Guangci XU, Dexia ZHANG, Dan LI, Fanfan ZHANG, Yunfang LI, Suomin FENG, Jiang GONG, Xia ZHANG, Shifeng NI*

1. College of integrated traditional and Western Medicine, Hunan University of Chinese Medicine, Changsha 410208, China;

2. Pharmaceutical Institute, Xi’an Medical University, Xi’an 710021, China;

3. Department of Medicine, Tibet Nationality College, Xianyang 712082, China;

4. College of Life Sciences, Northwest University, Xi’an 710069, China

Introduction of Poria with hostwood

Sources

Poria with hostwood (Poriacum Radix Pini) parasitizes on and surround tree roots, which has better quality than ordinary Poria[1].

Characteristics

Poria with hostwood has a shape of square block, attached with cut cylinder-like hostwood. The hostwood has a width and a length both of 4-5 cm and a thickness of 0.4-0.6 cm,with a diameter of the wood center not greater than 1.5 cm. The surface of Poria with hostwood was off-white,while some is faint red. Poria with hostwood has heavy and rigid body,and is odorless, bland, and sticky while chewing. Under microscope,many irregular colorless granular masses and terminal blunt round branched masses can be seen, which were soluble in chloral hydrate, and the mycelium is long thin, slightly curve,and branched[2-3].

Processing

Cheng et al.[4]suggested that Poria with hostwood was processed with minimum usual dose as basis unit,and each block of Poria with hostwood was best controlled at a weight of about 6 g.

Identification

Physic identification A piece of genuine Poria with hostwood and a piece of fake Poria with hostwood are placed into two beakers filled with clear water, respectively, and soaked.The beaker with genuine Poria with hostwood has more brown loose scraps, while the one with fake Poria with hostwood has fewer or no. This method is suitable for identify “singlepiece fake”Poria with hostwood[5-6].

Chemical identification When iodine test solution is dropped onto samples,genuine Poria with hostwood has no change while fake Poria with hostwood changes into blue or purple brown. This method is suitable for“multiple-peice fake” Poria with hostwood[5].

Application methods and dosage

Poria with hostwood appears in 300 Chinese medicinal nootropic prescriptions in "Chinese medicinal nootropic theropy"for 79 times.It usual dosage is(35.1±7.6)g[8].It should be noted that cinnabar-coated Poria with hostwood cannot be added into decoctions, and calcined magnet and cinnabar-coated Poria with hostwood cannot be formulated into decoctions for oral administration[9-10].

Quality control of compounds

By thin-layer chromatography,Mantis egg case shows black blue spots while Poria with hostwood shows blue spots, they thus can be identified, and the method is used for the quality control of Sanfu Yishen Decoction and Sangpiaoxiao Powder[9-10].

Composition Study

Polysaccharides

Extraction process The optimal extraction process by ultrasonic method is performed by adding 15 times of water into medicinal material with a granularity of 40 mesh and ultrasonically treating at 50.0 kHz for 45 min twice.The ultrasonic method has an extraction rate better than those of decoction and enzymolysis methods, and it is time-saving, simple, convenient with higher extraction efficiency and suitable for large-scale production[13].

Polysaccharide components The main components of Poria with hostwood are polysaccharides with a content of 1%-4%, and they have main chains composed of β-(1→3)D-glucan with few β-(1→6)glucan branched chains, and contain D-galactose, D-fructose, D-rahmnose, D-mannose, D-xylose and so on[14-15].

Triterpenes

More than thirty triterpene components mainly of lanostane type tetracyclic triterpenes have been isolated from Poria with hostwood at present,which can be classified according to structural characteristics into following four groups:12 kinds of lanostane type triterpanes,9 kinds of 3, 4-seco-lanostene type triterpenes and other triterpene components[7]. Seventy eight triterpene components mainly of lanostane type tetracyclic triterpenes have been isolated from Poria with hostwood at present, which can be classified according to structural characteristics into following four groups:18 kinds of lanosta-8-ene type triterpenes, 37 kinds of lanosta-7, 9 (11)-diene type triterpenes,6 kinds of 3,4-seco-lanosta-8-ene type triterpenes, and 17 kinds of 3, 4-seco-lanosta-7, 9(11)-diene type triterpenes. In its decoction pieces, the total content of triterpenes is of 0.349 1%-0.588 7%[16].

