1. Prescription Source & History

1. Origin & Development

Sheng Mai San was first recorded in 'Emergency Prescriptions Worth a Thousand Gold' written by Sun Simiao in the Tang Dynasty, originally named 'Shengmai Decoction'. At that time, it was mainly used to treat symptoms such as 'heat injuring vital energy, limb fatigue, shortness of breath, listlessness in speech, dry mouth and thirst, and incessant sweating'. Through long-term clinical practice, Sun Simiao discovered this effective formula that can benefit qi and promote fluid production, astringe yin and stop sweating, providing an important foundation for treating qi-yin deficiency syndrome in later generations.

Over time, with the continuous application and development by later generations of physicians, the application scope of Shengmai San gradually expanded, and its curative effect was further verified and improved. Physicians in each dynasty adjusted and supplemented the formula according to their clinical experience to make it more suitable for the disease spectrum and clinical needs of different periods.

2. Historical Records & Inheritance

In 'Formulary of the Bureau of People's Welfare Pharmacy' in the Song Dynasty, the formula and application of Shengmai San were recorded in more detail, and it was officially named 'Shengmai San'. Since then, it has become one of the commonly used formulas in traditional Chinese medicine clinical practice and has been widely included in various traditional Chinese medicine classics. For example, 'Complete Works of Jingyue' by Zhang Jingyue in the Ming Dynasty and 'Golden Mirror of the Medical Tradition' by Wu Qian in the Qing Dynasty both expounded on Shengmai San in depth and summarized the application experience, enabling this formula to be passed down from generation to generation in the field of traditional Chinese medicine and still play an important role in clinical practice today.

Through the inheritance and development of physicians in past dynasties, Shengmai San has not only been widely used in China but also spread to neighboring countries such as Japan and Korea, having a profound impact on the development of medicine in East Asia. Its historical inheritance reflects the process of gradual improvement of traditional Chinese medicine formulaology through continuous practice and summary, and also provides valuable experience and reference for modern traditional Chinese medicine clinical research.

2. Composition Introduction (King, Minister, Assistant, Guide)

1. King Drug - Ginseng

Ginseng tastes sweet and slightly bitter, is slightly warm in nature, and enters the spleen, lung, heart, and kidney meridians. It greatly tonifies primordial qi and restores pulse and secures collapse, being a crucial medicine for saving the critically ill and relieving collapse. In Shengmai San, ginseng serves as the sovereign drug, mainly playing the role of benefiting qi and promoting fluid production. When the human body suffers from qi-yin deficiency due to various reasons and the primordial qi is deficient, ginseng can quickly supplement the required primordial qi of the human body, enabling qi to be abundant and yin fluid to be naturally generated, thus improving symptoms of qi-yin deficiency such as shortness of breath and fatigue.

Ginseng contains various active ingredients, such as ginsenosides, polysaccharides, amino acids, etc. Among them, ginsenosides have multiple physiological functions such as regulating the nervous system, cardiovascular system, immune system, etc., can enhance the body's stress resistance, improve the body's tolerance to various harmful stimuli, and have a good effect on improving symptoms such as physical weakness and fatigue caused by qi-yin deficiency.

2. Minister Drug - Ophiopogon Root

Ophiopogon japonicus tastes sweet and slightly bitter, is slightly cold in nature, and enters the heart, lung, and stomach meridians. It can nourish yin and moisten the lungs, promote fluid production in the stomach, and clear the heart and remove vexation. In Shengmai San, Ophiopogon japonicus assists ginseng in playing the role of benefiting qi and nourishing yin, enhancing the effect of the formula in nourishing yin and promoting fluid production. It has a good effect on symptoms such as dry mouth and dry throat caused by qi-yin deficiency.

Ophiopogon japonicus contains various nutritional components, such as Ophiopogon japonicus polysaccharides, steroidal saponins, flavonoid compounds, etc. These components have functions such as antioxidation, anti-inflammation, and immune regulation, can nourish the yin of the lung and stomach, improve symptoms of yin deficiency and excessive fire, and cooperate with ginseng to jointly regulate the qi-yin balance of the human body.

