Traditional Chinese medicine for regulating content of 5-HT and CGRP in serum

Abstract

The invention provides a traditional Chinese medicine for regulating the content of 5-HT and CGRP in serum. The traditional Chinese medicine is prepared from the following raw materials: rhizoma gastrodiae, rhizoma pinellinae praeparata, pericarpium citri reticulatae, poria cocos, ligusticum wallichii, roasted stiff silkworm, radix angelicae, radix puerariae, roasted rhizoma atractylodis macrocephalae and herba asari. According to the present invention, the serum 5-HT content and the serum CGRP content are recovered to the normal level, and the key effect is provided for the nervous system, the cardiovascular system and the pain regulation.

Description

Technical Field

[0001] The present invention relates to the field of pharmacy, and in particular to a traditional Chinese medicine for regulating the contents of 5-HT and CGRP in serum. Background Art

[0002] 5-HT (5-hydroxytryptamine, serotonin) and CGRP (calcitonin gene-related peptide) are two important neurotransmitters and vasoactive substances. Changes in their levels can reflect a variety of physiological and pathological conditions, particularly playing a key role in the nervous system, cardiovascular system, and pain regulation. Abnormal 5-HT is closely associated with conditions such as depression, migraine, and irritable bowel syndrome (IBS). Elevated CGRP is a key biomarker for migraine, hypertension, and neurogenic inflammation. Existing Western medications are used clinically to regulate serum 5-HT and CGRP levels, but they are associated with side effects and individual variability. Traditional Chinese medicine and its active ingredients, due to their multi-target and low toxicity properties, have become potential alternatives for regulating 5-HT and CGRP. Summary of the Invention

[0003] The purpose of the present invention is to solve the shortcomings of the prior art and to propose a traditional Chinese medicine for regulating the levels of 5-HT and CGRP in serum.

[0004] To achieve the above purpose, the present invention adopts the following technical scheme: a traditional Chinese medicine for regulating the content of 5-HT and CGRP in serum, comprising the following raw materials: Gastrodia elata, Pinellia ternata, dried tangerine peel, Poria cocos, Chuanxiong, roasted Bombyx batryticatus, Angelica dahurica, Pueraria root, stir-fried Atractylodes macrocephala, and Asarum.

[0005] Preferably, the weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

[0006] Preferably, the weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

[0007] To achieve the above purpose, the present invention also adopts the following technical scheme: a traditional Chinese medicine for treating vestibular migraine of wind-phlegm-stasis type, comprising the following raw materials: Gastrodia elata, Pinellia ternata, dried tangerine peel, Poria cocos, Chuanxiong, roasted Bombyx batryticatus, Angelica dahurica, Pueraria root, stir-fried Atractylodes macrocephala, and Asarum.

[0008] Preferably, the weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

[0009] Preferably, the weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

[0010] Compared with the prior art, the present invention has the following beneficial effects: the present invention can increase the serum 5-HT content of patients, reduce the serum CGRP content, restore the serum 5-HT content and serum CGRP content to normal levels, and play a key role in the nervous system, cardiovascular system and pain regulation; during the attack period of vestibular migraine of wind-phlegm-stasis type, abnormal serum 5-HT content and serum CGRP content will occur. The present invention can better increase the serum 5-HT content and reduce the serum CGRP content of patients with vestibular migraine, play the role of calming wind and vertigo, removing phlegm and removing blood stasis, unblocking meridians and relieving pain, effectively improve the clinical symptoms of vestibular migraine of wind-phlegm-stasis type, promote the repair and compensation of vestibular function, and improve the quality of life of patients. DETAILED DESCRIPTION

[0011] In order to provide a further understanding of the purpose, structure, features, and functions of the present invention, the present invention is described in detail below with reference to the embodiments. Example 1

[0012] The invention provides a traditional Chinese medicine for regulating the content of 5-HT and CGRP in serum. The traditional Chinese medicine comprises the following raw materials: gastrodia elata, pinellia tuber, dried tangerine peel, tuckahoe, ligusticum chuanxiong, roasted bombyx batryticatus, angelica dahurica, kudzu root, stir-fried atractylodes macrocephala and asarum.

[0013] Preferably, the weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

[0014] Preferably, the weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

[0015] Clinical trials: 1. Research Objectives To clarify the clinical efficacy of traditional Chinese medicine that regulates serum 5-HT and CGRP levels on the nervous system, cardiovascular system and pain regulation.

[0016] 2. Main research methods (1) Criteria for case selection Patients with abnormal 5-HT and CGRP levels, aged 18-90 years, both men and women.

[0017] (2) Research plan A total of 49 patients who visited the outpatient or inpatient department of encephalopathy at Nanjing Hospital of Traditional Chinese Medicine between March 2022 and February 2025 were enrolled. They were treated with a traditional Chinese medicine formula that regulates serum 5-HT and CGRP levels. The formula consisted of 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong rhizome, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum. The herbs were decocted twice with water, the combined decoctions concentrated to 400mL, and taken once daily, morning and evening, for two weeks.

