Qi gives life to the world. Where there is Qi, there must be life. For Chinese herbal medicine, Qi mainly refers to the physiological activity of each Zang-Fu organ. For example, Spleen Qi represents the Spleen’s function of transporting and transforming water and food. Heart Qi refers to the Heart’s physiological activities of controlling the Blood and storing the Mind. Lung Qi refers to the Lung’s function of dominating inspiration and expiration. Kidney Qi represents the Kidney’s control of the bladder, sexual function, and bones.
Qi Deficiency is characterized by weakness or vacuity of these physiological activities with respect to each internal Zang-fu organ. The major clinical signs of Qi Deficiency include general weakness, fatigue, exercise intolerance, anorexia, diarrhea, loss of body weight, muscle atrophy, dyspnea, asthma, or urinary or fecal incontinence. In these patients, the tongue is often pale and wet and the pulses are usually weak. A Qi Deficiency Pattern is often seen in older patients with chronic illnesses including renal failure, congestive heart failure, chronic diarrhea, lower airway diseases, and immunodeficiency.
According to the Huang Di Nei Jing, "deficiency is treated with tonification" to restore the equilibrium of the body. There are four categories of Chinese herbs which tonify deficiency: Qi Tonics, Blood Tonics, Yin Tonics and Yang Tonics. Each herb category treats a specific Deficiency Pattern because the herbs provide counteracting properties to the particular deficiencies within that patient.
Qi Tonic Herbs are primarily for Spleen, Lung, Kidney or Heart Qi Deficiency Patterns. The Liver stores and spreads the body’s Qi, so it generally is not deficient in this respect. The mechanism of herbal action is to invigorate and enhance the physiological functions of the Zang-fu organs in order to provide a cure. The majority of these Qi tonic herbs are neutral or warm with a sweet taste.
2. Comparison of Qi Deficiency Patterns
General Qi Deficiency and clinical differentiation of Spleen, Lung, Heart and Kidney Qi Deficiency are listed in Table 1.
Table 1 Qi Deficiency and Corresponding Qi Tonic Herbal Formulations
3. How to select Qi Tonic Herbal Medicines
Chinese herbal selection is based on the diagnostic pattern. All of the following herbal medicines can be used for generalized Qi Deficiency, but a formula is specifically selected to match the main clinical complaint associated with a specific internal organ Qi Deficiency (Table 2). Acupoints with similar actions have been listed in Table 2 along with comparisons of each formula’s clinical application and its relative strength with respect to Qi tonification.
Spleen Qi Deficiency
1) Anorexia: Eight Gentlemen (Xiang Sha Liu Jun Zi Tang)
2) Vomiting: Happy Earth
3) Body Weight Loss or Muscle Atrophy: Qi Performance
4) Diarrhea: Shen Ling Bai Zhu
5) Edema: Shi Pi Yin
6) Prolapse or Fecal Incontinence: Bu Zhong Yi Qi
Lung Qi Deficiency
7) Cough, Dyspnea or Asthma: Bu Fei San
8) Poor performance or Exercise Intolerance : Qi Performance
9) Recurrent respiratory infections or other generalized immunodeficiency: Wei Qi Booster
Kidney Qi Deficiency
10) Lin syndrome or Urinary Incontinence
a. Young patient: Suo Quan Wan
b. Older patient: Jin Suo Gu Jing Wan
c. With yang deficiency or IVDD: Wu Bi Shan Yao
11) Renal failure: Rehmannia 8 (Jin Gui Shen Qi)
12) Bi Syndrome or general arthritis: Dok’s Formula or Equine Du Huo
13) Wei Syndrome or hindlimb weakness: Bu Yang Huan Wu
14) Infertility: Epimedium Powder
Heart Qi Tonic
15) Congestive heart failure: Heart Qi Tonic
16) Heart Yang and Qi Collapse: Chinese Ginseng or Ginseng and Astragalus Liquid
Other Qi Deficiency Conditions
17) Diabetes or Insulin Resistance: Jiang Tang Cha
18) With Concurrent Yin Deficiency
a. Heart disease: Sheng Mai Yin
b. Diabetes, Cushings: Rehmannia 11
c. Thyroid disorder: Jia Bing Fang
19) With Blood Deficiency
a. General: Eight Treasures (Ba Zhen Tang)
b. Immune-mediated hemolytic anemia or thrombocytopenia: Gui Pi Tang
20) With Yang Deficiency
a. Cushing’s disease: Rehmannia 14
b. CHF: Zhen Wu Tang
21) With Blood and Yang Deficiency: Shi Quan Da Bu
Table 2: Most Common Qi Tonics: Comparison of clinical applications, relative strength, and acupoints with similar actions