ABSTRACT
Shengmai San (SMS), a traditional Chinese medicine (TCM) formula now existing in various pharmaceutical preparations, is comprised of Radix Ginseng, Radix Ophiopogonis and Fructus Schisandrae (1:3:1.5, w/w). Radix Salviae Miltiorrhizae is usually selected as a substitute for the Ginseng component in SMS because of its similar Qi-invigorating property. Radix Ginseng/Radix Salviae Miltiorrhizae is the principal pharmacological component in the formulation of SMS that can produce positive inotropic, peripheral vasodilating, and blood viscosity-lowering effects. However, because of its warm-heat nature and bi-directional pharmacological properties, administration of Radix Ginseng/Radix Salviae Miltiorrhizae may exaggerate the symptoms of Yang hyperactivity in the already Yang-hyperactive patients. On the other hand, Radix Ophiopogonis and Fructus Schisandrae are effective Yin-nourishing herbs, the combined use of these herbs with Radix Ginseng/Radix Salviae Miltiorrhizae can offset the side effects of Radix Ginseng/Radix Salviae Miltiorrhizae, thereby preventing the incidence of imbalance between Yin and Yang in the patients given SMS treatment. Nevertheless, patients with apparent hyperactive Yang should avoid using SMS to prevent the exaggeration of Yin-Yang imbalance. Yang hyperactivity is clinically manifested as distention of head, headache, dizziness and restlessness, and is usually associated with strong pulses, tongue redness with little fur and yellowish urine. Furthermore, SMS should not be prescribed for patients with pyretic and sthenia syndromes, such as uncontrolled acute inflammatory responses (fever, infection, icterus, etc.). Hence, SMS treatment should only be applied on the basis of Differentiation of Signs and Symptoms so as to avoid the incidence of unfavorable side effects.
