Exploration Of The Clinical Application And Dosage Of Desertliving Cistanche

Abstract: By collecting the clinical experience from ancient medical books and modern doctors, it is concluded that desert living cistanche has the following characteristics:

(1) Its dosage range in clinical decoctions is mostly 6-30 g, and its common dosage range is 10-30 g, while in pills mostly 0.5-3.35 g. 

(2) Its optimal dosage should be selected according to different diseases, syndrome types and symptoms. For instance, when used for Improve the kidney and strengthen yang in the treatment of male diseases (premature ejaculation, oligospermia), gynecological diseases (polycystic ovary syndrome, dysmenorrhea, infertility), mental diseases (schizophrenia), etc., its dosage range in decoctions is 6-30 g, while in pills 0.5-3.35 g. For nourishing essence and blood to treat flaccidity diseases and ptosis, its dosage range in decoctions is 10-15 g. For clearing intestines and facilitating feces excretion in the treatment of digestive system diseases (senile constipation, habitual constipation), its dosage range in clinical decoctions is 15- 30 g. 

(3) In order to give full play to its best effect, it is often combined with corresponding traditional Chinese drugs according to different diseases, syndrome types, and symptoms. For example, for Improving the kidney and strengthening yang, it is often combined with epimedium herb, two toothed achyranthes root, morinda root, etc. For clearing intestines and facilitating feces excretion, it is often combined with licorice root, etc. 

 Keywords: cistanche; dose-effect relationship; clinical application; compatibility of medicines

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Cistanche is the dry, scaly stem of Cistanche deserticola Y.C.Ma or Cistanche tubulosa (Schenk) Wight of Cistanche deserticola Y.C.Ma.

This product mainly contains echinacoside, acteoside, flavonoids, etc. Cistanche is sweet, salty, and warm; it belongs to the kidney and large intestine meridians, and has the functions of  Improve kidney yang, nourishing essence and blood, moistening intestines and laxatives. In this paper, through the analysis of the classic prescriptions of Cistanche deserticola and the clinical experience of ancient and modern physicians, the commonly used clinical dose, compatibility and dose-effect relationship of Cistanche deserticola were summarized, in order to provide some reference for the clinical application of Cistanche deserticola.

1 Dosage and compatibility of classic prescriptions of Cistanche 

 Ancient physicians often used Cistanche in combination with different traditional Chinese medicines to treat constipation, impotence, nocturnal emission, and other diseases. For example, it is compatible with Angelica sinensis and Achyranthes, such as Jichuanjian (Jingyue Quanshu of Ming Dynasty) Jichuanjian; fry for seven or eight minutes in water for one and a half minutes, and take it before eating), Cistanche deserticola (about 3 g per dollar, the daily dose is two , Sanqian about 6 ~ 9 g) Warms the kidney and nourishes the essence, moistens the dryness and smoothes the intestines, is compatible with Angelica sinensis, Achyranthes, laxatives, warms the waist and nourishes the kidney, treats kidney deficiency in the elderly, constipation, backache and foot softness, etc.

Such as compatibility with yam, such as incomparable yam pills (Tang "Beiji Qianjin Yaofang"; the last twelve flavors are the last, honey pills are like Wuzi, take twenty pills with wine before food, add to thirty pills, and then reapply), Cistanche ( One phoenix tree seed is about 0.5 g, take 10 pills about 5 g per day) to warm yang and nourish essence. It is compatible with yam to nourish yin and warm yang, invigorate the kidney and replenish essence, and strengthen vitality. It is mainly used to treat kidney qi deficiency and exhaustion, backache, and tinnitus, nocturnal emission, night sweats, or vaginal coldness, etc. Such as compatibility with dodder, such as Cistanche pills (Song "Taiping Shenghui Fang"; top is the end, refining honey into pills, such as sycamore seeds, each serving thirty pills, hollow warm wine to send, take before dinner), Cistanche ( One sycamore seed is about 0.5 g, taking 6.7 pills about 3.35 g per day) warms the kidneys and laxatives, and is compatible with Dodder seed to nourish the essence and fill the marrow, invigorate the kidney and strengthen the yuan, and treats impotence and consumptive exhaustion. Such as compatibility with antler cream, such as antler cream pills (Song "Song Ji Zonglu"; the top is the end, the wine-boiled batter is a pill, such as the size of a sycamore seed, each serving is twenty pills, and the hollow warm wine is sent), cistanche (one phoenix tree) Seed about 0.5 g, take 4 pills about 2 g a day) to warm the kidney and replenish the essence, with deer horn cream to fill the essence and blood, generate yang qi, and treat kidney cold and thinness.

Dosage and compatibility experience of 2 old Chinese medicine practitioners of Cistanche

Li Furen believes that the root cause of senile constipation is the gradual decline of righteousness and the low function of the five internal organs. Therefore, the treatment is based on the basic principle of strengthening the body and strengthening the foundation and proposes the "moisturizing" method. Hemp seed and licorice can enhance righteousness, preserve the original righteousness, and achieve the purpose of eliminating evil without harming righteousness. The dosage of Cistanche is mostly 15-30 g[2].

