Tong Qiao Huo Xue Tang (TQHXT)
Specifically for Migraine
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Why it works for Migraine:
Traditional TCM rationale
- In TCM the formula is used for “blood stasis in the head/face” causing headache, vertigo and related signs. The formula’s actions are described as “activate blood, resolve stasis and open the orifices” — conceptually that maps to improving circulation in the head and relieving stagnation that TCM links to headache. TCM Wiki
Modern pharmacological / physiological mechanisms (proposed)
- Several of the component herbs (e.g. Chuanxiong (Ligusticum), Hong Hua (Carthamus/safflower), Tao Ren (peach kernel)) have demonstrated vasodilatory, antiplatelet/anticoagulant or blood-flow-improving actions in lab and animal studies. Such effects could plausibly reduce vascular tension, microthrombi or local ischemia that are theorised in some headache mechanisms. ScienceDirect
- Animal and cell studies of Tong-Qiao-Huo-Xue decoction show effects on cerebral blood flow, blood–brain-barrier permeability, anti-inflammatory signalling and modulation of neurotransmitters or synaptic function in brain injury/stroke models — mechanisms that could theoretically reduce headache susceptibility or intensity. These are preclinical and not direct migraine trials, but they provide plausible biological pathways. ScienceDirect
Summary: TCM theory + pharmacology of constituent herbs gives a plausible basis — the formula is traditionally targeted at “blood stagnation” of the head and modern studies show circulatory / anti-inflammatory / neuroprotective actions in preclinical models. That plausibility is supportive but not definitive proof for migraine. TCM Wiki
How to use for Migraine:
Traditional decoction (classical instructions)
- The classic recipe (from Yi Lin Gai Cuo, Wang Qingren) lists: Chi Shao (3 g), Chuan Xiong (3 g), Tao Ren (9 g), Hong Hua (9 g), Cong Bai (scallion) (3 g), Sheng Jiang (9 g), Da Zao (7 dates), plus tiny She Xiang (musk). Traditional preparation: decoct the herbs in yellow wine and take before bed (this is how it’s recorded in classical sources). Exact gram weights vary by edition/practitioner. TCM Wiki
Modern manufactured preparations
- TQHXT is commonly available as pills/teapills or capsules. Over-the-counter product guides and some suppliers report a common pill dose such as 8 pills, three times daily (product formulations vary; check the product label). Some clinical reports used standardised granules or decoctions with specified gram equivalents. If using packaged products, follow the manufacturer/practitioner dose on the label. Yue Fung Tong
Clinical practice (what clinicians do)
- In Chinese clinical reports the formula has been used as a decoction given orally for 1–2 week courses in acute settings or over longer periods for chronic problems — but protocols vary across studies and clinical settings. Some trials combine the decoction with acupuncture or with Western preventive medications. If a licensed TCM practitioner prescribes it, they will tailor dose, frequency and duration to the patient’s TCM pattern and co-medications. J-GLOBAL
Practical advice
- Do not self-prescribe without checking: because this formula is blood-activating it interacts with bleeding risk and pregnancy (see warnings below). Best practice: consult a qualified TCM practitioner or clinician; if you take anticoagulants, consult the prescribing physician before starting. Chinese Herbal Dictionary
Scientific Evidence for Migraine:
What exists specifically for migraine
- There are relatively few high-quality, large RCTs in English journals testing TQHXT specifically for migraine. Several Chinese clinical reports and small trials claim benefit for migraine — for example:
- A clinical observation reported in Chinese literature comparing TQHXT vs flunarizine (salt form: flunarizine hydrochloride) in migraine — the summary report states higher effectiveness in the TQHXT group (reported in Hunan Zhongyi Zazhi 2012). These are typically small, single-centre Chinese trials with limited reporting in English. zysj.com.cn
- A clinical report indexed on J-GLOBAL described TQHXT combined with wrist-ankle acupuncture for migraine and reported clinical benefit; details are in Chinese and the study designs are usually non-blinded or observational. J-GLOBAL
Related evidence from cerebrovascular / neurological studies
- Much higher volume of research exists for TQHXT in cerebrovascular disease / ischemic stroke (animal models, clinical RCTs in China, and systematic reviews/meta-analyses). Systematic reviews find TQHXT combined with Western medicine often shows improved surrogate outcomes in ischemic stroke trials — however these are a different condition and cannot be directly equated with migraine. Europe PMC
Quality & limits
- Most migraine data are small, frequently Chinese-language clinical reports with limited methodological detail, and many modern pharmacology data are preclinical (animal, cell). High-quality, double-blind, placebo-controlled RCTs of TQHXT specifically for migraine in international journals are sparse. Therefore the evidence for migraine is suggestive but not conclusive; more rigorous trials are needed. zysj.com.cn
Specific Warnings for Migraine:
Bleeding risk & drug interactions: key herbs in TQHXT (Hong Hua / safflower and Tao Ren / peach kernel, and others) have antiplatelet/anticoagulant effects or are reported to potentiate bleeding. If you are taking anticoagulants/antiplatelet agents (warfarin, heparin, aspirin, clopidogrel, NOACs, etc.) do not start TQHXT without discussing with your prescriber. Herbal components may have additive effects on bleeding risk. Chinese Herbal Dictionary