3. Assistant Drug - Schisandra Fruit

Schisandra chinensis tastes sour and sweet, is warm in nature, and belongs to the lung, heart, and kidney meridians. It has the effects of astringing and consolidating, replenishing qi and generating fluid, and tonifying the kidney and tranquilizing the mind. In Shengmai San, Schisandra chinensis mainly plays the role of astringing yin and stopping sweating, preventing excessive dissipation of qi and yin. At the same time, it can also regulate the balance of yin and yang in the human body, enabling qi to be astringed and yin to be nourished.

Schisandra chinensis contains rich components such as lignans, polysaccharides, volatile oils, etc. Among them, lignan components have effects such as antioxidant, liver protection, and regulation of the cardiovascular system, and polysaccharide components have effects such as immune regulation and anti-tumor. These components work together to enhance the effects of Shengmai San in replenishing qi and nourishing yin, and astringing yin and stopping sweating, making the formula more perfect.

4. Guide Drug - Synergistic Effect

The three herbs in Shengmai San are mutually compatible and work synergistically. Ginseng greatly tonifies primordial qi, laying the foundation for tonifying both qi and yin; Ophiopogon japonicus nourishes yin and generates fluid, supplementing yin fluid, and when combined with ginseng, the power of tonifying both qi and yin is stronger; Schisandra chinensis astringes yin and stops sweating, preventing the leakage of qi and yin. The three cooperate with each other to jointly achieve the effects of replenishing qi and generating fluid, and astringing yin and stopping sweating, thereby regulating the qi-yin balance in the human body and treating the syndrome of qi-yin deficiency. This way of compatibility of monarch, minister, assistant, and envoy reflects the subtlety of the compatibility of traditional Chinese medicine formulas, making the effects of the formula more comprehensive and coordinated, and is one of the important principles in the clinical use of traditional Chinese medicine.

III. Pathogenesis, Efficacy & Indications

1. Pathogenesis Analysis

The pathogenesis targeted by Shengmai San is mainly qi-yin deficiency. Under the influence of various factors in the human body, such as heat pathogen injuring body fluid, prolonged illness with weak constitution, overexertion, etc., qi and yin fluid are consumed, resulting in the pathological state of qi-yin deficiency. Symptoms of qi-yin deficiency can include shortness of breath, fatigue, spontaneous sweating, night sweating, dry mouth, dry throat, restlessness, insomnia, etc.

When there is qi-yin deficiency, the physiological functions of the human body are affected. The promoting, warming, and astringing functions of qi are weakened, and the moistening and nourishing functions of yin fluid are insufficient. Further development of qi-yin deficiency can lead to disharmony of zang-fu functions and trigger various diseases. Therefore, regulating qi-yin deficiency is a key link in the treatment of various diseases, and Shengmai San is an effective formula targeting this pathogenesis.

2. Efficacy Explanation

Shengmai San has the effects of replenishing qi and generating fluid, and astringing yin and stopping sweating. Replenishing qi and generating fluid can supplement the consumed qi and yin fluid in the human body, making qi flourish and fluid generate, and improving symptoms such as shortness of breath, fatigue, and dry mouth caused by qi-yin deficiency. Astringing yin and stopping sweating can astringe the leaked yin fluid and sweat in the human body, preventing further dissipation of qi and yin, and has a good therapeutic effect on symptoms such as spontaneous sweating and night sweating.

Through the synergistic effects of replenishing qi and generating fluid and astringing yin and stopping sweating, Shengmai San can regulate the qi-yin balance in the human body, enhance the resistance of the body, improve various discomfort symptoms caused by qi-yin deficiency, and promote the recovery of the body.

