Ginkgo Formula
Yin Guo Ye Wan
Origins: Modern Formula
Ginkgo Formula (Yin Guo Ye Wan) is a modern formula in the jian nao/bu nao (healthy brain/tonify brain) category. There are
many formulas in this category with similar names, each with its own unique approach to supporting brain function.
General Signs/Symptoms
The usual signs and symptoms will involve brain function or the central nervous system at some level: Parkinson’s disease,
Alzheimer’s disease, vertigo, “brain fog,” memory loss, poor concentration, insomnia, anxiety, and mental illness, to name a few.
Modern research has identified a number of other signs/symptoms/conditions that are effectively addressed with jian nao/bu nao
(healthy brain/tonify brain) products and with ginkgo leaf (yin guo ye). (See Indications and Modern Applications below.)
Classical Applications
1. Nourishes heart
and liver blood
2. Astringes and
protects lung qi
3. Invigorates
blood in chest
4. Opens orifices
and calms the
spirit
5. Sedates liver fire and liver wind
Ingredients
Pinyin Latin English Percent of Formula
Yin Guo Ye (chief)
Ginkgo (folium)
Ginkgo leaf
23.8%
Suan Zao Ren (deputy)
Ziziphi spinosa (semen)
Sour Date seed, Jujube seed
15.3%
Dang Gui (assistant)
Angelicae Sinensis (radix)
Dong Quai, Tang Kuei root
10.2%
Shan Yao (assistant) Dioscoreae (rhizoma)
Chinese Yam
8.5%
Rou Cong Rong (deputy)
Cistanches (herba)
Broomrape, Cistanches
6.7%
Gou Qi Zi (assistant)
Lycii (fructus)
Lycium fruit, Chinese Wolfberry
6.7%
Wu Wei Zi (deputy)
Schisandrae (fructus)
Schisandra fruit 6.7%
Yi Zhi Ren (deputy)
Alpiniae Oxyphyllae (fructus)
Black Cardamom, Alpinia fruit
5.1%
Hu Po (deputy)
Succinum (resina)
Amber
3.4%
Long Gu (assistant)
Fossilia Ossis Mastodi
Fossilized Mineral
3.4%
Ren Shen (assistant) Ginseng (radix)
Asian Ginseng root
3.4%
Jiu Jie Chang Pu (deputy)
Anemones Altaicae (rhizome)
Altai Anemone rhizome
3.4%
Bai Zi Ren (deputy)
Platycladi (semen)
Oriental Arborvitae seed, Biota seed
3.4%
General Indications / Modern Applications
• Alzheimer’s disease
• Angina
• Amnesia
• Brain fog
• Cerebral Infarction, post
• Concentration, poor
• Diabetes mellitus
• Dizziness
• Hyperlipidemia
• Inflammation, chronic
• Insomnia
• Intermittent claudication
• Liver fibrosis
• Macular degeneration
• Memory, poor
• Mental confusion
• Mental fatigue
• Mental illness
• Multiple Sclerosis
• Muscular degeneration
• Nasal congestion, chronic w/
neither cold nor heat
• Neuropathy
• Obsessive Compulsive Disorder
• Palpitations
• Parkinson’s disease
• Psychosis
• Restlessness
• Schizophrenia
• Tinnitus
• Vertigo, geriatric
Synergy of Ingredients
The base formula consists of deputy and assistant substances long believed to be able to nourish the shen (spirit) and “open” the orifices of consciousness in order to facilitate mental processing. Added to this base formula is ginkgo leaf (yin guo ye), which serves the
role of chief.
The “traditional” qualities and functions of ginkgo leaf (yin guo ye) barely hint at its more common uses today, even in China.
Ginkgo Formula Monograph © September 2013, Herbal Medicine Press
2
Ginkgo Formula
Formula Actions
• Nourishes heart and liver
blood
• Astringes and protects qi
• Invigorates blood flow
• Opens orifices and calms the
spirit
• Sedates liver fire and liver
wind
Tongue
Pale or light purple, may have red
sides, may be quivering, thin or no
coating.
Pulse
May be thin, rapid, or choppy.
