Tsinino Diagnosis and Treatment of Raynaud's Disease

Raynaud's disease, also known as Raynaud's syndrome, is a primary arterial spasm disorder of the extremities. Due to cold exposure, the incidence of Raynaud's disease is significantly higher in northern China compared to southern China. The disease is more common in women, and the exact cause of arterial spasm remains unclear. The main symptoms are typical episodic changes in the fingers (toes)—pallor, cyanosis, and flushing—after exposure to cold or emotional excitement, with cold, numb fingers; if untreated for long, the small arteries narrow and eventually close, leading to hard skin changes, ulcers, or ischemic gangrene at the fingertips/toes. Tsinino considers this condition within the scope of "cold extremities" in traditional Chinese medicine. The "Zhubing Yuanhou Lun" describes "Cold Extremities due to Deficiency Labor": "All meridians start from hands and feet. Deficiency labor leads to depletion of blood and qi, unable to warm the extremities, hence cold extremities." Dr. Jiang Yanzhong of the Peripheral Vascular Disease Center at Taizihe Hospital in Liaoyang believes, after years of research, that this disease results from spleen-kidney yang deficiency combined with cold invasion, leading to insufficient yang energy unable to warm the extremities. They adopt the principle of "warming meridians, dispelling cold, activating blood, and unblocking collaterals," selecting over 60 Chinese herbs to develop a series of oral decoctions for Raynaud's disease, applying syndrome differentiation and treatment based on individual patterns. The Tsinino diagnosis divides this disease into two types.
Qi Deficiency Type: Coldness, cyanosis, and pain in the extremities, general aversion to cold and weakness, pale tongue with thin white coating, taut and fine pulse. The condition belongs to spleen-kidney deficiency with cold congealing and collateral obstruction. Treatment should strengthen spleen and kidney, warm meridians, and unblock collaterals. Medications include: raw astragalus, dangshen, chinese angelica, cinnamon twig, water leech, hornet, witch hazel, stir-fried white mustard seed, achyranthes root, fine cinnamon, cinnamon, licorice, sappan wood, deer antler glue, white atractylodes, dodder seed, female virgin root, white peony, ligusticum, angelica root, roasted ginger, etc.
Blood Deficiency Type: Coldness, cyanosis in extremities, finger tips becoming thin, stiff, swollen, even ulcerated and discharging fluid, severe pain, pale complexion, general weakness, shortness of breath, pale tongue, thin white coating, deep and weak pulse. The condition belongs to blood deficiency with cold invasion and collateral obstruction. Treatment should nourish blood and qi, unblock blood vessels. Medications include: raw astragalus, peach kernel, scrophularia, achyranthes root, licorice, white芷, angelica, rehmannia, white peony, licorice, cinnamon twig, fine cinnamon, chicken blood vine, luolu tong, frankincense, honeysuckle, liji nu, windproof, soap pod, fritillary bulb, trichosanthes root, etc.
Since Raynaud's disease often flares up upon cold exposure, warming and dispelling cold is a common method in clinical practice. For those primarily with blood deficiency, the use of blood-activating and stasis-resolving herbs can be emphasized to relax vascular smooth muscle and reduce blood viscosity.