ABSTRACT
The classical prescription Kaixinsan，which is recorded in an ancient medical book named Beiji Qianjin Yaofang，is one of the famous prescriptions used by ancient physicians to treat amnesia. Research on classical prescriptions has attracted more and more attention from scientific research institutions and related enterprises. Based on ancient books，textual research on origins and development of prescriptions，combing the evolution of prescriptions，preparations，oral ways，taboos and others are the important contents of the study on classical prescriptions. The research results show that the creation of Kaixinsan in Beiji Qianjin Yaofang can be traced back to Kaixinsan recorded in Jiyanfang and Dingzhiwan recorded in Gujinluyanfang. Later generations of physicians created many associated prescriptions in the process of applying Kaixinsan，and the efficacy of these prescriptions was constantly expanded with the development of the times. In the Tang and Song dynasties，Kaixinsan and its associated prescriptions were mainly used to treat amnesia，sorrow，fear，and other diseases. In the Jin and Yuan dynasties，these prescriptions were also used to treat convulsions and yawning. In the Ming dynasty， they were mainly for the treatment of hyperopia， myopia， sprematorrhea，and constipation. In the Qing dynasty，these herbs could be used to treat auricular deafness， aging and sweating. The dosage of Ginseng Radix et Rhizoma and Poria should be increased in the treatment of farsightedness，spermatorrhea and blurred urine，and in the treatment of nearsightedness，the dosage of Polygalae Radix and Haliotidis Concha should be increased. The main pathogenesis of the disease that Kaixinsan and its associated prescriptions treated could be summarized as the deficiency of heart and spleen，imbalance between heart-Yang and kidney-Yin，and the internal resistance of phlegm stagnation. By summarizing the contents of the preparation of tradition Chinese medicine products for Kaixinsan and its associated prescriptions，it is suggested that the dosage form of Kaixinsan can be pills，with the specification size confroming to the most record of ancient generations of physicians，as big as Firmiana platanifolia's fruit.The volume of a single pill is about 0.25 mL and the weight is about 0.3 g. The initial dosage is fifteen pills，which can be modified according to the severity of the illness，with no more than forty pills for each time，three times a day. Also，some excitant food like the sour food，sweet food and mutton should be avoided during the medication. The above research results can provide literature basis for the development of compound tradition Chinese Medicine preparation of Kaixinsan.
ABSTRACT
Kaixinsan recorded in an ancient medical book named Beiji Qianjin Yaofang is one of the famous classical formula，which is one of the common prescriptions used by ancient physicians to treat amnesia. In the process of using this prescription，later generations of physicians derived many kinds of associated prescriptions. The effect and indications of these prescription have been inherited and expanded from those in the Beiji Qianjin Yaofang because of the changes in dosages. Therefore，it is necessary to verify the effect and indications of the formulas and the rules of dosage changes. The research results showed that its basic effects included to nourish the mind，induce resuscitation，strengthen the spleen and calm the mind，and keep balance between heart-Yang and kidney-Yin. The main indications included amnesia，sorrow and sadness，fright and fear，and so on，which may differ slightly in different dynasties. In Song，Jin and Yuan dynasties，it also demonstrated the effect of warming the heart and Yang，clearing away heat and relieving wind besides the basic effects， with basically the same indications （slightly different from those in previous dynasties）. In Ming dynasty，it demonstrated the effect of nourishing Yin，clearing away heat and nourishing blood besides the basic effects，and the indications expanded to farsightedness，nearsightedness，spermatorrhea and blurred urine. In the Qing dynasty，its effect also included to nourish the heart and kidney on the basis of the Ming dynasty，and the indications were basically the same with those in the previous dynasties. The compatibility ratio of ancient physicians in the application of this prescription and its associated prescriptions showed some remarkable features，for example，Ginseng Radix et Rhizoma and Poria should be increased and their ratio was≈1∶1 in the treatment of amnesia，sorrow，sadness，fright，fear，farsightedness，spermatorrhea and blurred urine，with ratio of Polygalae Radix to Acori Tatarinowii Rhizoma≈1∶1； the dosage of Polygalae Radix and Acori Tatarinowii Rhizoma should be increased in the treatment of nearsightedness，and their ratio was≈1∶1. The compatibility ratio of Polygalae Radix-Ginseng Radix et Rhizoma-Poria-Acori Tatarinowii Rhizoma=2∶3∶3∶2 was the most frequent，which basically included the indications of this prescription and its associated prescriptions. According to statistics，the average dosages that ancient physicians used were significantly higher than those in the modern times，Polygalae Radix 57 g，Ginseng Radix et Rhizoma 62 g，Poria 70 g，and Acori Tatarinowii Rhizoma 54 g，respectively in ancient times，while Polygalae Radix 11 g，Ginseng Radix et Rhizoma 15 g，Poria 17 g，and Acori Tatarinowii Rhizoma 9.5 g，respectively in modern times. The above textual research results can provide some reference for preparation of tradition Chinese medicine products of Kaixinsan.
ABSTRACT
<p><b>OBJECTIVE</b>To study the relationship between the expressions of thrombin-antithrombin (TAT) complex and excess syndrome of stroke (ESS) and depletion syndrome of stroke (DSS) by dynamically observing the expressions of TAT complex in the plasma and hematoma fluid of intracerebral hemorrhage (ICH) patients.</p><p><b>METHODS</b>Sixty patients were assigned to three groups according to syndrome typing, i.e., as yang excess group (18 cases), yin excess group (22 cases), and depletion syndrome group (20 cases). The hemorrhage volume was assessed. NIHSS and GCS were scored. Besides, 30 healthy volunteers at the Physical Examination Center, Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were recruited as the normal control group. Another 10 patients in need of lumbal anesthesia were recruited as the cerebrospinal fluid control group, who suffered from surgical, gynecologic pelvic diseases, or diseases from lower limbs, but unaccompanied with cardio-/cerebrovascular diseases. The expressions of TAT complex were detected in the venous blood and hematoma fluid of the patient groups and in the venous blood or the cerebrospinal fluid of the control group using ELISA.</p><p><b>RESULTS</b>The syndromes were sequenced as the depletion syndrome > the yin excess syndrome > the yang excess syndrome according to the hemorrhage volume and NIHSS score. They were sequenced as the yang excess syndrome > the yin excess syndrome >the depletion syndrome according to the GCS score. The plasma TAT complex content on the 4th day in the ICH group was lower than that at the rest time points, showing statistical significance (P<0.01). Compared with the normal control group, the plasma TAT complex on the 1st, 2nd, and 4th day all increased with statistical difference (P<0.01). Statistical significance of the TAT complex in the hematoma fluid of the ICH group existed when compared it on the 1st, 2nd, and 4th day (P<0.01). Compared with the cerebrospinal fluid control group, the contents of the TAT complex in the hematoma fluid of the ICH group increased with statistical difference (P<0.01). The hemorrhage volume of ICH patients was positively correlated with NIHSS (r=0.809, P<0.01) and negatively correlated with GCS (r=-0.833, P<0.01). The TAT complex was obviously higher in the ICH group than in the two control groups in a dynamic way (P<0.01). There was obvious difference in the expressions of TAT among yang excess group, yin excess group, and depletion syndrome group (P<0.01). The expressions of TAT in the plasma and the hematoma fluid of the ICH group were negatively correlated with GCS score and positively correlated with NIHSS score (both P<0.01).</p><p><b>CONCLUSIONS</b>TAT complex participated in secondary neuron injury after ICH, which could be taken as an objective index for clinical observation. It also could provide evidence for syndrome quantification of excess syndrome and depletion syndrome.</p>