Tian Ma Gou Teng Yin (天麻钩藤饮): Gastrodia and Uncaria Decoction — Calming Liver Wind and Yang

What Is Tian Ma Gou Teng Yin?

Tian Ma Gou Teng Yin (天麻钩藤饮) — the “Gastrodia and Uncaria Decoction” — is a modern classic formula that bridges traditional TCM wisdom with 20th-century clinical research. Developed in the 1950s by a research group at the Hunan College of Chinese Medicine, it was specifically designed to address Liver Yang Rising with Wind — the TCM pattern most closely associated with modern hypertension.

Unlike formulas inherited from ancient texts, Tian Ma Gou Teng Yin was created through systematic clinical observation of hypertensive patients, matching TCM pattern differentiation with herbs of demonstrated efficacy. It has since become one of the most widely prescribed formulas in modern Chinese hospitals for cardiovascular conditions.

Formula Composition

Herb	Chinese Name	Dosage	Role
Tian Ma	天麻	9g	Chief — extinguishes Wind, calms Liver Yang
Gou Teng	钩藤	12g (post-decoct)	Chief — calms Liver, extinguishes Wind, reduces BP
Shi Jue Ming	石决明	18g (decoct first)	Deputy — calms Liver Yang, anchors to lower
Zhi Zi	栀子	9g	Assistant — clears Heart and Liver heat
Huang Qin	黄芩	9g	Assistant — clears Liver heat
Chuan Niu Xi	川牛膝	12g	Assistant — directs blood downward, invigorates
Du Zhong	杜仲	9g	Assistant — nourishes Liver-Kidney, strengthens lower
Yi Mu Cao	益母草	9g	Assistant — invigorates blood, promotes urination
Ye Jiao Teng	夜交藤	15g	Assistant — calms spirit, promotes sleep
Fu Shen	茯神	9g	Assistant — calms Heart, promotes urination

Ingredient Analysis

The Chief Pair — Tian Ma + Gou Teng:

This is the core of the formula:

• Tian Ma (Gastrodia): The premier herb for extinguishing internal Wind. It does not have a strong flavor — its action is focused and penetrating. It specifically targets dizziness, vertigo, and headache from Liver Yang rising.
• Gou Teng (Uncaria): Calms Liver and extinguishes Wind. Modern research shows it contains rhynchophylline, which has vasodilatory and antihypertensive effects. Must be added late in decoction (后下) to preserve active compounds.

The Anchoring Force — Shi Jue Ming + Chuan Niu Xi:

• Shi Jue Ming (Abalone Shell): Heavy and settling — anchors the rising Yang downward. Must be decocted first (先煎) to release minerals.
• Chuan Niu Xi: Directs blood and Fire downward toward the lower body. This is the key directional herb — it literally pushes the pathological upward-rising energy back down.

Heat-Clearing — Zhi Zi + Huang Qin:

• Clears the heat that accompanies and drives Liver Yang rising
• Zhi Zi clears triple burner heat; Huang Qin specifically targets Liver-Gallbladder heat

Kidney Support — Du Zhong:

• Nourishes Liver and Kidney — addressing the underlying deficiency that allows Yang to rise
• Strengthens the lower body as a counterweight to upper body rising

Spirit-Calming — Ye Jiao Teng + Fu Shen:

• Calms the Shen (spirit) for insomnia, irritability, and restlessness
• Addresses the emotional and sleep components of the pattern

Blood Regulation — Yi Mu Cao:

• Invigorates blood and promotes urination
• Ensures that as Yang is calmed and heat is cleared, the blood moves smoothly

TCM Pattern: Liver Yang Rising (肝阳上亢)

Key Signs

Symptom	Description
Headache	Often at temples or vertex, throbbing, worse with anger or stress
Dizziness / Vertigo	Feeling of head spinning or unsteadiness
Tinnitus	Ringing in ears, often high-pitched
Irritability	Easy anger, short temper, feeling of heat rising to head
Insomnia	Difficulty falling asleep, vivid dreams
Red face and eyes	Flushed complexion, bloodshot eyes
Hypertension	Elevated blood pressure readings

Tongue: Red body, especially tip and sides; thin yellow coating Pulse: Wiry, tight, or rapid — especially at the Liver position

Why Liver Yang Rises

The Liver in TCM is like a tree — it naturally grows upward. When Liver Yin and Kidney Yin are sufficient, this upward energy is contained. But when Yin becomes deficient (through aging, stress, overwork, or poor sleep), there is nothing to anchor the Yang energy, and it rises unchecked to the head — causing headaches, dizziness, and high blood pressure.