3. Indicated Diseases

Shengmai San is mainly used to treat the syndrome of qi-yin deficiency. Common symptoms include:

- Shortness of breath and fatigue: These are typical manifestations of qi and yin deficiency. Insufficient qi leads to weak propulsion, and deficiency of yin fluid fails to nourish the limbs, resulting in symptoms such as shortness of breath, lassitude, and fatigue in the body.

- Spontaneous sweating and night sweating: Due to qi and yin deficiency, the body's exterior defense is not firm, and the leakage of body fluid leads to spontaneous sweating; internal heat due to yin deficiency forces the leakage of body fluid, resulting in night sweating. Shengmai San can astringe yin and stop sweating, effectively improving the symptoms of spontaneous sweating and night sweating.

- Dry mouth and dry throat: Insufficient yin fluid fails to moisten the mouth and throat, leading to dry mouth and dry throat. Ophiopogon japonicus in Shengmai San can nourish yin and promote the production of body fluid, alleviating the symptoms of dry mouth and dry throat.

- Restlessness and insomnia: Due to qi and yin deficiency, internal heat is generated, disturbing the mind, and symptoms such as restlessness and insomnia may occur. Shengmai San helps to improve restlessness and insomnia by supplementing qi and nourishing yin, clearing away heat and relieving restlessness.

In addition, Shengmai San can also be used to treat various diseases caused by qi and yin deficiency, such as coronary heart disease, arrhythmia, chronic bronchitis, diabetes, etc., and has a certain therapeutic effect in improving the symptoms of qi and yin deficiency in these diseases.

IV. Analysis of Formula Principles

1. Principle of Tonifying Qi and Promoting Fluid Production

Ginseng greatly tonifies primordial qi and is a key drug for supplementing qi. Only when the primordial qi is sufficient can it promote the normal operation of zang-fu functions and facilitate the generation and distribution of qi, blood, and body fluid. Ophiopogon japonicus nourishes yin and promotes the production of body fluid. Its sweet and cold nature can nourish the yin of the lung and stomach, replenishing the consumed yin fluid in the body. The combination of ginseng and Ophiopogon japonicus, one for tonifying and the other for nourishing, tonifies both qi and yin, enabling qi to generate body fluid and yin to support qi, thus achieving the purpose of supplementing qi and promoting the production of body fluid.

For example, when treating symptoms such as shortness of breath, fatigue, and dry mouth caused by qi and yin deficiency, ginseng can quickly supplement primordial qi and enhance the body's functional activities; Ophiopogon japonicus can moisten the mouth, throat, etc., alleviating the symptoms of dry mouth and dry throat. The two work synergistically to improve the pathological state of qi and yin deficiency.

2. Mechanism of Astringing Yin and Stopping Sweating

Schisandra chinensis tastes sour and astringes. It can astringe the leaked yin fluid and sweat in the body. In the case of qi and yin deficiency, the body's exterior defense is not firm, and symptoms such as spontaneous sweating and night sweating are likely to occur. Schisandra chinensis, through its astringent property, enables the yin fluid to be conserved internally and the sweat to stop leaking. At the same time, Schisandra chinensis can also regulate the balance of yin and yang in the body, enabling qi to be astringed and yin to be nourished, further enhancing the effect of the formula in astringing yin and stopping sweating.

When patients present with symptoms of spontaneous sweating and night sweating, simply using drugs that boost qi or nourish yin may not effectively stop sweating. Schisandra chinensis in Shengmai San can astringe and stop sweating. When combined with drugs that boost qi and nourish yin, it treats both the symptoms and the root cause, thus achieving the purpose of treating spontaneous sweating and night sweating.

3. Synergistic Effect of Overall Compatibility

The three herbs in Shengmai San, namely Ginseng, Ophiopogon japonicus, and Schisandra chinensis, are exquisitely formulated and work synergistically. Ginseng is the sovereign herb, greatly replenishing primordial qi and laying the foundation for boosting qi and promoting fluid production. Ophiopogon japonicus is the ministerial herb, nourishing yin and promoting fluid production, assisting Ginseng to enhance the power of boosting qi and nourishing yin. Schisandra chinensis is the adjuvant herb, astringing yin and stopping sweating, regulating the balance of yin and yang, and preventing the leakage of qi and yin. The three cooperate with each other, boosting qi without consuming qi and yin, nourishing yin without being greasy and obstructing qi, and astringing yin without retaining pathogenic factors, jointly achieving the effects of boosting qi and promoting fluid production, astringing yin and stopping sweating, reflecting the scientificity and rationality of the compatibility of traditional Chinese medicine prescriptions.

