Dang Gui Liu Huang Tang (Tangkuei and Six Yellow Decoction)

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Indications

Western Uses:

• What is Dang Gui Liu Huang Tang used for in modern practice?

  In modern practice Dang Gui Liu Huang Tang is referenced for night sweating and heat-intolerance patterns, most often menopausal/perimenopausal night sweats and hot flashes, and as an adjunct alongside antithyroid drugs for hyperthyroidism (Graves’ disease), where Western medicine recognizes vasomotor sweating and heat intolerance.

  These biomedical correlates are offered as a reference to the formula’s traditional use, not as a claim that it treats any disease. A small body of randomized-trial evidence exists for menopausal symptoms and as a hyperthyroidism adjunct (see research), but overall trial quality remains low. Any use for a diagnosed condition belongs with a qualified practitioner and appropriate medical care.

  Source: traditional-use correlates summarized from Bensky & Barolet, Formulas & Strategies, cross-checked against PubMed clinical literature (see research); reference only, not a treatment claim.

Originally Appeared In:

• Secrets from the Orchid Chamber (Lan Shi Mi Cang)

Notes:

• Where does the name Dang Gui Liu Huang Tang come from, and how does it compare with other sweat-stopping formulas?

  “Six Yellow” (liu huang) refers to the six ingredients whose names contain the character huang (yellow): Huang Qin, Huang Lian, Huang Bai, Huang Qi, Sheng Di Huang, and Shu Di Huang — Dang Gui is the seventh, unnamed herb that rounds out the formula. It was recorded by Li Dongyuan in Lan Shi Mi Cang (Secret Records from the Orchid Chamber, Jin dynasty) as the classic formula for night sweats due to yin deficiency with effulgent fire.

  • vs Mu Li San: Mu Li San (Calcined Oyster Shell Powder, with Huang Qi, Ma Huang Gen, Fu Xiao Mai) stabilizes and astringes sweat from wei-qi/exterior deficiency without heat; Dang Gui Liu Huang Tang is for sweat driven by fire, with clear heat signs.
  • vs Liu Wei Di Huang Wan / Zhi Bai Di Huang Wan: those nourish Kidney yin (and, with Zhi Mu/Huang Bai added, drain deficiency fire more broadly) but are not specifically built to stop sweating the way the three-yellows-plus-Huang-Qi combination here is.

  Key point: the formula’s Huang Qi is given in a distinctly larger dose than the other six herbs specifically to secure the exterior and stop the sweat, not primarily to tonify qi.

  Source: Bensky & Barolet, Formulas & Strategies; formula origin cross-checked against Qiu J et al., Medicine (Baltimore) 2024 (PMID 39252269), which dates the formula to Lan Shi Mi Cang, 1276.

Clinical Studies & Research:

• Is there modern research on Dang Gui Liu Huang Tang?

  Yes — a modest body of randomized-trial evidence plus network-pharmacology and cell-based mechanistic work, though overall quality is described as low. A systematic review of five RCTs found Danggui Liuhuang decoctions may improve Kupperman-index menopausal symptom scores comparably to conventional drug therapy, though the certainty of evidence was rated very low. A larger meta-analysis of 20 RCTs (1,757 patients) found the formula added to antithyroid drugs improved thyroid function markers and symptom scores versus antithyroid drugs alone in hyperthyroidism, with fewer adverse events, again with generally low methodological quality in the source trials.

  • Menopausal symptoms (clinical, low-certainty): systematic review of 5 RCTs, Kupperman index outcomes (PMID 32613007).
  • Hyperthyroidism adjunct (clinical meta-analysis): 20 RCTs, 1,757 patients, combined with antithyroid drugs vs antithyroid drugs alone (PMID 39732298).
  • Night sweats mechanism (preclinical/computational): network pharmacology and molecular docking identified baicalein, quercetin, and other constituents acting on IL-6, TNF, and PI3K-Akt-related targets (PMID 39252269).

  Sources: PubMed 32613007; PubMed 39732298; PubMed 39252269 / PMC 11384048. Research context, not a therapeutic claim; direct high-quality clinical trial evidence remains limited.