Others

Poria with hostwood has therein components including fatty acid, gum,chitin, protein, lecithin, dextrose, adenine, histidine and choline; inorganic components including SiO2, Ca, Mg,Fe, I, Na, S, P, Mn and Cl; as well as β-pachyman enzyme and trace protease[7]. Lin extracted ergosterol peroxide, pachymic acid, 5-(4-hydroxyphenyl)dihydrogen furan-2 (3H)-ketone, β-D-Glu (3-1)-α-D-Glu and αlinolenic acid from Poria with hostwood[17].

Pharmacological Research

Pharmacology of western medicine Antitumor effect Poria with hostwood inhibits the growth of tumors mainly by triterpene components and polysaccharide components. Its poriatin can significantly inhibit the transportation of L1210 cell nucleuses of leukemic mice, and thus has a synergistic effect on anticaner drug, and it also can enhance the ability of macrophages for producing tumor necrosis factor[16].Methyl ester of triterpene compoents in Poria with hostwood can be used as tumor prophylactic. Pachymaran obtained from reaction of pachyman has an inhibition rate up to 96% to S180 sarcoma, and the pachyman derivative obtained from the hydrophilization thereof also has good antitumor effect[7]. Carboxymethyl pachyman has an inhibition rate up to 92.7% to U-14 tumor and certain inhibition effect on 5180 sarcoma and H22 liver cancer[18].

Sedative, hypnotic and anticonvulsive effects Carboxymethyl polysaccharides extracted from Poria with hostwood has good sedative effect,and can enhance the inhibition effect of thiopentone to maincenter of mice,significantly prolonging anaesthesia time[19]. Fushen mixture can significantly prolong disappearing duration of righting reflex of mice caused by sodium pentobarbital and shorten time to onset of persistent sleep,and can obviously increase animal sleep percentage together with sodium pentobarbital in a subliminal amount of pentobarbital induced hypnosis[20]. It also can postpone the incubation period of being convulsed by central stimulant pentylenetetrazole and reduce the number of convulsed mice, thus having stronger central inhibitory effect[21].Hu detected that Poria with hostwood had a good sedative effect on mice by intragastric administration and intraperitoneal injection of Fushen decoction[22]. The functional food extracted from Jujuboside and Poria with hostwood has a good effect of regulating sleep of mice, a medium dose group can prolong hypnotic lasting time induced by sodium pentobarbital and shorten the hypnotic latent period induced by sodium pentobarbital, and a high dose group also can improve the rate of sleeping mice by subliminal sodium pentobarbital[23]. Linglingshen Granule has a synergistic effect with sodium pentobarbital in increasing the number of sleeping mice[24].

Anti-inflammatory effect Pachyman has an effect of inhibiting acute and chronic inflammation reaction and an effect of inhibiting aggravation of subcutaneous granuloma of rats caused by cotton balls, and a small dose of pachyman can effectively inhibit ear swelling of mice caused by xylene[16]. Triterpenes in Poria with hostwood can inhibit the activity of phospholipase A2, and also can inhibit ear swelling of mice caused by TPA.Pachymic acid can well inhibit SLT-IIe from inducing endothelial cells of intestinal mucosa to secrete excessive sICAM-1 that weakens the adhesion between leukocytes and microvascular endothelial cells, effectively inhibiting excessive leukocytes from arriving inflammatory sites through microvessels,thus preventing excessive inflammation[7].

Bacteriostasis Filer paper with 100% extract of Poria with hostwood has an inhibition effect on Staphylococcus aureus,Pseudomonas aerugi-nosa,Bacillus anthracis,Staphylococcus albus,group A Streptococcus,Escherichia coli, group B Streptococcus,and also has a good effect of regulating intestinal flora[16].

Hepatoprotective effect Poria with hostwood has obviously protection effect on rat liver injury caused by carbon tetrachloride by remarkably reducing the activity of glutamic-pyruvic transaminase, preventing hepatocellular necrosis. Its effect of resisting necrosis of liver cells is so significant as to remarkably reduce hepatocyte swelling and accelerate hepatocyte regeneration, thereby protecting liver and lowering transaminase. Poria with hostwood also can slow down the occurrence of hepatic fibrosis of rats,and the mechanism might be related to the down regulation of TGF-β1 and PDGF expression, inhibition of HSC proliferation and activation, promotion of extracellular matrix degradation and reduction of deposition of liver fiber connective tissue[7].

Hypoglycemic effect Triterpene components of Poria with hostwood can enhance differentiation-inducing activity of insulin, and triterpene components themself also have differentiation-inducing activity[7].

