Zhi Bai Dihuang Wan​ (Anemarrhena, Phellodendron, and Rehmannia Pill) is a commonly used formula in Traditional Chinese Medicine to nourish yin and reduce fire, with the functions of enriching kidney yin and clearing deficiency heat. However, through strategic formulation, it can be adapted to address more complex body constitutions and achieve enhanced therapeutic outcomes.

Zhibai Dihuang Wan + Guifuzhi Dihuang Wan → Regulating both yin and yang deficiency

If both symptoms of kidney yin deficiency and kidney yang deficiency appear, such as soreness and weakness in the waist and knees, difficulty urinating, feeling both cold and hot, night sweats, and intermittent fever, this condition of dual deficiency can refer to the combination of these two formulas. Zhibai Dihuang Wan nourishes yin and reduces fire, while Guifuzhi Huang Wan warms and tonifies kidney yang. When used together, they can tonify both yin and yang, harmonizing the body's yin-yang balance.

Zhibai Dihuang Wan + Buzhong Yiqi Wan → Improving qi and yin deficiency

When qi and yin deficiency is accompanied by excess fire, common symptoms include fatigue in the limbs, general weakness, poor appetite, sallow complexion, dizziness, and blurred vision. In this combination, Zhibai Dihuang Wan nourishes yin and clears heat, while Buzhong Yiqi Wan tonifies the spleen and Qi. Together, they synergistically tonify qi and yin while clearing and reducing excess fire.

Zhibai Dihuang Wan + Jiaotai Wan → Solving upper heat and lower cold

Many people experience upper body heat (mouth ulcers, gum swelling and pain) and lower body coldness (lower back and knee cold pain, frequent urination and diarrhea) symptoms associated with upper heat and lower cold syndrome, which is often related to the imbalance between the heart and kidneys. The kidney water cannot nourish the heart fire, and the heart fire cannot warm the kidney water. In this combination, Zhibai Dihuang Wan nourishes the kidneys and reduces fire, while Jiaotai Wan (Coptis chinensis, Cinnamon bark) harmonizes the heart and kidneys, guiding the fire back to its origin.

Case Sharing

Case Example:​ Mr. Wang, a 45-year-old teacher, presented with recurrent oral ulcers, cold pain in the lower back and knees, and frequent nocturia after a period of prolonged overwork. He experienced unbearable heat sensations in his upper body, while his lower body felt cold and averse to cold. His tongue was red with scant coating, and his pulse was thin and rapid. The pattern was differentiated as heart-kidney disharmony​ (failure of communication between the heart and kidneys) with upper heat and lower cold. He was treated with a modified combination of Zhi Bai Dihuang Wan​ and Jiaotai Wan​ (Communicating Heaven and Earth Pill). After one week of medication, his oral ulcers healed. After two weeks, the cold pain in his lower back and knees lessened. After one month, his primary symptoms were largely resolved.

It should be noted that the combination of traditional Chinese patent medicines is best done under the guidance of a physician. The dosage ratios for different constitutions and syndromes require professional differentiation, and medication should not be used arbitrarily without consultation.