Contraindications / Cautions
This formula should not be taken
concurrently with Warfarin,
Coumadin or any antiplatelet or
anticoagulant.
Dosage
Standard dosage is two tablets,
taken three times daily.
“Traditionally,” it enters only the lung channel, where it astringes the lung qi to calm wheezing and invigorates blood flow through the chest to reduce thoracic pain and oppression.
But modern research informs its use today. Extensive studies have shown the chief of this
formula to be a powerful scavenger of oxygen free radicals,i a regulator of neurotransmitters
and hormones,ii and a valuable substance in the treatment of both cardio-cerebral diseaseiii and
neurodegenerative disease.iv
The deputies in Ginkgo Formula (Yin Guo Ye Wan) all serve to either calm shen, nourish/
astringe jing, or open orifices. The main deputy, in terms of proportion and function, is jujube
date seed (suan zao ren). Jujube date seed (suan zao ren) is the chief ingredient in many of the
jian nao/bu nao (healthy brain/tonify brain) formulas which do not contain ginkgo leaf (yin
guo ye). It is astringent and tonifying, nourishing the heart yin and liver blood; it has a strong
sedating action and is often used to calm anxiety and induce sleep when there is insomnia.
Deputies with similar tonifying actions, which also calm shen are biota seed (bai zi ren), and
schisandra (wu wei zi). Lycium fruit (gou qi zi) and Chinese yam (shan yao) are assistant herbs
with the ability to astringe and nourish yin and essence, but without directly calming shen.
Two substances, both deputies, cistanches (rou cong rong) and alpinia fruit (yi zhi ren) are yang
tonics. In this formula, they serve to augment the kidney qi and jing and support the kidney
function to transform jing into marrow. Altai anemone rhizome (jiu jie chang pu) is included in
the formula for its ability to open the orifices of consciousness while it calms the shen. Amber
(hu po) and fossilized mineral (long gu) are mineral substances included to sedate and pacify an
unquiet spirit.
Ginseng (ren shen) is used in the formula, rather than its common substitute, codonopsis
(dang shen), because only ginseng can nourish qi at the level of the yuan qi, while its ability to
calm shen is superior among qi tonics. Lastly, angelica root (dang gui) is employed as an assistant because it supplements and invigorates not only heart and liver blood, but it is indicated
for conditions where the kidney function and blood have a close connection, as in its extensive
use in menstrual and postpartum disorders, in trauma formulas to help re-knit bone, and in
the treatment of post-stroke conditions.
Formula Discussion
As a modern formulation, Ginkgo Formula (Yin Guo Ye Wan) does not have a classical history. In fact, the chief ingredient, ginkgo leaf (yin guo ye), was only used in China for medicinal
purposes on a regular basis after China learned about it from the West. Over time, interest
in ginkgo leaf (yin guo ye) lead to extensive Asian research into its medicinal qualities. The
specific formulation under discussion here differs from other common formulations of jian
nao/bu nao (healthy brain/tonify brain) products precisely by the inclusion of ginkgo leaf (yin
guo ye). The remaining ingredients are all commonly used in jian nao/bu nao (healthy brain/
tonify brain) products.
In classical China, the brain did not receive anywhere near the scope and scale of medical
inquiry as it now does. Until the late Ming Dynasty “consciousness” was always believed to
reside in the heart and in the blood, while the brain, as a “curious organ,” was merely “the sea of
marrow” and the receiver of data from the senses. As the receiver of sense data, the brain was
thought to function primarily as a kind of computer, having various and influenceable degrees
of efficiency in its processing of the data it received. The “influences” come from the quality of
postnatal qi and the kidney essence we provide our brains (derived from food, drink, sleep,
and lifestyle), but also from the condition and character of our shen (spirit). It was reflection upon these ideas of how the brain’s function can be influenced and the close connection
between brain function and shen that lead Li-shi Zhen in the 16th Century to introduce his
“brain ruling” theory of consciousness, wherein he posited the brain to be the governor of
consciousness. The medical implications of this notion were not explored in the years that
followed, not even by Li-shi Zhen himself. It took another three centuries and much crossenculturation with the West before Wang Qing Ren would be able to emphatically declare
that “intelligence and memory reside not in the heart but in the brain.”