Diuretic effect Pachyman can facilitate the discharge of potassium, sodium and related electrolytes in urine,with its diuretic effect strength varied according to animal species[16].

Enhancing of immune function

The material base of Poria with hostwood for regulating immune function is mainly triterpenes, soluble sugar and acidic polysaccharides[7].

Antidepression effect Poria with hostwood can up-regulate the expression level of astrocyte GFAP, which might be due to the activation effect on As, while the exact mechanism remains to be further researched[25].

Analgesic effect The result from analgesic effect of the compounds of Poria with hostwood showed that in hot plate test only its extract and soluble triterpenes has remarkable analgesic activity. The experimental result by writhing method showed water extracts, soluble triterpene components,and crude polysaccharides of the compounds of Poria with hostwood and linglingshenmi Paste can remarkably reduce mouse writhing times by inhibiting local pain induced by glacial acetic acid and improving pain threshold of mice, and the dosage of soluble triterpenes was of 0.44 g/kg,with most significant efficacy[17].

Pharmacology of Chinese medicine

Poria with hostwood is sweet in taste and neutral in nature, attributed to heart and spleen meridians. It has the effect of nourishing heart and tranquilizing mind, and mainly treat malaise, palpitation due to fright and amnesia[26].

Clinical Application

Most clinical treatments adopt this medicine for a very long history.

Insomnia

Professor Gao Ziping often adds radix polygonati officinalis and Poria with hostwood when treating insomnia caused by pruritus, with good efficacy[27]. By analyzing ancient insomnia prescription with literature search and statistical analysis, the result showed that Poria with hostwood was used for 65 times in 177 prescriptions, with a fourth utilization frequency[28]. Danzhi Xiaoyao Shengmai Mixture was used for treating 30 cases with insomnia together with western medicine therapy,achieving an effective rate of 100%[29].Fushen Zaoren Decoction had an effective rate of 95.6%in treating 68 patients with refractory insomnia[30].Shi[32]mentioned 22 prescriptions, 11 of which used Poria with hostwood.Medicated food, modified Zhuxin Fushen Decoction and Guipi Decoction was used for treating heart-spleen deficiency type insomnia with respective effective rates of 83.8% and 91.11%[33-34].Jiaotai Anshe Yin cooperated with acupuncture and moxibustion has remarkable effect in treating refractory insomnia, with a total effective rate up to 94.4%[35].

Emotional syndrome

Zhou studied 153 cases with emotional syndrome of stagnation of phlegm-dampness in middle Jiao,and found that Poria with hostwood was used for 55 times in 153 prescriptions[36].

Postpartum psychosis Forty eight patients with postpartum depression are treated with Fushen Powder by oral administration, in which 33 cases were cured, 8 cases felt obvious efficacy and 4 cases were promoted,with a total effective rate of 93.75%[37]. Hao treated postpartum depression, and classified it into three types, all of which were treated with application of Poria with hostwood[38].

Anxiety disorder Yanxue Anshen Decoction was used to treat 200 cases suffered anxiety disorder, 141 cases were cured, 40 cases were improved greatly and 13 case felt its efficacy,with a total effective rate of 90.5%[39].

Climacteric mental disorder Ganmai Dazao Decoction cooperated with Guipi Decoction was used for treat 57 cases with climacteric depression, achieving an effective rate of 96.49%[40].Modified Bozi Yanxin Pill has a total effective rate of 90% in treating climacteric syndrome[41].Modified Zhibai Dihuang Decoction was used for treating 40 cases with climacteric syndrome, in which 22 cases were cured and 16 cases acquired significant efficacy, with a total effective rate of 95%[42].

Epilepsy

Dingxian Pill attained remarkable efficacy in treating epilepsy together with sodium valproate tablets, achieving a total effective rate of 98.36%[43].Huanshen Decoction was adopted for treating 33 cases with depressive psychosis, in which 12 cases recovered,and 15 cases recognized an obvious efficacy, with a total effective rate of 81.8%[44]. In the treatment of 50 cases with insanity by Longyucheng Qi Decoction,43 cases were cured, and remarkable efficacy appeared on 5 cases,with a total effective rate of 96%[45].