This method of compatibility enables Shengmai San to comprehensively regulate the qi and yin balance of the human body when treating qi and yin deficiency syndrome, comprehensively conditioning the pathogenesis of qi and yin deficiency, thus achieving good therapeutic effects.

V. Comparison with Other Similar Formulas

1. Comparison with Yupingfeng San

Jade Screen Powder is mainly composed of three herbs: Astragalus membranaceus, Atractylodes macrocephala, and Saposhnikovia divaricata, and has the effect of boosting qi and strengthening the exterior to stop sweating. It focuses on treating spontaneous sweating due to deficiency of the exterior, mainly strengthening the exterior with qi to enhance the function of the defensive qi of the human body, resisting the invasion of exogenous pathogens, and preventing the leakage of sweat.

Shengmai San, on the other hand, mainly focuses on boosting qi and promoting fluid production, astringing yin and stopping sweating, and is applicable to qi and yin deficiency syndrome. It can not only treat spontaneous sweating and night sweating, but also improve symptoms such as shortness of breath, fatigue, and dry mouth caused by qi and yin deficiency. Compared with Jade Screen Powder, Shengmai San pays more attention to the dual supplementation of qi and yin, and its mechanism of action and applicable diseases are different.

For example, for patients with a weak constitution, prone to catching colds, and having spontaneous sweating, if it is simply due to deficiency of the exterior and insecurity, Jade Screen Powder can be selected; if there are symptoms such as spontaneous sweating and shortness of breath due to qi and yin deficiency, Shengmai San is more suitable for treatment.

2. Comparison with Liuwei Dihuang Pills

Liuwei Dihuang Pills It is composed of six herbs: Rehmannia glutinosa preparata, Cornus officinalis, Moutan bark, Dioscorea opposita, Poria cocos, and Alisma orientale, and has the effect of nourishing yin and tonifying the kidney. It is mainly used to treat kidney yin deficiency syndrome, focusing on nourishing kidney yin and regulating symptoms such as soreness and weakness of the waist and knees, dizziness and tinnitus, and hectic fever and night sweating caused by insufficient kidney yin.

Shengmai San There are obvious differences in the efficacy and main treatment of Shengmai San and Liuwei Dihuang Pills. Shengmai San mainly targets qi and yin deficiency syndrome, focusing on replenishing qi and nourishing yin. Its scope of action is wider, involving multiple zang-fu organs such as the lung, heart, and spleen. While Liuwei Dihuang Pills focus on regulating kidney yin deficiency. In clinical application, it is necessary to accurately select the appropriate formula according to the specific symptoms and pathogenesis of the patient.

For example, for patients with obvious kidney yin deficiency, Liuwei Dihuang Pills can be selected; for patients with qi and yin deficiency, with qi deficiency symptoms such as shortness of breath and fatigue, and yin deficiency manifestations such as dry mouth and night sweats, Shengmai San should be selected for treatment.

3. Comparison with Guipi Decoction

Guipi Tang It is composed of Atractylodes macrocephala, Poria cocos, Astragalus membranaceus, Longan aril, Semen ziziphi spinosae, Ginseng, Aucklandia lappa, Honey-fried Licorice Root, Angelica sinensis, and Polygala tenuifolia, and has the effects of replenishing qi and nourishing blood, strengthening the spleen and nourishing the heart. It is mainly used to treat heart and spleen qi and blood deficiency syndrome, manifested as palpitations, insomnia, forgetfulness, sallow complexion, fatigue, and poor appetite.

