation (SJ) uses Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) to treat blood stasis in the upper jiao, a condition characterized by circulatory disorders in the upper parts of the body. Clinically, Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) has been shown to have a 89.3% rate of effectiveness to treat cardiac ischemia in 84 patients,[24] a 92.8% rate of effectiveness to treat bradyarrhythmia in 28 patients,[25] a 90% rate of effectiveness to treat vascular headache in 50 patients,[26] a 93.33% rate of effectiveness to treat headache in 15 patients,[27] a 92.3% rate of effectiveness to treat concussion in 12 patients,[28] an 87% rate of effectiveness to treat cerebral atherosclerosis in 63 patients,[29] and a 95% rate of effectiveness to treat hyperlipidemia with elevated cholesterol and triglyceride levels in 20 patients.[30]

        Circulation (SJ) uses Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction) to treat blood stasis in the middle jiao. Clinical researches have been shown that Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction) has an 86% rate of effectiveness to treat hepatic hemangioma in 32 patients,[31] a marked effect to treat chronic active hepatitis in 25 patients,[32] good success to treat pleural adhesion in 60 patients,[33] a 90.6% rate of effectiveness to treat chronic pelvic inflammatory disease in 64 patients,[34] a 90% rate of effectiveness to treat prostatic hypertrophy in 22 patients,[35] a 96% rate of effectiveness to treat chronic colitis in 75 patients,[36] and a 90% rate of effectiveness to treat gastric or duodenal ulcer in 30 patients.[37]

        Circulation (SJ) uses Shao Fu Zhu Yu Tang (Drive Out Blood Stasis in the Lower Abdomen Decoction) to treat blood stasis in the lower jiao, a condition characterized by circulatory disorders in the lower parts of the body. According to numerous clinical research studies, Shao Fu Zhu Yu Tang (Drive Out Blood Stasis in the Lower Abdomen Decoction) has a marked effect to treat both male and female infertility.[38]^,[39],[40] Furthermore, it may also be used to treat various other disorders with great success, such as a 97.5% rate of effectiveness in 40 women with endometriosis,[41] a 92% rate of effectiveness in 50 women with oophoritic cyst,[42] a 97% rate of effectiveness in 100 patients with dysmenorrhea,[43] a 94% rate of effectiveness in 14 patients with hysteromyoma,[44] a 92% rate of effectiveness in 42 women with pelvic inflammatory disease,[45] and a marked effect in 32 women with uterine bleeding associated with functional disorder.

        In summary, Circulation (SJ) is an herbal formula with a wide range of therapeutic applications to address numerous disorders characterized by qi stagnation and blood stasis. Pharmacologically, many herbs in this formula have marked antiplatelet, anticoagulant, thrombolytic and vasodilating effects. Clinically, the herbs in Circulation (SJ) have been shown to treat cardiovascular, circulatory, clotting, and many other disorders.

 

COMPARATIVE ANALYSIS

Cardiovascular and circulatory disorders are complex illnesses that affect various parts of the body. In Western medicine, these disorders are treated with medications such as antiplatelets [aspirin and Ticlid (ticlopidine)] and anticoagulants [heparin and Coumadin (warfarin)]. In emergencies, nitroglycerin and thrombolytic drugs may be used to dilate blood vessels and dissolve blood clots, respectively. Though these drugs have serious side effects, their use can be justified because they offer tremendous benefits, especially in urgent situations.

        Use of herbs is also beneficial to treat cardiovascular and circulatory disorders. In fact, many drugs used for treatment of cardiovascular and circulatory disorders are originally derived from natural sources. Similarly, these herbs have similar pharmacological effects to those of the drugs, such as antiplatelet, anticoagulant, thrombolytic, and vasodilating effects. Furthermore, herbs are much safer than drugs, as they have a regulatory effect on blood hemodynamics, thereby achieving desired effects with minimal side effects.

        Both drugs and herbs are effective for prevention and treatment of mild to moderate cases of cardiovascular and circulatory disorders. Drug therapies are more potent and precise, but do have more side effects. However, drugs are simply the most effective and most reliable therapy in emergency cases such as in acute heart attack. On the other hand, herbs are effective for both prevention and treatment of cardiovascular and circulatory disorders. However, they should not be used in emergencies, as Western medicine is more suitable for crisis management.