Heart diseases

Modified Pingchong Wenxin Decoction was used for treating 3 patients had palpitation,all were cured[46].In treating 68 cases suffered postinfarction angina by Yiqi Tongmai Decoction combined with conventional western medicine, the higher effective rate was of 88.24%[47].In the treatment of 50 cases suffered coronary heart disease combined with arrhythmia by modified Guipi Decoction combined with metoprolol,the therapy had a significant efficacy on 26 cases and also had an efficacy on 16 cases,with a total effective rate of 84%[48]. Dingji Fumai Decoction was used for treating48 cases with sick sinus syndrome, in which 24 cases acquired significant efficacy and 16 cases was improved,achieving a total effective rate of 83%[49].

Senile dementia

In the treatment of 57 cases with vascular cognitive impairment(VCI)by Tianzhi Granule combined with western medicine , the therapy had a significant efficacy on 10 cases, and was effective to 39 cases,with a total effective rate of 86.1%[50]. Xixin Decoction can obviously improve the level of O-GlcNAcylation modifying Tau protein of hippocampus tissues in rats with sporadic Alzheimer’s disease,and thus might be capable of inhibiting hyperphosphorylation on Tau protein at important sites and Tau toxicity thereof, preventing the aggravation of sporadic Alzheimer’s disease[51].In the treatment of vascular dementia by Yizhi Decoction, a significant efficacy appeared on 82 cases, and 16 cases were improved,achieving a total effective rate of 81.82%[52].

Hypertension

Tianma Gouteng Decoction cured 99 cases and had a significant efficacy on 8 cases in the treatment of 108 cases with primary hypertension, with a total effective rate of 92.50%[53]. Cui Yuheng treats hypertension with Pinggan Qianyang Decoction and Yanxin Anshen Decoction with good effect[54].

Diabetes

Treating 66 aged patients with type 2 diabetes with Modified Fushen Buxu Decoction combined with Danxing GuiJian Decoction achieved an effective rate up to 83.33%[55]. Poria with hostwood attained an effective rate of 89% in the treatment of 38 cases with diabetes[56].

Cervicogenic cerebral ischemia

Fushen Juming Decoction can fundamentally improve blood circulation of vertebrobasilar arteries of patients with cervicogenic cerebral ischemia,achieving an idea efficacy[57].

Enuresis

In the treatment of 44 cases with Fangfushen Decoction,32 cases were cured, and 12 cases were improved,with a total effective rate of 100%[58].

Health protection

The jelly taking semen ziziphi spinosae and Poria with hostwood as main materials and white granulated sugar, edible gelatinizing agent and citric acid as auxiliary materials, has comprehensive nutrition and good health protection function[59].

Others

Ancient prescription from southern Fujian, Fengfushen, is capable of treating morbid night crying of babies and mental disorder[60]. Fushen Decoction can treat hypotension,leukopenia and rheumatic carditis[61].Mixing Poria with hostwood with cinnabar can enhance the effect of tranquilizing the mind. In Chinese medicinal prescriptions, cinnabarcoated Poria with hostwood is also a drug frequently used[62].

Summary and Prospect

Poria with hostwood is widely distributed in China, with larger resource quantity as well as long medicinal history and exact efficacy, while further study is still needed. The future research is directed at steride components and protein components, and the pharmacological activity mainly researched is central activity. Meanwhile, the protection of its resource should not be neglected, in order to provide sustainable medicinal material sources for further rational development.

[1]WU PL(吴佩林),YIN YJ(尹玉洁). Erroneous evidence for annotation of “thousand-year pine root, Poria with hostwood sclerotium ”(“千年松根, 茯苓胆”校注证误) [J]. A Dream of Red Mansions (红楼梦学刊),2014,23 (2):323-333.

[2]NIU XL (牛小丽). Poria with hostwood morphological identification(茯神的性状鉴别)[N].Chinese Medicine Information News (中国医药报), 2001-1-11, sixth edition(第6 版).

[3]REN XL (任晓龙).Identification of adulteration in commoin Poria with hostwood( 常见茯神块的掺伪鉴别)[J]. Primary Journal of Chinese Materia Medica(基层中药杂志),2000,14(5):32-33.

[4]CHEN GY(陈桂英),WANG GS(王高升),GAO Y(高音). Research on processing specification of Poria with hostwood (茯神炮制规格研究)[J].Lishizhen Medicine and Materia Medica Research (时珍国医国药),2000,11(8):693.

[5]LIU HB(刘海宝),GAO AH(高阿辉).Identification of Poria with hostwood and fake Poria with hostwood (茯神与伪品茯神的鉴别)[J]. Journal of Practical Traditional Chinese Medicine(实用中医药杂志),2009,25(11):777.

