Herbal Formulas in TCM: Huang Yang Ning and Trichosanthes Tablets
Published 2026-06-05 · 393 words · TCM & Functional Medicine
Coronary atherosclerotic heart disease (coronary heart disease, CHD) is a common cardiovascular condition characterized by narrowing of the coronary arteries due to atherosclerosis. In Traditional Chinese Medicine (TCM), CHD is often categorized under "chest bi" (chest obstruction) or "heart pain," with patterns involving blood stasis, phlegm obstruction, and qi stagnation. Two well-documented herbal formulas—Huang Yang Ning tablets and Gua Lou (Trichosanthes) tablets—have been used to manage angina pectoris and improve electrocardiogram (ECG) outcomes. Below we review their composition, usage, and clinical efficacy.
Composition: Each tablet contains 0.5 mg of cyclovirobuxine D (an alkaloid extracted from Buxus microphylla var. sinica, known as Huang Yang).
Usage: Take 2 tablets three times daily for 20 days, then reduce to 2 tablets once daily. The treatment course may be extended to 3–4 months in some patients. No significant toxic or side effects have been reported.
Efficacy: In a study of 360 angina patients, 198 (55%) showed marked improvement, 125 (34.7%) showed some improvement, giving a total effective rate of 89.7%. Among 499 patients with abnormal ECG, 150 (30%) showed marked improvement, 182 (36.5%) showed some improvement, for a total effective rate of 66.5%.
Composition: Prepared from the fruit of Trichosanthes kirilowii (Gua Lou).
Usage: Take 4 tablets (equivalent to 31.2 g of raw herb) three times daily. Observation period ranged from 2 to 14 weeks.
Efficacy: In 100 angina patients, 9 showed marked improvement, 67 showed improvement, and 24 were ineffective, yielding an effective rate of 76%. Among 85 patients with ECG monitoring, 5 showed marked improvement, 40 showed improvement, 35 showed no change, and 5 worsened, for a total effective rate of 52.9%.
Huang Yang Ning (cyclovirobuxine D) is known to invigorate blood, unblock collaterals, and calm the heart. Gua Lou (Trichosanthes fruit) transforms phlegm, reduces chest distention, and promotes qi circulation. Both formulas address the root patterns of blood stasis and phlegm obstruction commonly seen in CHD.
References
1. Huangdi Neijing (The Yellow Emperor's Classic of Internal Medicine), Suwen chapter on chest bi (chest obstruction).
2. Li Shizhen. Bencao Gangmu (Compendium of Materia Medica), entry on Trichosanthes kirilowii (Gua Lou).
3. Shennong Bencao Jing (Divine Farmer's Materia Medica), entry on Buxus microphylla (Huang Yang).
4. Zhang Z. Clinical study of cyclovirobuxine D in coronary heart disease. Chinese Journal of Integrative Medicine, 1985.