Ku Gua Huang Qi Tang, Momordica & Astragalus Decoction

This formula is a modification of Fang Ji Huang Qi Tang (Stephania & Astragalus Decoction) first found in Zhang Zhong-jings late Han dynasty Jin Gui Yao Lue (Essentials from the Golden Cabinet). The main modifications are by Wang Qi and Li Ying-shuai from the Beijing Chinese Medical University and are based on their long clinical experience in treating metabolic syndrome, diabetes mellitus, and insulin resistance. These modifications consist of eliminating Sheng Jiang (uncooked Rhizoma Zingiberis), Da Zao (Fructus Jujubae), and Gan Cao (Radix Glycyrrhizae) and adding Cang Zhu, He Ye. Pu Huang, Ji Nei Jin, Ju Hong, Shan Zha, and Da Huang. Bob Flaws has then substituted Ku Gua for Fang Ji (Radix Stephania Tetrandrae) due to that ingredients possible substitution by some aristolochic acid containing species and in order to make this formulas hypoglycemic effect even more pronounced. Our version is a 10: 1 extract in 500mg capsules.

RX
Ku Gua (Fructus Momordicae Charantiae)                     82 mg
Huang Qi (Radix Astragali)                                            68 mg
Bai Zhu (Rhizoma Atractylodis Macrocpehalae)             41 mg
Cang Zhu (Rhizoma Atractylodis)                                  41 mg
Ze Xie (Rhizoma Alismatis)                                            41 mg
He Ye (Folium Nelumbinis)                                             41 mg
uncooked Pu Huang (Pollen Typhae)                             41 mg
Ji Nei Jin (Endothelium Corneum Gigeriae Galli)             41 mg
Shan Zha (Fructus Crataegi)                                         41 mg
Ju Hong (Pericarpium Citri Erythrocarpae)                     41 mg
uncooked Da Huang (Radix Et Rhizoma Rhei)                22 mg

FUNCTIONS
Transforms phlegm and eliminates dampness assisted by fortifying the spleen and boosting the qi, clearing heat, dispelling stasis, and dispersing stagnation

INDICATIONS
An excessively phlegm damp bodily constitution with spleen vacuity, stomach and intestinal heat, blood stasis, and possible food stagnation resulting in metabolic syndrome (a.k.a. syndrome X), diabetes mellitus, high cholesterol, obesity, and high blood pressure.

CONTRAINDICATIONS
Hypoglycemia, anorexia, bulemia, chronic diarrhea

THE SIGNS & SYMPTOMS OF PHLEGM DAMPNESS INCLUDE

• Obesity 

• Profuse phlegm

• A slippery pulse 

• Bodily heaviness

• Thick, slimy tongue fur

THE SIGNS & SYMPTOMS OF SPLEEN VACUITY INCLUDE

• Fatigue 

• A swollen, enlarged tongue with teeth-marks on its edges

• Lack of strength

THE SIGNS & SYMPTOMS OF STOMACH AND INTESTINAL HEAT INCLUDE

• Excessive appetite 

• Possible bleeding gums

• Rapid hungering 

• Yellow tongue fur

• Thirst with a desire to drink 

• A possibly rapid pulse

• Possible constipation

THE SIGNS & SYMPTOMS OF BLOOD STASIS INCLUDE

• Engorged veins, including spider nevi, varicose veins, and teleangiectasia

• A purplish dark, possibly brownish skin discoloration (as in age spots)

• A purplish tongue

• A bowstring, possibly bound or intermittent pulse

THE SIGNS & SYMPTOMS OF FOOD STAGNATION INCLUDE

• Bad breath

• Abdominal distention

FORMULA RATIONALE
Metabolic syndrome is the combination of obesity, high cholesterol, insulin resistance, and high blood pressure. This syndrome is directly correlated to the incidence of life-threatening heart disease and stroke. In particular, the above formula addresses insulin resistance and diabetes mellitus in a person who is visibly overweight in their mid-section, so-called truncal or central obesity. In terms of Chinese medical patterns, this patient has lots of phlegm, dampness, and turbidity (i.e., the adipose tissue) plus stomach heat, spleen vacuity, a strong tendency to blood stasis, and the probable complication of at least some food stagnation. Therefore, within this formula, Huang Qi, Bai Zhu, and Cang Zhu fortify the spleen and boost the qi, move and transform phlegm and dampness, bank and supplement the middle burner. He Ye and Ju Hong aromatically penetrate and loosen the center, transform phlegm and disperse fat, and mildly diffuse the upper burner. Uncooked Pu Huang, uncooked Da Huang, Ji Nei Jin, and Shan Zha dispel stasis and transform phlegm, rectify the qi and disperse stagnation. Ze Xie blandly seeps and disinhibit waters, transforms phlegm and seeps dampness. Ku Gua,1 He Ye, and Da Huang clear heat from the stomach and intestines. Thus this formula treats all three burners.

In terms of pharmacodynamics, Huang Qi, Ze Xie, Bai Zhu, Cang Zhu, and Ku Gua have all demonstrated marked hypoglycemic effects. However, it is Ku Gua that has shown some of the best blood sugar lowering effects of any Chinese medicinal. To date, close to 100 in vivo studies have demonstrated the blood sugar-lowering effect of Ku Gua. In one comparative study, this herb performed better at lowering blood sugar than the hypoglycemic drug tolbutamide. This fruit has also shown the ability to enhance cells uptake of glucose, promote insulin release, and potentiate the effect of insulin. In other in vivo studies, Ku Gua has been shown to reduce total cholesterol. Further, yet other trials have shown that Ku Gua can reduce adiposity (fat) and blood pressure. He Ye suppresses appetite and promotes lipolysis, the breakdown of fat; thus it promotes weight loss. In addition, it reduces low-density lipids (LDL) while increasing high-density lipids (HDL). Shan Zha is also hypolipidemic, meaning that it too lowers blood lipid levels. It also improves the flow of the coronary arteries and lowers blood pressure.

HERB-DRUG INTERACTIONS
May potentiate exogenous insulin. May potentiate hypoglycemic drugs.

DOSAGE
3 capsules 2 times per day or as directed by your health care provider

MAY PATIENT DOES PRESENT THE SIGNS AND SYMPTOMS OF
Phlegm dampness
Spleen vacuity
Stomach-intestinal heat 
Blood stasis (not absolutely necessary)
Food stagnation (not absolutely necessary)