Shengmai San The difference between Shengmai San and Guipi Tang is that Shengmai San focuses on regulating qi and yin deficiency, while Guipi Tang focuses on treating heart and spleen qi and blood deficiency. Guipi Tang mainly replenishes qi and nourishes blood, strengthens the spleen and nourishes the heart, and improves the symptoms of qi and blood deficiency by regulating the functions of the heart and spleen. Shengmai San mainly has the effects of replenishing qi and promoting the production of body fluid, astringing yin and stopping sweating, and treats the pathogenesis of qi and yin deficiency.

In clinical practice, if the patient mainly shows symptoms of heart and spleen qi and blood deficiency, such as palpitations, insomnia, and sallow complexion, Guipi Tang can be selected; if mainly showing symptoms of qi and yin deficiency, such as shortness of breath, spontaneous sweating, and dry mouth, Shengmai San should be selected for treatment.

VI. Clinical Applications and Indications

1. Cardiovascular Diseases

- Coronary heart disease: Patients with coronary heart disease often present symptoms of qi and yin deficiency, such as chest tightness, chest pain, palpitations, shortness of breath, fatigue, etc. Shengmai San can replenish qi and nourish yin, improve the state of myocardial ischemia and hypoxia, enhance myocardial contractility, relieve the symptoms of coronary heart disease patients, and improve the quality of life. Clinical studies have shown that the combination of Shengmai San and western medicine in the treatment of coronary heart disease can reduce the frequency of angina attacks and improve the ischemic changes in electrocardiogram.

- Arrhythmia: Patients with arrhythmia of qi and yin deficiency type present symptoms such as palpitations, shortness of breath, fatigue, spontaneous sweating, etc. Shengmai San regulates the qi and blood circulation of the heart through the action of replenishing qi and nourishing yin, and stabilizes the heart rhythm. It has a certain therapeutic effect on arrhythmias such as premature beats and atrial fibrillation, especially applicable to functional arrhythmias caused by qi and yin deficiency.

2. Respiratory Diseases

- Chronic bronchitis: Patients with chronic bronchitis often show manifestations of qi and yin deficiency in the late stage of the disease, such as cough, shortness of breath, fatigue, spontaneous sweating, dry mouth, etc. Shengmai San can replenish qi and nourish yin, enhance the body's immunity, improve the symptoms of patients, and reduce the recurrence rate of chronic bronchitis. Clinical application has found that Shengmai San can improve the lung function of chronic bronchitis patients and relieve symptoms such as cough and shortness of breath.

- Pulmonary heart disease: Due to long-term lung diseases, the cardiopulmonary function of patients with pulmonary heart disease is damaged, and qi and yin deficiency syndrome is prone to occur. Shengmai San can replenish qi and nourish yin, improve cardiopulmonary function, relieve the symptoms of dyspnea and fatigue in patients, and improve the quality of life and survival rate of patients. Research shows that the combination of Shengmai San and conventional treatment can reduce the number of hospitalizations of pulmonary heart disease patients and improve cardiac function indexes.

3. Endocrine Diseases

- Diabetes: If diabetic patients present symptoms of qi and yin deficiency, Shengmai San can be used as an auxiliary treatment prescription. It can replenish qi and nourish yin, regulate the body's sugar metabolism, and improve symptoms such as thirst, excessive drinking, excessive eating, polyuria, and fatigue in diabetic patients. Clinical observations have found that Shengmai San has a certain improvement effect on indexes such as blood glucose and glycosylated hemoglobin in diabetic patients, and at the same time helps to reduce the risk of diabetic complications.

4. Other Diseases

- Neurasthenia: Patients with neurasthenia commonly show manifestations of qi and yin deficiency, such as insomnia, dreaminess, restlessness, dizziness, fatigue, etc. Shengmai San can replenish qi and nourish yin, nourish the heart and soothe the nerves, improve the sleep quality and mental state of neurasthenia patients. By regulating the function of the nervous system, it relieves the emotions such as anxiety and depression in patients and improves the quality of life of patients.