The present formulation is a reflection of both classical and modern understandings of
how certain classifications of issues related to consciousness (focus, memory, mental illness,
Alzheimer’s, sleep vs. wake, etc.) are treated medically and how brain health in particular is an
essential consideration. Ginkgo Formula (Yin Guo Ye Wan) opens/unblocks the orifices of
consciousness, nourishes the kidney yin and jing, calms shen, and invigorates the flow of blood
as well as cerebral spinal fluid. These are its primary actions, and they are all tonifying in some
sense. The secondary actions of the formula are sedative. They include draining liver fire and
settling liver wind.
Modern Applications
The modern applications of other jian nao/bu nao (healthy brain/
tonify brain) formulas are very similar and include insomnia, anxiety,
restlessness, palpitations, dream disturbed sleep,v and sinusitis or nasal
congestion that are due to kidney qi or jing deficiency.vi
Ginkgo leaf (yin guo ye) is the chief herb in Ginkgo Formula (Yin Guo
Ye Wan) and makes up nearly a quarter of the total volume. While
bearing in mind the actions and “modern applications” of the jian nao/
bu nao (healthy brain/tonify brain) base, this section will concentrate
on the results of studies performed on the chief ingredient.
Ginkgo extract has been used extensively in Europe, and approved by
the German botanical equivalent of the FDA, the E Commission, for
symptomatic treatment of depression and impairment of memory and
concentration secondary to organic brain syndrome. Ginkgo is one of
the most frequently studied herbal medicinals, with more than 400
studies completed on it in the last 30 years. It has been studied for
use in treatment of dementia, stroke, traumatic brain injury, macular
degeneration, anoxia, psychiatric illness and other disorders. Studies show that benefits from the use of this herbal medicine include
improved recognition memory, processing speed, attention, concentration, mood, tinnitus, sexual dysfunction, nephrotoxicity, glaucoma and
claudication.vii The mechanisms for how ginkgo leaf is able to be so
versatile are well understood compared to many other herbal mechanisms. They can be summed up in ten generalized actions/functions: viii
1. Anti-hyperlipidemia—The first formal studies conducted
on ginkgo were performed in Germany in the 1960s and
showed its effectiveness for lowering serum cholesterol.
2. Scavenging oxygen free radicals
3. Antagonizing platelet activating factors (PAF)
4. Strengthening the central nervous system
5. Regulating neurotransmitter and hormones
6. Improving hemorrheologic conditions
7. Hepatoprotective
8. Neuroprotective
9. Anti-inflammatory
10. Anti-anaphylaxis
Neurodegenerative and Geriatric Disease
Alzheimer’s Disease – Jian nao/bu nao (healthy brain/tonify brain)
products were originally created to treat dementia.ix Ginkgo leaf (yin
guo ye) extract has been successfully used in Europe to treat Alzheimer’s disease.x Many of the actions of how ginkgo leaf (yin guo ye) is
able to benefit Alzheimer’s patients have been well-studied. (1) It is
known to inhibit the formation of beta-amalyoid (Aß) from ß-amyloid precursor protein (APP),xi an essential stage in the pathogenesis
of Alzheimer’s disease. (2) Ginkgo leaf (yin guo ye) also inhibits free
radical accumulation induced by Aß and reduces neuron apoptosis.
Neuron apoptosis (the degeneration of neuron cells) is considered one
of the main causes of neurodegenerative disease.xii (3) Ginkgo leaf
(yin guo ye) has been shown to improve cerebral blood flow by stimulating norepinephrine secretion.xiii
Poor Memory – Perhaps no other natural substance is as well-known
to help memory as ginkgo leaf.xv
Cerebral infarction – One of the major applications of ginkgo leaf
(yin guo ye) extract is the treatment of post cerebral infarction to
promote early recovery. By virtue of its ability to dilate blood vessels,
improve microcirculation, hemorrheological conditions, and suppressing thrombosis, ginkgo leaf (yin guo ye) was seen as a possible resource
for treating patients who had recently suffered from cerebral infarction.