[6]LIU HF(刘涵芳),WANG YF(王玉芬).Identification of fake Poria with hostwood(一种伪造茯神块的鉴别)[J].Journal of Chinese Medicinal Materials(中药材),1994,17(8):23.

[7]ZHANG X (张雪),XIANG RP (向瑞平),LIU CH(刘长河). Journal of Zhengzhou College of Animal Husbandry Engineering(茯神的化学成分和药理作用研究进展)[J].Journal of Zhengzhou College of Animal Husbandry Engineering (郑州牧业工程高等专科学校学报),2009,29(4):19-21.

[8]LAI PF (来平凡),FAN Y (范英).Mathematical statistic analysis of commonly used drugs and dosages thereof in all ages (历代益智方中常用药物及其用量的数理统计分析)[J].Journal of Mathematical Medicine(数理医学杂志),1998,11(1):46-47.

[9]XU HX (许华欣).Investigation on compatibility of forged magnet with cinnabar-coated Poria with hostwood and cinnabar-coated Radix Ophiopogonis(对锻磁石与朱茯神、 朱麦冬配伍的探讨)[J].Henan Traditional Chinese Medicine(河南中医),2010,30(10):1023-1024.

[10]ZENG GG(曾光华).Report of one case poisoned by cinnabar-coated Poria with hostwood caused by scorch during decoction (煎药烧焦引起硃茯神中毒一例报导)[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica(云南中医杂志),1986,1(4):2.

[11]GUO SW (郭胜伟). Identification of Mantis Egg-case and Poria with hostwood in Sangfuyishen decoction by thin layer chromatography(桑茯益肾汤中桑螵蛸茯神的薄层色谱鉴别) [J].Lishizhen Medicine and Materia Medica Research(时珍国医国药),2003,16(6):356.

[12]SUN Y(孙艳), ZHANG X(张弦), GUO SW (郭胜伟). Identification of Mantis Egg-case and Poria with hostwood in Sangpiaoxiao San by thin layer chromatography(桑螵蛸散中桑螵蛸及茯神的薄层色谱鉴别)[J]. Research and Practice on Chinese Medicines(现代中药研究与实践),2003,17(2):52.

[13]ZHANG X(张雪). Ultrasonic Extraction of Pachyman (超声波提取茯神多糖的工艺研究)[J]. Modern Food Science and Technology(现代食品科技),2011,27(2):170-177.

[14]NIE L (聂磊), SHENG CC (盛昌翠),SONG SW (宋世伟),et al.Comparative study on polysaccharide content in Poria with hostwood, Poria with hostwood,Poria with hostwood peel (茯苓茯神及茯苓皮多糖的含量比较研究)[J]. Lishizhen Medicine and Materia Medica Research (时珍国医国药),2014,25(5):1075-1076.

[15]ZHANG J(张捷),HUANG RH(黄荣花),ZHANG SH(张书华).Determination of polysaccharides in Poria with hostwood by standard curve method (标准曲线法测定获神中多糖的含量) [J],China Pharmaceuticals (中国药业),2013,22(16):15-16.

[16]NIE L (聂磊). A Comparative Study of Poria, Poria with hostwood and Poria cutis(茯苓、茯神和茯苓皮成分比较研究) [D]. Hubei: Hubei University of Chinese Medicine(湖北: 湖北中医药大学), Master Dissertation (硕士论文),2014.

[17]LIN L(林琳),CUI YB(崔业波),BAO HY( 包海鹰). Study on Chemical Constituents from Poria cum Radix Pini and Pharmacodynamics of the Compound (茯神化学成分及其复方药效学研究)[J].Edible Fungi of China(中国食用菌),2013,32(3):34-37.

[18]LU SC(吕苏成),CAO QL(曹巧俐).Effects of pachyman on Immunologic Functions of Normal Tumor Mouse(茯神多糖对正常肿瘤小鼠免疫功能的影响)[J]. Journal of First Military Medical University (第一军医大学学报),1990,10(3):267-268.

[19]ZHANG XM(张秀明).Overview of pharmacological research on Poria with hostwood(茯神药理作用研究概况)[J].Journal of Chinese Medicinal Materials(中药材),2001,24(6):446-449.

[20]YOU QY (游秋云), WANG P (王平).Study on the sedative-hypnotic effect of Poria cocos and Fushen water decoction(茯苓、茯神水煎液对小鼠镇静催眠作用的比较研究)[J]. Journal of Hubei Vniversity of Traditional Chinese Medicine (湖北中医药大学学报) ,2013,15(2):15-17.