- After tumor radiotherapy and chemotherapy: Tumor patients often present symptoms of qi and yin deficiency after radiotherapy and chemotherapy, such as nausea, vomiting, fatigue, spontaneous sweating, dry mouth, etc. Shengmai San can replenish qi and nourish yin, reduce the adverse reactions of radiotherapy and chemotherapy, enhance the body's resistance of patients, and improve the tolerance of patients to radiotherapy and chemotherapy. Clinical studies have shown that Shengmai San can improve the quality of life of tumor patients after radiotherapy and chemotherapy and enhance the immune function of patients.

VII. Modifications

1. Those with obvious qi deficiency

If the qi deficiency symptoms of the patient are more prominent, such as aggravated shortness of breath and fatigue, the dosage of ginseng can be increased to enhance the power of replenishing qi. Astragalus membranaceus can also be added. Astragalus membranaceus tastes sweet and is slightly warm in nature, belonging to the spleen and lung meridians. It can tonify qi and lift yang, secure the exterior and stop sweating. Acting synergistically with ginseng, it further enhances the effect of replenishing qi. The compatibility of Astragalus membranaceus and ginseng can make the power of replenishing qi stronger, and has a good conditioning effect on patients with severe qi deficiency.

2. Those with obvious yin deficiency

When the symptoms of yin deficiency are obvious, such as aggravated dry mouth and throat, the dosage of Ophiopogon japonicus can be increased, or drugs for nourishing yin such as Rehmannia glutinosa and Scrophularia ningpoensis can be added. Rehmannia glutinosa is sweet, bitter, and cold in nature, and belongs to the heart, liver, and kidney meridians. It can clear heat and cool blood, nourish yin and promote the production of body fluid. Scrophularia ningpoensis is sweet, bitter, salty, and slightly cold in nature, and belongs to the lung, stomach, and kidney meridians. It can clear heat and cool blood, nourish yin and detoxify. The combination of Rehmannia glutinosa, Scrophularia ningpoensis and Ophiopogon japonicus can enhance the effect of nourishing yin and clearing heat, and effectively improve the symptoms of yin deficiency.

3. Those with severe spontaneous sweating

If the symptoms of spontaneous sweating and night sweating are severe, the dosage of Schisandra chinensis can be increased, or drugs for astringing sweating such as calcined Dragon Bone and calcined Oyster can be added. Calcined Dragon Bone is sweet, astringent, and neutral in nature, and belongs to the heart, liver, and kidney meridians. It can calm the mind by suppressing fright, suppress the hyperactive liver-yang, astringe and secure. Calcined Oyster is salty and slightly cold in nature, and belongs to the liver, gallbladder, and kidney meridians. It can calm the mind by suppressing fright, suppress the hyperactive liver-yang, nourish yin, soften hardness and dissipate nodules, astringe and secure. The combination of calcined Dragon Bone, calcined Oyster and Schisandra chinensis can enhance the effect of astringing yin and stopping sweating, and effectively control the symptoms of spontaneous sweating and night sweating.

4. Those with concurrent blood stasis

For patients with qi-yin deficiency complicated with blood stasis, drugs for promoting blood circulation and removing blood stasis such as Salvia miltiorrhiza and Ligusticum chuanxiong can be added. Salvia miltiorrhiza is bitter and slightly cold in nature, and belongs to the heart and liver meridians. It can activate blood circulation to remove blood stasis, dredge the meridians to stop pain, clear the heart to remove vexation, cool blood and eliminate carbuncles. Ligusticum chuanxiong is pungent and warm in nature, and belongs to the liver, gallbladder, and pericardium meridians. It can promote blood circulation and qi movement, dispel wind and stop pain. The combination of Salvia miltiorrhiza, Ligusticum chuanxiong and drugs for supplementing qi and nourishing yin can activate blood circulation to remove blood stasis and improve blood circulation on the basis of supplementing qi and nourishing yin, and has a good therapeutic effect on the syndrome of qi-yin deficiency complicated with blood stasis.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional Dosage

The traditional usage of Shengmai San is to combine the three herbs of Ginseng, Ophiopogon japonicus and Schisandra chinensis in a certain proportion and decoct them with water. The general dosage is 9g of Ginseng, 9g of Ophiopogon japonicus, and 6g of Schisandra chinensis. After soaking the herbs for 30 minutes, bring to a boil over high heat, then reduce the heat and simmer for about 30 minutes. Take the decoction, one dose per day, divided into two doses.