Pregnancy: TQHXT is contraindicated or strongly cautioned against in pregnancy because it is a blood-activating formula (can stimulate uterine activity and raise miscarriage risk). Several components (Tao Ren, Hong Hua, She Xiang/musk) are classically listed as contraindicated in pregnancy. Do not use during pregnancy. chineseherbinfo.com
She Xiang / musk considerations: She Xiang (natural musk) is rare/expensive and can have effects on heart rate and blood pressure; historically it was used in tiny amounts. Natural musk from wild musk deer is endangered and regulated — many modern products use synthetic substitutes. There are specific cautions (pregnancy, hypertension, legal/ethical sourcing). chineseherbinfo.com
Allergic reactions / GI effects / herb quality variability: as with any herbal product, there’s a risk of allergic/dermatologic or GI adverse effects. Also, product quality varies across manufacturers: adulteration, inaccurate herb identity, or heavy-metal contamination are potential concerns with non-regulated supplements. Choose reputable manufacturers and, when possible, practitioner-grade products that provide testing. (Systematic reviews of TQHXT often note sparse reporting of adverse events in trials.) Herald Open Access
Use with surgery or invasive procedures: because of antiplatelet effects, stop use before planned surgery—discuss timing with your surgeon/clinician. (This is general best practice when taking blood-affecting herbs.) Chinese Herbal Dictionary
General Information (All Ailments)
What It Is
Tong Qiao Huo Xue Tang (TQHXT) is a classical blood-invigorating formula in Traditional Chinese Medicine (TCM). It was first recorded in Wang Qing-Ren’s Yi Lin Gai Cuo (《医林改错》), a Qing-dynasty text focused on pathology of “blood stasis.” The formula is designed primarily to open the orifices of the head and sensory portals by promoting the circulation of blood and fluids upward to the head and face.
Core ingredients typically include:
Chuan Xiong, Tao Ren, Hong Hua, Chi Shao (or Bai Shao variants), She Xiang (aromatic or modern substitute), Cong Bai (scallion stalk), Sheng Jiang (fresh ginger juice), and Da Zao (jujube). Modern prescriptions may modify due to regulation or patient-specific patterns.
How It Works (TCM Mechanism)
TQHXT is used when TCM diagnosis implicates obstruction of the sensory orifices due to blood stasis and constrained fluids. Mechanistically in TCM language, the formula:
• “Moves blood” — disperses static or congealed blood that fails to nourish the upper orifices.
• “Opens the portals” — aromatic agents and blood-invigorators relieve obstruction so the clear Yang can ascend.
• “Regulates fluids” — promotes proper movement of nasal, ocular and cranial fluids so congestion resolves.
• “Harmonizes ascent” — by moving and warming without excessive drying, it helps the head receive sufficient, unobstructed supply.
Biomedical corollaries proposed in contemporary research include: microcirculation enhancement, reduced blood viscosity, anti-platelet/anti-thrombotic tendencies, and modulation of inflammatory mediators, though evidence is heterogeneous and largely pre-clinical or small-scale.
Why It’s Important
From a TCM clinical logic point of view, stasis-based head symptoms rarely respond to “clearing” or “draining” alone. When the underlying driver is mechanical/congestive (stasis), removing heat or mucus without moving blood can produce only short-lived or incomplete relief. TQHXT addresses a root mechanism — the failure of free movement of blood and fluids affecting the head — rather than suppressing downstream symptoms.
It therefore occupies an important niche: head and sense-organ complaints with a blood-stasis signature (e.g., fixed, stabbing, or chronic/recurrent patterns; purplish tongue or choppy pulse; stubborn nasal or orbital congestion not relieved by simple antihistamine-like strategies; post-injury sequelae, etc.). In these patterns, “activating” can be more corrective than “clearing.”
Considerations (Appropriate Use, Safety and Clinical Handling)
TQHXT is not a general “head formula”. It is intended only when a practitioner judges that blood stasis obstructing the portals is present. Using it in the wrong pattern can aggravate symptoms (e.g., using blood-movers in patients with qi deficiency collapse, or in dry-fluid patterns without stasis).
Additional considerations:
• Individualization is the rule — the classical base is often modified (e.g., aromatic substitutions, removal of musk, addition of phlegm-transformers or heat-clearers depending on tongue/pulse).
• Bleeding risk — blood-invigorating herbs may interact with anticoagulant/antiplatelet drugs or be inappropriate in hemorrhagic diathesis or active bleeding.
• Pregnancy — formulas that move blood are typically used with caution or are contraindicated, depending on context.
• Aromatics — classical musk (麝香) is strictly regulated or replaced; modern clinical equivalents preserve intent without employing banned substances.
• Chronicity and supervision — TQHXT is not meant for long-term blind self-administration; periodic reassessment is standard to avoid overshooting once stasis resolves.
Helps with these conditions
Tong Qiao Huo Xue Tang (TQHXT) is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Migraine
Traditional TCM rationaleIn TCM the formula is used for “blood stasis in the head/face” causing headache, vertigo and related signs. The formula’s act...
Tinnitus
TCM rationale (blood stasis in the head/ear): TQHXT is a classic Wang Qing-ren formula for “blood stasis in the head/face,” a pattern that can include...
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