Later, it was expanded to be used in prevention of cerebral infarction
for patients who were considered at high risk. Both applications have
shown to be very successful. xx, xxi
Hepatology
In 2004, Yao Ping headed a study that looked at the protective effects
that ginkgo leaf (yin guo ye) had against chronic alcoholic oxidative
injury, which showed that this herb could “markedly inhibit” injury
to the liver from high levels of oxidation.xxii Several studies have been
conducted to indicate that ginkgo leaf (yin guo ye) can inhibit fibrosis
formation and even reverse liver fibrosis with no ill effects.xxiii
Diabetes Mellitus
Ginkgo leaf (yin guo ye) extract antagonizes PAF (platelet activating
factors); and in conjunction with at least two other actions, can thus
decrease insulin resistance in patients with diabetes mellitus.xxiv It also
benefits the diabetes mellitus patient by improving blood circulation
and preventing large vascular changes.xxv It was also suggested in a
study by WL Meng, et al., that diabetic neuropathy can be effectively
treated with ginkgo leaf (yin guo ye) extract.xxvi
Chemotherapy Adjuvant / Anti-Cancer
A major cause of side-effects caused by chemotherapy stems from the
resulting elevated oxygen free radicals, hydroxyl free radicals, and lipid
peroxidation (oxidative degradation of lipids) in the system. Studies
have shown that ginkgo leaf (yin guo ye) extract effectively scavenges
the free radicals and reduces peroxidation to reduce damage from
chemotherapy.xxvii
Ginkgo leaf (yin guo ye) extract beneficially influences proper gene
expression (cell proliferation, cell differentiation, and apoptosis) in
breast and bladder cancer models.xxviii
Mental Illness
In a 2005 study, positive effects were seen using ginkgo leaf extract to
treat schizophrenia patients. The positive results were believed to be
linked to ginkgo’s ability not only to scavenge oxygen free radicals, but
also to increase the levels of the body’s own antioxidant enzymes, like
superoxide dismutase (SOD), catalase, and glutathione peroxidase.xxix
In an article entitled, Atypical Antipsychotics from Scratch to the Present
Ashish Chauhan, et al., cite the use of Bu Nao Wan (Tonify the Brain
Pill) as a treatment for both psychosis and compulsive disorders. xxx
Tinnitus —A 12 week study that included 99 patients with chronic
tinnitus was conducted to determine the efficacy of ginkgo leaf (yin
guo ye) extract for treating tinnitus. Half the group was given ginkgo
leaf (yin guo ye) extract, dosed at 120 mg. daily. The other half of the
group received a placebo medication. The results indicated that the
loudness of the tinnitus sounds were, on the average, reduced significantly more in the group treated with ginkgo leaf (yin guo ye) extract. xxxi
3
Peri-menopausal and Menopausal Brain Fog – Jian nao/bu nao
products are considered suitable for treating peri-menopausal brain
fog.xvi Ginkgo leaf (yin guo ye) on its own has also been shown to be
effective in treating brain fog/poor focus.xvii
As a powerful scavenger of oxygen free radicals, ginkgo leaf (yin guo
ye) has numerous applications in cardiovascular disease. Additionally,
ginkgo leaf (yin guo ye) can help prevent damage of cardiovascular cell
membranes from cellular aging, relieve ischemia/reperfusion injury
in both brain and myocardium, protect vascular endothelium, and
improve microcirculation.xviii Ginkgo leaf (yin guo ye) raises the survival capacity of myocardial cells and protects the myocardium under
ischemic conditions.xix
Ginkgo Formula
Parkinson’s Disease – A major issue with treating Parkinson’s patients is the reliance on L-Dopa, which causes some level of neurotoxicity. Ginkgo leaf (yin guo ye) was shown to reduce this toxicity,
indicating the use of a combined L-Dopa and ginkgo treatment.xiv
Cardio-Cerebral Disease
4
Ginkgo Formula
Formula Comparisons
No other formulas compare closely with Ginkgo Formula (Yin Guo
Ye Wan). There are, of course, a number of yin and jing tonics, such
as Zizyphus Formula, Jing Qi Formula, and Nourish Essence
Formula, to name a few, but these lay little claim on nourishing the
brain or treating brain disorders. Others, such as Ming Mu Formula,
can nourish yin and help drain liver fire from the head, but the focus
is more on the eyes than the brain. Yet, there are a number of formulas
that address some of the same conditions as Ginkgo Formula. These
are too numerous to list, as the number of patterns that can produce
symptoms and the long list of indications would be multiplied together.