This traditional decoction method can fully extract the active ingredients of the herbs and exert the best curative effect of the formula. However, it should be noted that the variety and quality of Ginseng have a certain impact on the medicinal effect, and high-quality Ginseng should be selected. At the same time, the heat and time should be strictly controlled during the decoction process to ensure the medicinal effect of the herbs.

Usage and Dosage of Modern Concentrated Granules

Modern concentrated granules are made by extracting and concentrating the three herbs in Shengmai San into granules. Its usage and dosage are relatively simple, generally taking one bag each time,冲服 with boiling water, twice a day. Modern concentrated granules maintain the medicinal effect of the traditional formula, are convenient to take, easy to store, and are suitable for the modern fast-paced lifestyle.

Compared with the traditional decoction method, modern concentrated granules avoid the cumbersome decoction process, saving time and energy. However, when choosing modern concentrated granules, attention should be paid to selecting products produced by regular manufacturers to ensure the quality and safety of the drugs.

IX. Precautions and Taboos

1. Contraindicated for Excess and Heat Syndromes

Shengmai San is mainly used to treat the syndrome of qi-yin deficiency and is not suitable for patients with excess syndrome or heat syndrome. In patients with excess syndrome, pathogenic factors are excessive in the body and healthy qi is not deficient. Using Shengmai San at this time may cause the retention of pathogenic factors and aggravate the condition. Patients with heat syndrome often have symptoms such as fever, thirst, flushed face, and restlessness. The effect of supplementing qi and nourishing yin of Shengmai San may promote pathogenic heat and is not conducive to the treatment of the condition.

For example, in patients with fever and cough caused by exogenous wind-heat, if Shengmai San is used, it may prevent the timely dispersion of wind-heat pathogens, leading to lingering illness. Therefore, in clinical application, accurate syndrome differentiation must be carried out to avoid mis-treatment.

2. Use with Caution for Weak Spleen and Stomach

Patients with weak spleen and stomach and indigestion have relatively weak functions of the spleen and stomach in transportation and transformation. The drugs in Shengmai San are relatively greasy and may increase the burden on the spleen and stomach, resulting in aggravated symptoms such as indigestion, abdominal distension, and loose stools. When using Shengmai San, such patients should be carefully evaluated. If necessary, the spleen and stomach functions can be regulated first, or the dosage and compatibility of the prescription can be appropriately adjusted under the guidance of a doctor.

3. Dietary Taboos during Medication

During the period of taking Shengmai San, spicy, greasy, and stimulating foods such as chili peppers, fried foods, strong tea, and coffee should be avoided. These foods may affect the absorption and efficacy of the drug and may also aggravate the symptoms of qi and yin deficiency. A light diet should be maintained, and foods with the effects of replenishing qi and nourishing yin such as lilies, tremella, Chinese yam, and red dates should be eaten more, which helps to enhance the physique and promote the recovery of the disease.

4. Medication Precautions for Special Populations

Special populations such as pregnant women, lactating women, and children should be particularly cautious when using Shengmai San. When using drugs during pregnancy, the impact on the fetus needs to be considered. The drug components in Shengmai San may pose potential risks to the fetus. Therefore, if pregnant women need to use it, it must be carried out under the strict guidance of a doctor. The drugs used by lactating women may affect the baby through breast milk, and the dosage for children needs to be adjusted according to factors such as age and weight. When these special populations use Shengmai San, they must follow the doctor's advice to ensure the safety of medication.