[21]CHEN GL (陈光亮),WANG QM (王钦茂), DUAN YI, et al. Experimental study on pharmacologic action of Poria cocos mixture (药理作用的实验研究)[J], Chinese Journal of Traditional Medical Science and Technology(中国中医药科技),1997,4(2):87-88.

[22]HU CJ(胡崇家).Sedative effect of Semen Ziziphi Spinosae and Poria with hostwood (酸棗仁与茯神的鎮靜作用)[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong (武汉医学院学报),1957,1(1):125-133.

[23]ZHANG X(张雪),LI HP(李和平),LI GS(李更生). Effect of dormancy improving in mice test of functional food extraction from jujuboside and Poria coco(酸枣仁、 茯神功能食品的制备及改善睡眠功效的研究) [J],Food Science and Technology (食品科技),2012,37(1):99-102.

[24]CUI YB(崔业波),BAO HY(包海鹰), LI Y(李玉). Research on the Preparation Technology and Pharmacological Effect of Ling-ling Shen Granule(灵苓神颗粒剂的研制及其药理作用的研究)[J].Edible Fungi of China(中国食用菌),2007,26(5):37-40.

[25]DAI JG (戴建国),WANG ZL (王中立),CHEN L (陈琳),et al. Animal Experimental Study on the Antidepressant Effects of Six Tranquilizing Medicines(6 种宁神类药物抗抑郁作用动物实验研究)[J].Journal of Nanjing University of Traditional Chinese Medicine (南京中医药大学学报), 2014, 30 (2): 193-194.

[26]ZHANG HP (张海湃).Interpretation of 178 of "Yao Xing San Zi Jing"-Poria with hostwood, Prunus Tomentosa Thunb.[N].Shang Hai News Of Traditional Chinese Medicine (上海中医药报),2013-8-2,The third edition (第三版).

[27]ZHOU LJ(周丽娟),LI F(李帆), WU KJ(吴开举),et al.Experience for treating insomnia caused by pruritus with radix polygonati officinalis and Poria with hostwood(高子平运用玉竹与茯神治疗痉痒性皮肤病所致失眠经验)[J]. Hunan Journal of Traditional Chinese Medicine (湖南中医杂志), 2013, 29(12):37-39.

[28]SONG YM(宋咏梅), CUI LR(崔利锐),LI JW (李军伟).Document analysis of ancient insomnia prescription (古代失眠方药的文献分析)[J]. Journal of Shandong University of Traditional Chinese Medicine (山东中医药大学学报),2012,36(5):392-394.

[29]WANG CX (王春霞).Clinical observation of treating insomnia with Danzhi Xiaoyao Shengmai mixture combined with western medicine therapy(丹栀逍遥生脉合剂配合西药治疗失眠疗效观察)[J]. Shaanxi Journal of Traditional Chinese Medicine(陕西中医),2010,31(4):45-46.

[30]CHEN GL (陈贵林). The treatment of 68 patients with refractory insomnia by Fushen Zaoren Decoction(茯神枣仁汤治疗顽固性失眠68 例)[J]. China's Naturopathy(中国民间疗法),2009,17(7):28.

[31]LU YE (路亚娥),MA Y (马勇),LIANG ZR (梁振荣).The treatment of 80 patients with insomnia caused by deficiency in aheart-qi due to stagnation of liver qi and spleen deficiency by Yuchai Fushen Decoction(郁柴茯神汤治疗肝郁脾虚心气不足型失眠80 例)[J]. Shaanxi Journal of Traditional Chinese Medicine(陕西中医),2009,30(10):1318-1320.

[32]SHI C(石春明).Recent development of studies on Chinese traditional treatment of insomnia[J].Journal of Shaanxi College of Traditional Chinese Medicine (陕西中医学院学报),2008,31(2):60-62.

[33]SHANG K(尚坤), YANG QG(杨启光),WANG DY(王德友),et al.(药膳猪心茯神汤治疗心脾两虚型失眠症临床研究)[J], Journal of Changchun College of Traditional Chinese Medicine (长春中医药大学学报),2012,28(2):213-214.

[34]ZHAO JM (赵健美),LIU ZC (刘宗春),ZHAO JL (赵健丽).Insomnia of Heartspleen Deficiency Type Treated by Modified Guipi Decoction (归脾汤加减治疗心脾两虚型失眠56 例) [J].Shaanxi Journal of Traditional Chinese Medicine(陕西中医),2005,26(2):128.