Hu Jianhua treats chronic nephritis proteinuria by strengthening the spleen and strengthening the kidney. He usually uses Cistanche tubulosa to warm and invigorate the yang of the kidney. It is combined with Gorgon Radix and Golden Yingzi to invigorate the spleen, invigorate the kidney and restrain astringency. The combination of various medicines is used to regulate and strengthen the foundation of the day. The dosage of Cistanche is 12 g. For menstrual headaches that are not healed repeatedly, use Cistanche deserticola to regulate Chongren, Gastrodia elata and Uncaria to calm the liver and suppress wind, red peony root and Curcuma curcuma to promote blood circulation and remove blood stasis. Tang Qisheng believes that schizophrenia belongs to the "madness" of traditional Chinese medicine. Phlegm confuses the heart orifice as the standard, and the deficiency of kidney qi is the foundation. The treatment of schizophrenia with negative symptoms is mainly used. The two herbs are used in combination to invigorate the kidney and nourish the essence, and help the yang to increase the aspiration. The combination of the two drugs can invigorate the kidney and help the yang, and treat the fire failure of the gate of life. The dosage of Cistanche deserticola is 15 g [4]. Liu Boling believes that kidney deficiency type low back pain is more responsible for the elderly and kidney failure, or the waist is strained, and the kidney is damaged over time. The treatment is mainly to invigorate the deficiency and warm the yang, and protect the yin. The dosage of Cistanche is 20 g [5].

Zhang Zhiyuan believes that premature ejaculation is caused by excessive indulgence, internal injury of emotions, invasion of dampness and heat, chronic illness and physical deficiency. Deficiency syndrome is mostly caused by a deficiency of yin and yang in the kidney. The treatment is to supplement yin and yang to nourish the liver and kidney. Lycium barbarum, Rehmannia glutinosa, Digupi nourish yin and reduce fire, together with Eucommia, Achyranthes huai, and Cuscuta seeds to nourish liver and kidney, and play the role of nourishing yin and essence, warming kidney and strengthening yang. The dosage of Cistanche deserticola is 6 g [6]. Wang Xiaoyun believes that early-onset ovarian insufficiency can be treated based on five zang-organ syndrome differentiation. If the symptoms are late menstruation or amenorrhea, light menstrual color, cold pain in the abdomen, cold limbs, cold vaginal discharge, indifference of sexual desire, pale and fat tongue, tooth marks on the edges, white and slippery coating, slow and weak pulse, etc. Spleen and kidney yang deficiency syndrome. Cistanche is often used to warm the kidney and yang, and dried ginger is used in combination with cannon ginger to warm the kidney and spleen, and then a small amount of cinnamon is used to ignite the fire and return to the Yuan.

3 Dosage and compatibility of experts from the Dosage-effect Research Committee of Prescriptions

 Professor Tong Xiaolin believes that the slow transit of the colon and the prolonged stool stay in the body are the direct manifestations of senile constipation. Although the causes are complicated, the general manifestations are "yang deficiency" such as hypofunction or weakness, and decreased metabolic activity. Yang qi stimulates the body’s function, so Cistanche tubolosa is used in combination with Zengye Chengqi Decoction to treat senile constipation. Cistanche deserticola warms the kidneys, helps yang, benefits Jing and clears the bowels. Zengye Chengqi Decoction nourishes yin and increases liquid, moistens the intestines and clears the bowels. For kidney yang and bowel movements, the dose of Cistanche deserticola is mostly 9-30 g[9].

Li Jiren believes that progressive muscular dystrophy belongs to the category of "atrophy syndrome" in traditional Chinese medicine. When the disease occurs due to nourishment, the treatment should not stick to the method of "Internal Classics" "to treat atrophy by taking Yangming alone". In the treatment of progressive muscular dystrophy of liver and kidney deficiency type, Cistanche is commonly used to invigorate kidney yang, nourish essence and blood, Morinda officinalis to strengthen muscles and bones, and to soothe the five internal organs. The two medicines are used in combination to nourish the spleen and kidney meridians, so that the deficiency will heal itself, and the tendons will be strong. Bone health [10].

In addition, in the treatment of atrophy and deficiency syndrome, Li Jiren also commonly used Cistanche to invigorate the liver and kidney, activate qi and blood, and be combined with Astragalus to invigorate qi. The combination of the two medicines can harmonize qi and blood, and treat both liver and kidney. In the early stage of treatment, in order to prevent the patient from not being supplemented, the dosage of astragalus should be increased or decreased according to the changes of the disease condition and the patient's syndrome (the specific decoction method, dosage and adverse reactions are not specified.

Jiao Yongzheng believes that oligoasthenozoospermia belongs to the categories of "oligospermia without children" and "essence" in traditional Chinese medicine. A small amount of sperm or a small number of sperm indicates a deficiency of kidney essence and a deficiency of kidney qi. The treatment is mainly to nourish the deficiency and nourish the kidney, To promote blood circulation and nourish blood as a supplement, use Yijing recipe (20 g of dodder seed, 20 g of rehmannia glutinosa, 20 g of mulberry, 20 g of mulberry octopus, 20 g of cistanche, 20 g of chive seeds, 15 g of epimedium, 15 g of rhizoma rhizoma, schisandra 15 g, Polygonatum 12 g, Atractylodes Rhizoma 12 g, Angelica 9 g, Safflower 9 g), Cistanche deserticola warms the kidney and invigorates yang, is compatible with Rehmannia glutinosa, mulberry octopus to invigorate the kidney and fill the essence, together with Angelica sinensis and safflower to promote blood circulation, play a total of promoting blood and nourishing. For the power of blood, kidney and essence, the dosage of Cistanche deserticola is 20 g[12]. Chen Wenbo believed that the lack of kidney yang, the inability to warm the kidney essence and the lack of sperm, therefore proposed Wenyang Shengjing Decoction (10 g of rehmannia glutinosa, 10 g of rehmannia glutinosa, 5 g of asparagus, 5 g of Ophiopogon japonicus, 10 g of dogwood, 10 g of wolfberry fruit, Treating oligospermia with 10 g of Cortex Phellodendri and Anemarrhena 10 g), Cistanche deserticola in the prescription warms and invigorates the kidney-yang, while Epimedium and Curcuma currante warm the kidney and fill the essence.

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