X. Modern Research Progress

1. Research on Pharmacological Effects

Shengmai San first appeared in many famous medical works handed down through generations such as 'Medical Origins'. It is composed of ginseng, ophiopogon japonicus, and schisandra chinensis, and has the effect of replenishing qi and promoting the production of body fluid, and is mainly used to treat syndromes of qi and yin deficiency such as dry mouth and tongue. Clinically, Shengmai Yin is commonly used or codonopsis pilosula is used instead of ginseng. In modern times, there are dosage forms such as Shenmai injection. It is said that Emperor Qianlong of the Qing Dynasty once took it for health preservation.

Modern pharmacological research shows that Shengmai San has a variety of pharmacological effects. It can enhance myocardial contractility, improve the state of myocardial ischemia and hypoxia, and has an obvious protective effect on the cardiovascular system. Components such as ginsenosides in Shengmai San can regulate the function of the heart, increase coronary blood flow, and reduce myocardial oxygen consumption, thereby improving the symptoms of cardiovascular diseases such as coronary heart disease.

At the same time, Shengmai San also has the effect of regulating immune function, can enhance the resistance of the body, improve the activity of lymphocytes, and promote the production of antibodies. This has certain significance for the prevention and treatment of various infectious diseases, tumors, etc. In addition, Shengmai San also has antioxidant, anti-aging, and endocrine-regulating effects, can improve the metabolic function of the body, and delay the aging process.

2. Clinical Application Research

In terms of clinical application, the application scope of Shengmai San is constantly expanding. In addition to traditional diseases of the cardiovascular system, respiratory system, endocrine system, etc., Shengmai San also has certain application research in diseases of the nervous system, digestive system, urinary system, etc. For example, when treating nervous system diseases such as Alzheimer's disease and Parkinson's disease, Shengmai San can improve the cognitive function and motor function of patients through its effects of replenishing qi and nourishing yin and regulating nerve function.

Among digestive system diseases, Shengmai San can be used to treat diseases such as chronic atrophic gastritis and gastric ulcer. By regulating gastrointestinal function, it can promote the repair of gastric mucosa and relieve the symptoms of patients. Among urinary system diseases, Shengmai San has a certain therapeutic effect on diseases with qi and yin deficiency such as diabetic nephropathy, can improve renal function indexes, and delay the progression of the disease.

3. Dosage Form Improvement Research

With the development of modern technology, the dosage forms of Shengmai San are constantly being improved. In addition to the traditional decoction and modern concentrated granules, various dosage forms such as injection, capsule, and tablet of Shengmai San have been developed. Shengmai San injection has the advantages of rapid onset and direct action, and can be used for the treatment of first aid and critically ill patients. Dosage forms such as capsules and tablets are convenient to take and easy to carry, meeting the needs of different patients.

The research on dosage form improvement not only improves the clinical application effect of Shengmai San, but also provides more medication options for patients. At the same time, through dosage form improvement, the quality and stability of the drug can be better controlled, ensuring the safety and effectiveness of the drug.

4. Future Research Outlook

In the future, the research on Shengmai San will develop in a more in-depth and extensive direction. In terms of pharmacological effects, its mechanism of action will be further explored to find new active ingredients, laying a foundation for the development of new drugs. In clinical applications, more large-sample, multi-center clinical trials will be carried out to verify the efficacy and safety of Shengmai San in different diseases and expand its application scope.

Furthermore, with the advancement of the modernization of traditional Chinese medicine, the combination of Shengmai San and modern medical technologies will be closer. For example, using gene technology, proteomics technology, etc. to study the effects of Shengmai San on gene expression and protein regulation in the body, providing a new perspective for revealing its mechanism of action. At the same time, strengthening the quality control research of Shengmai San is also an important direction in the future. By establishing a more complete quality standard system, ensuring the quality stability and controllability of Shengmai San, and promoting Shengmai San to better serve clinical treatment.