[35]MA YZ (马云枝),ZHOU XQ (周晓卿).Clinical observation of treating 90 patients with refractory insomnia by acupuncture combined with medicine(针药结合治疗顽固性失眠90 例疗效观察)[J].Journal of Sichuan of Traditional Medicine (四川中医),2004, 22(6):51-52.

[36]ZHOU Y (周莺),WU SZ (邬珊志),LIN QY(林清叶),et al.Mathematical analysis of medicine rule in 153 ancient medical records of stagnation of phlegm-dampness in emotional syndrome (153 例古代情志病证痰湿内停证医案用药规律)[J].Journal of Jiangxi College of Traditional Chinese Medicine (江西中医学院学报), 2011,23(3):19-20.

[37]WANG QF (王秋凤).Clinical observation of treating 48 patients with postpartum depression by Fushen Powder(茯神散治疗产后抑郁48 例临床观察)[J]. Journal of Traditional Chinese Medicine (光明中医), 2010, 25(9):1630-1631.

[38]HAO YX (郝有孝). My view on distinguishing and treatment of postpartum psychosis(产后精神异常辨治我见)[J].Shaanxi Journal of Traditional Chinese Medicine(陕西中医),16(6):287.

[39]WANG QJ(王秋菊),HUANG QS(黄青松).Treatment of treating 200 patients with anxiety by Yangxue Anshen Decoction (养血安神汤治疗焦虑症200例)[J]. Shaanxi Journal of Traditional Chinese Medicine(陕西中医),2011,32(9):1172-1173.

[40]XIE Z (谢珍). Clinical observation of treating 57 patients with involutional melancholia by modified Ganmai Dazao Decoction and Guipi Decoction(甘麦大枣汤合归脾汤加减治疗更年期抑郁症57 例疗效观察)[J]. Journal of New Chinese Medicine(新中医),2004,36(10):26-27.

[41]MEI RS(镁日斯).Modified Baizi Yangxin Pills for the Treatment of Menopausal Syndrome (柏子养心丸加味治疗更年期综合征的疗效观察)[J]. Journal of Guangzhou University of Traditional Chinese Medicine (广州中医药大学学报),2015,22(5):357-359.

[42]LIU ZH (刘志辉), LIU XQ (刘小琼),DING LL (丁玲玲). Treatment of 40 patients with climacteric syndrome by modified Zhibo Dehuang Decoction(知柏地黄汤加味治疗更年期综合征40例)[J].Chinese Journal of Trauma and Disability Medicine (中国伤残医学),2012,20(3):51-52.

[43]YAO ZH (姚志浩),GAO JM (高觉民).Parallel Randomized Controlled Study of Epilepsy Pill Given Valproate Tablets Combined Therapy (定痫丸联合丙戊酸钠片治疗癫痫病随机平行对照研究)[J].Journal of Practical Traditional Chinese Medicine Department of internal medicine(实用中医内科杂志),2014,29(4):104-106.

[44]ZHANG HK(张宏宽), ZHOU EQ(周恩庆). Clinical observation of treating 33 cases with depressive psychosis by Huanshen decoction(欢神汤治疗癫症33 例疗效观察)[J].Shaanxi Journal of Traditional Chinese Medicine (陕西中医),1985,6(12):537.

[45]ZHANG QY(张启元),QIU RQ(邱荣琼).Treatment of 50 cases with insanity by Longyucheng Qi decoction (龙郁承气汤治疗癫狂50 例)[J].Shaanxi Journal of Traditional Chinese Medicine (陕西中医),1985,6(12):539-540.

[46]CHEN X (陈馨),WANG GM (王桂敏),YANG ZD(杨振东).Medical records of treating palpitation with modified Pingchong Wenxin Decoction (平冲稳心汤加减治疗心悸验案) [J].CHinese Community Doctors 社区中医药,2009,16(25):34.

[47]WEI JT(魏家亭).Treatment of 68 cases with postinfarction angina by Yiqi Tongmai Decoction combined with conventional western medicines (益气通脉汤配常规西药治疗心肌梗塞后心绞痛68 例)[J]. Shaanxi Journal of Traditional Chinese Medicine (陕西中医),2006,27(7):782-783.

