How to treat Raynaud's Phenomenon with Chinese Medicine?

Tiejun Tang
This winter is extremity cold; many people have very cold hands and feet in such weather. Some people’s cold extremities come by episodic attacks. When the attack occurs, the skin colour changes from white to blue and red. The hands and feet become cold and numb. Some patients describe the sensation as tingling, or painful "pins and needles". The attack is usually triggered by exposure to cold or emotional stress. This phenomenon is called Raynaud’s phenomenon in western medicine. This phenomenon can be subdivided into primary and secondary conditions. The primary form is known as Raynaud’s disease, whereas the secondary form is known as Raynaud’s syndrome.

Raynaud's phenomenon is a disorder that affects the blood vessels in the fingers and toes. This disorder causes vasospastic attacks where the blood vessels in the fingers and toes constrict thus causing a loss of circulation. This phenomenon can affect between 5 to 10 percent of the general population. Women are more susceptible to have the disorder in comparison to men, and it appears to be more prevalent in the winter season of colder climate areas.

In Western medicine the treatment of Raynaud's syndrome is carried out with calcium-channel blockers. These cause the smooth muscle to relax and consequently dilate the small blood vessels. In some patients, doctors use alpha blockers that counteract the actions of norepinephrine. These medicines can often cause some side effects, in which case many patients have to stop using them. These medications may also have a detrimental affect on a growing foetus; therefore women who are pregnant or are trying to have a baby should avoid taking these medications. Unfortunately Raynaud’s is more likely to occur in women of childbearing age.

In Chinese medicine Raynaud’s phenomenon falls within the category of Hanjue (寒厥). It means cold extremities. The interior pathology of this disease is Qi and blood deficiency and Yang deficiency, whereas the exterior pathology would relate to cold invasion within the meridian. The treatment principle should be to nourish the qi and blood, whilst expelling the cold and to warm the yang. This theory can be carry out through the use of herbs, acupuncture and moxibustion.
A herbal prescription suitable for this condition is; Danggui Sini Tang. This would be used as the first choice for this disease, as it is a traditional formula which originates from Shanhanlun, a classic text of TCM, written by Zhang Zhongjing about 1700 years ago. The ingredients include; Danggui (Angelica sinensis), Guizhi (Ramulus Cinnamomi), Baishao (Radix Paeoniae Alba), Xixin (Manchurian Wildginger), Tongcao (Tetrapanax papyriferus), Dazhao（Fructus Jujubae）, Zhigancao (Radix Glycyrrhizae Preparata). If patient have more qi deficiency symptoms, add Huangqi (Radix Astragali) and Baizhu (Rhizoma Atractylodis Macrocephalae). If there is more of a blood deficiency, Jixueteng (Millettia dielsiana) and Heshouwu (Fallopia multiflora) can be add, and if there is more of a yang deficiency, Rougui (Cortex Cinnamomi) and Ganjiang (Dried Ginger) can be included.

With regards to the Acupuncture and moxibustion, these can be very helpful in the treatment of Raynaud’s disease. The acupuncture point selection would include; Mingmen (DU4), Shenshu (BL23), Guanyuan (RN4), Qihai (RN6), Xuehai (SP10), Zusanli (ST36), Baxie (EX-UE9), Bafeng (EX-LE10). Reinforcing manipulation can also be applied. The specific point selection for Moxibustion application should be Guanyuan (RN4) and Shenque (RN8).

I have a student who has been diagnosed with Raynaud’s disease. She often has Raynaud’s attacks during the winter period, but has cold hands and feet all year. She came to see me with regards to this problem last summer, and after few treatment sessions her hands and feet felt a lot warmer. Her Raynaud’s attack did not occur this winter.

Chinese medicine therapy is effective in treating both primary and secondary Raynaud’s phenomenon. It never causes any side effects, and is safe for pregnant women. If you often have cold limbs you need to nourish your qi and blood and warming your meridian pathways at any time during the year, you should not wait until winter. Generally it is better to start your treatment before the attack happens. A good treatment can give you a warmer and more comfortable winter.