Clinical Applications

1. Hypertension (高血压)

The primary modern application:

• Essential hypertension with Liver Yang Rising pattern
• Often shows best results for mild-to-moderate elevation
• Especially effective for hypertension with prominent headache and dizziness symptoms
• Many Chinese hospitals use this formula as standard TCM treatment for hypertension

2. Headaches (头痛)

• Throbbing headaches, especially at temples
• Vertex (top of head) headaches — Liver meridian territory
• Stress-related tension headaches
• Morning headaches associated with high blood pressure

3. Vertigo and Dizziness (眩晕)

• Tian Ma is considered the single most important herb for dizziness in TCM
• The formula is highly effective for Meniere’s disease–type vertigo
• Positional dizziness worsened by movement

4. Insomnia with Vivid Dreams (失眠多梦)

• Difficulty falling asleep due to racing thoughts
• Waking between 1–3 AM (Liver time)
• Vivid, sometimes disturbing dreams
• Restless sleep with frequent waking

5. Tinnitus (耳鸣)

• High-pitched ringing in the ears
• Worse with stress or emotional upset
• Associated with dizziness or headache

Modern Research

Clinical studies on Tian Ma Gou Teng Yin have shown:

• Antihypertensive effects — multiple clinical trials demonstrate blood pressure reduction
• Vasodilatory — Gastrodia and Uncaria compounds relax vascular smooth muscle
• Sedative and anxiolytic — calming effects on the central nervous system
• Neuroprotective — Gastrodin (from Tian Ma) shows protective effects on neurons
• Anti-convulsant — consistent with the traditional Wind-extinguishing action
• Cerebral blood flow — improves circulation to the brain

Key researched compounds: gastrodin (Tian Ma), rhynchophylline (Gou Teng), and genipin (Zhi Zi).

Preparation and Usage

Decoction Instructions

1. Shi Jue Ming — crush and decoct first for 20 minutes (先煎)
2. Add all other herbs except Gou Teng
3. Decoction for 20–25 minutes
4. Add Gou Teng in the last 5–8 minutes (后下) — critical for preserving active compounds
5. Strain and drink warm
6. Typically taken twice daily

Commercial Forms

• Available as patent pills, granules, and capsules in Chinese pharmacies
• Granules are the most common modern form — dissolve in hot water
• Pills may be less potent but more convenient for long-term use

Precautions

Situation	Guidance
Severe hypertension	Do not use alone — combine with Western medication and medical supervision
Pregnancy	Consult practitioner — contains blood-moving herbs
Spleen-Stomach cold deficiency	Use cautiously — contains heat-clearing herbs
Very low blood pressure	Not suitable — this formula lowers blood pressure
On anticoagulants	Inform your doctor — Yi Mu Cao and Chuan Niu Xi affect blood flow

Key Takeaways

• Tian Ma Gou Teng Yin is a 1950s modern TCM classic for Liver Yang Rising and hypertension
• The chief pair Tian Ma + Gou Teng are the premier Wind-extinguishing, Yang-calming combination
• It is the most commonly prescribed TCM formula for high blood pressure in Chinese hospitals
• Also effective for headaches, vertigo, tinnitus, and stress-related insomnia
• Gou Teng must be decocted briefly (added last) to preserve its active compounds
• Modern research confirms antihypertensive, vasodilatory, and neuroprotective properties
• Should complement, not replace, prescribed blood pressure medications

Disclaimer: This article is for educational purposes only. Consult a licensed TCM practitioner before using Tian Ma Gou Teng Yin or any herbal formula.

Related Articles

• Tian Ma: Gastrodia in TCM
• Gou Teng: Uncaria in TCM
• TCM Circulation and Blood Pressure
• TCM Headache and Migraine Guide