With this in mind, careful pattern differentiation is indispensable.
Useful Combinations
With signs of heart and liver blood deficiency leading to
symptoms of poor memory, poor concentration, poor sleep,
palpitations, and restlessness
Use with Zizyphus Formula (Suan Zao Ren Tang).
With menopausal symptoms of hot flashes, poor concentration,
brain fog, poor memory, poor sleep, irritability, restlessness,
anxiety, and palpitations due to kidney yin deficiency and
heart/liver blood deficiency
Use with Heavenly Emperor’s Formula (Tian Wang Bu Xin
Dan).
Endnotes
i
Lu, ZM., The Physiological Basis of Pharmacological Action of Ginkgo Biloba Extract and its Clinical Application, Journal of Guangxi Traditional Chinese
Medicine University, 4:131-133, 2001
ii
Ibid.
iii
Ferrante, RJ., et al., Therapeutic Efficacy of Ginkgo Biloba Extract in Transgenic Mouse Model of a Myotrophic Lateral Sclerosis, Journal of Molecular
Neuroscience,17(1) 2001.
iv
Bastianetto, S., et al., The Ginkgo Biloba Extract Protects Hippocampal Neurons Against Cell Death Induced by Beta-amyloid, European Journal of
Neuroscience, 12:1882-90, 2000.
v
Fratkin, JP, Chinese Herbal Patent Medicines—The Clinical Desk Reference, Shya Publications, 2001, p. 742.
vi
Maclean, W and Lyttleton J, Clinical Handbook of Internal Medicine, Vol.1, pp. 256-7, University of Western Sydney, 1998.
vii
Diamond BJ Shiflett, SC, Feiwel, N, et al., Ginkgo biloba extract: mechanisms and clinical indications, Archives of Physical Medicine and Rehabilitation, 81:
668-678, 2000.
viii
This list, as well as some of the studies cited is indebted to two publications: The first is a summary of studies by Wang, GX, Cao, FL, and Chen, J. The
second is a similar survey published by Mahadevan, S and Park, Y.
ix
Dharmananda, S, Alzheimer’s Disease: Treatment with Chinese Herbs, Institute for Traditional Medicine, Portland, Oregon, July 1996.
x
Ibid.
xi
Yao, ZX, Han, Z, et al., Ginkgo Biloba Extract Inhibits Beta-Amyloid Production By Lowering Free Cholesterol Levels, Nutritional Biochemistry, 15:749-56,
2004.
xii
Bastianetto, S, Ramassamy, C., et al., Ginkgo Biloba Extract Protects Hippocampal Neurons Against Cell Death Induced By Beta-Amyloid, European
Journal of Neuroscience, 12:1882-90, 2000.
xiii
Yang, YL, Su, YW, et al., Extract of Ginkgo Biloba Facilitates Fear Conditioning Measured By Fear-Potentiated Startle, Neuroscience Letter 383:145-50, 2005
xiv
Cao, F, Wang, T, et al., Experimental Study on the Neurotoxic Effect of Levodopa and the Inhibitory Effect of Ginkgo Biloba Extract in Rats, Journal of
Huazhong University of Science and Technology (Health Science), 31:174-77, 2002.
xv
Walesiuk, A, Troffimiuk, E, Braszko, JJ, Ginkgo Biloba Extract Diminishes Stress-induced Memory Deficits in Rats, Pharmacological Reports, 57:176-87,
2005.
xvi
Dharmananda, S., Perimenopausal Brain Fog Acupuncture and Herbs to Stimulate Brain Activity, Institute for Traditional Medicine, Portland, May 2005.