[48]WANG ZS (王振生).Clinical observation of treating coronary heart disease combined with arrhythmia by modified Guipi Decoction (归脾汤加味治疗冠心病合并心律失常的疗效观察)[J].Journal of Sichuan of Traditional Medicine(四川中医),2013,31(9):79-80.

[49]LUO T (骆韬). Treatment of 48 cases with sick sinus syndrome by Dingji Fumai Decoction(定悸复脉汤治疗病态窦房结综合征48 例[J].Shaanxi Journal of Traditional Chinese Medicine(陕西中医),2002,23(12):108.

[50]SHI WG(石伟纲),HU JB(胡洁滨), FU HB (付红彪). Treatment of 57 cases with vascular cognitive impairment (VCI ) by Tianzhi Granule combined with western medicine (联合西药治疗血管性认知功能障碍57 例)[J].Traditional Chinese Medicinal Research(中医研究),2013,26(6):39-41.

[51]DIWU YC (第五永长),TIAN JZ (田金洲), SHI J (时晶). Effect of Xixin Decoction on O-GlcNAc glycosylation of tau proteins in rat brain with sporadic Alzheimer’s disease(洗心汤对散发性老年性痴呆大鼠脑内tau 蛋白O-Glc-NAc 糖基化修饰的影响)[J]. Chinese Traditional Patent Medicine (中成药),2013,35(8):1620-1625.

[52]LIU SC(刘锁超),ZHANG WX(张文学).Treatment of 82 cases with vascular dementia by Yizhi Decoction [J].Shaanxi Journal of Traditional Chinese Medicine (陕西中医), 2002, 23(8):699-700.

[53]LUO JY(罗建英),WANG XH(王向红).Tianma Gouteng Decoction in Treating Primary Hypertension Clinical Observation of 108 Cases (天麻钩藤饮治疗原发性高血压108 例临床观察) [J].Journal of Practical Traditional Chinese Medicine Department of internal medicine (实用中医内科杂志), 2013,27(5):21-22.

[54]XI ZL ( 郗增亮), YUAN JM (袁剑梅).Eight methods for treating hypertension by Cui Yuheng(崔玉衡治疗高血压八法) [J].Acta Chinese Medicine and Pharmacology (中医药学报),1991(5):35-37.

[55]KANG XM (康小明). Treatment of 66 aged patients with type 2 diabetes by modified Fushen Buxu Decoction and Danxing Guijian Decoction (茯神补虚汤合单行鬼箭汤加味治疗老年2 型糖尿病66 例)[J]. Shaanxi Journal of Traditional Chinese Medicine (陕西中医),2007,8(10):1336-1337.

[56]SU YJ (苏衍进), ZHU HB (祝海滨).Clinical experience in treating 38 cases with diabetes by Fushen Decoction(茯神汤方治疗糖尿病38 例临床体会)[J].Journal of Shaanxi College of Traditional Chinese Medicine(陕西中医学院学报),2006,29(3):21-22.

[57]LIANG XM (梁晓明).Fushen Jueming Decoction capable of treating Cervicogenic cerebral ischemia(茯神决明饮可治疗颈源性脑缺血)[J]. Seek Medical and Ask the Medicine (求医问药),2013,1:7.

[58]XU GL (许国良). Summary of treating infantile enuresis with Fangfushen Decoction(防茯神汤治疗小儿遗尿44 例小结)[J]. Journal of Changchun College of Traditional Chinese Medicine(长春中医学院学报),2000,16(3):37.

[59]ZHANG X(张雪),LI HP(李和平),LI YF(李云芳).Preparation of A Health Jelly using Semen Ziziphi Spinosae and Poria Cocos(酸枣仁、茯神营养果冻的研制) [J]. Modern Food Science and Technology (现代科技食品),2011,27(6):651-654.

[60]ZHOU LD (周礼达). Ancient prescription “fengfushen”in south Fujian(闽南古方“风茯神”)[J].Strait Pharmaceutical Journal (海峡药学), 1996, 8(1):101-102.

[61]REN XY (任晓余). Examples of new clinical uses of Fushen Decoction(茯神汤临床新用举隅)[J]. Shaanxi Journal of Traditional Chinese Medicine (陕西中医),1992,13(6):272-274.

[62]ZHAO ZJ (赵忠敬). Cinnabar-coated Poria with hostwood and Cinnabarcoated Medulla Junci (朱茯神和朱灯心)[J].Shanghai Journal of Traditional Chinese Medicine (上海中医药杂志),1963,12:39.