xvii
Kennedy, DO, Haskell, CF, et al., Acute Cognitive Effects of Standardized Ginkgo Biloba Extract Complexed with Phosphatidylserine, Human
Psychopharmacology 22:199-210, 2007. Also, Kennedy DO, Jackson PA, et al., Modulation of Cognitive Performance Following Single Doses of 120mg
Ginkgo Biloba Extract Administered to Healthy Young Volunteers, Human Psychopharmacology 22:559-566, 2008
xviii
Wang, GX, Cao, FL, et al., Progress in Researches on the Pharmaceutical Mechanisms and Clinical Application of Ginkgo Biloba Extract on Various Kinds
of Disease, Chinese Journal of Integrated Medicine, 12:234, 2006.
xix
Zhang, F, Chen, RF, et al., Effect of Gene Expression of bcl-2 and bcl-xL in Rabbit Myocardium by Ginkgo Biloba Extract, Chinese Traditional Patent
Medicine, 27:60-62, 2005.
xx
Hou, YF, Ding, J, et al., Clinical Evaluation on Treatment of Acute Cerebral Infarction. Journal of Clinical Research, 22:44-46, 2005.
xxi
Peng, YR, Jiang, J, et al., Pharmacodynamic Study of Ginkgo Leaf Extract on Promoting Blood Circulation, Journal of Chinese Pharmacological University,
34:558-560, 2003.
xxii
Yao, P, Liu, LG, Sun, XF, et al., Protective Effects of Flavonoids of Ginkgo Biloba on Liver Oxidative damage of Male Mice Induced by Chronic Alcohol
Intakes, Chinese Journal of Public Health, 20:1432-34, 2004.
xxiii
He, SX, Wang, YL, et al., Effects of Extracts of Ginkgo Biloba on CCl4 Induced Hepatic Fibrosis in Rats, Journal of Xi’an Jiongtong University of Medical
Science, 25:594-96, 2004.
xxiv
Liu LL, Yu, XR, The Medicinal Properties of Ginkgo, Chinese Traditional Herbal Drugs 25:219, 1994.
xxv
Wu, B, Han, P, Liu, YM, Effect of extract of Ginkgo Biloba Leaves on Plasminogen Activator Inhibitor 1 and Thromboxane B2 in Type 2 Diabetes Mellitus,
Chinese Journal of New Drugs and Clinical Remedies, 23:836-838, 2004.
xxvi
Meng WL, Wang RJ, Yu J, Clinical Observation on Ginkgo Biloba Leaves Extract and Vit B12 Combined Treatment in Diabetic Peripheral Neuropathies,
Chinese Journal of Integrative and Traditional Western Medicine, 24:645-6, 2004.
xxvii
Fukaya H, Kanno H, et al., Experimental Studies of the Protective Effect of Ginkgo Biloba Extract on Cisplatin Induced Ototoxicity in Rats, Nippon
Jibiinkoka Gakkai Kaiho 102:907-17, 1999.
xxviii
Papadopoulos V, et al., Drug-induced Inhibition of the Peripheral-type Benzodiazepine Receptor Expression and Cell Proliferation in Human Breast
Cancer Cells, Anti-Cancer Research, 20:2835-47, 2000.
xxix
Atmaca, M, Tezcan, E, et al., The Effect of Extract of Ginkgo Biloba Addition to Olanzapine on Therapeutic Effect and Antioxidant Enzyme Levels in
Patients with Schizophrenia, Psychiatry and Clinical Neurosciences, 59:652-6, 2005.
xxx
Chauhan, A, et al., Atypical Antipsychotics from Scratch to the Present, International Journal of Pharmacological Sciences and Research, 4(1):184-204, 2012.
xxxi
Morgenstern, C and Biermann, E., Ginkgo-Spezialextrakt Egb 761 in der Behandlung des Tinnitus, Fortshr. Med., 115:7-11, 1997. This article was cited
in Ernst, E, and Stevinson, C, Ginkgo biloba for tinnitus: a review, Clinical Otolaryngology, 24:164-167, 1999. Also cited in, Elovic, E, Zafonte, R, Gingko:
Applications in Traumatic Brain Injury, Journal of Head Trauma Rehabilitation, 16(6):603-607, 2001.