[0018] 3. Efficacy indicators 3.1 Serum 5-HT and CGRP indicators Before treatment and 2 weeks after treatment, 3 mL of fasting venous blood was collected from the patients and centrifuged at 3000 r / min to obtain serum. The levels of 5-HT and CGRP were detected using enzyme-linked immunosorbent assay kits.

[0019] 3.2 Statistical methods In this study, data processing was carried out using R (4.3.2) software. For count data, chi-square test was used for analysis; for measurement data, mean ± standard deviation was used. Statistical descriptions were provided. For continuous dependent variables, analysis of variance was performed. Measurement data were tested for normality. If the data conformed to a normal distribution, two independent sample t-tests were used for comparisons between groups; if not, nonparametric tests were used. A P value of < 0.05 was considered statistically significant.

[0020] 3.4 Comparison of serum 5-HT and CGRP levels before and after treatment There were no statistically significant differences in serum 5-HT and CGRP levels before treatment (P>0.05). After treatment, serum 5-HT levels were significantly higher in all patients (P<0.05), while serum CGRP levels were significantly lower in all patients (P<0.05). See Table 1.

[0021]

[0022] 4. Conclusion In conclusion, Chinese medicines that regulate the levels of 5-HT and CGRP in serum can regulate serum 5-HT and CGRP. Example 2

[0023] The invention provides a traditional Chinese medicine for treating vestibular migraine of wind-phlegm-stasis type, comprising the following raw materials: gastrodia elata, pinellia ternata, tangerine peel, tuckahoe, ligusticum chuanxiong, roasted bombyx batryticatus, angelica dahurica, kudzu root, stir-fried atractylodes macrocephala and asarum.

[0024] The monarch herbs are Gastrodia elata, roasted Bombyx batryticatus, and Pueraria root; the assistant herbs are Pinellia ternata, dried tangerine peel, stir-fried Atractylodes macrocephala, and Poria cocos; the adjuvant herbs are Asarum and Angelica dahurica; and the guiding herb is Chuanxiong. Gastrodia elata is adept at calming wind and can treat dizziness and headaches caused by wind-phlegm disturbances; roasted Bombyx batryticatus enters the liver meridian, dispelling phlegm and dissolving stagnation; and Pueraria root unclogs the meridians and disperses blood stasis. These three herbs, acting as monarch herbs, work together to dispel wind, resolve phlegm, and dissolve blood stasis. Pinellia ternata, aided by dried tangerine peel, promotes smooth flow of qi and dissipates phlegm; while dried tangerine peel, aided by Pinellia ternata, dissipates phlegm and promotes qi downward. These two herbs complement each other and, along with stir-fried Atractylodes macrocephala and Poria cocos, serve as assistant herbs to strengthen the spleen, eliminate dampness, and resolve phlegm. Asarum and Angelica dahurica, respectively, are adept at relieving headaches affecting the Shaoyin and Yangming meridians. Together, their aromatic properties reach upward, clearing the orifices and dispelling wind, dispelling cold, and relieving pain. Chuanxiong, acting as the guiding herb, is pungent, warm, fragrant, and drying, reaching the vertex and descending to the sea of blood, promoting qi, activating blood circulation, and dispersing blood stasis. The combination of these medicines has the effects of calming wind and stagnating dizziness, removing phlegm and removing blood stasis, unblocking meridians and relieving pain. It is mainly used to treat vestibular migraine caused by wind and phlegm blocking the meridians.

[0025] In one embodiment, the weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

[0026] In one embodiment, the weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

[0027] 5-HT regulates vasoconstriction, and CGRP regulates vasodilation. A balance between the two can reduce abnormal vascular fluctuations in migraines. Inhibiting CGRP alone may lead to a long-term compensatory increase in 5-HT, leading to the risk of vasospasm. Elevating 5-HT alone may overactivate CGRP and aggravate the inflammatory response of migraines. Synergistic regulation can avoid compensatory imbalance of a single pathway and reduce the risk of treatment resistance.

[0028] Clinical trials: 1. Research Objectives To clarify the clinical efficacy of traditional Chinese medicine in treating vestibular migraine of wind-phlegm-stasis type by regulating serum 5-HT and CGRP levels.

[0029] 2. Main research methods (1) Criteria for case selection Patients with vestibular migraine of wind-phlegm obstruction type, aged 18-90 years, both men and women.

[0030] Diagnostic criteria Western medicine diagnostic criteria for vestibular migraine: based on the diagnostic criteria in ICHD-3 (International Classification of Headache Disorders, 3rd Edition) developed by the IHS Migraine Classification Group in February 2022.

[0031] At least five episodes of moderate to severe vestibular symptoms (such as vertigo, dizziness, and postural instability), lasting from 5 minutes to 72 hours; Meet the diagnostic criteria for migraine or have a relevant medical history (such as headache, photophobia / phonophobia, visual aura, etc. during the attack); Other vestibular diseases (such as Meniere's disease, benign paroxysmal positional vertigo, etc.) were excluded.

[0032] TCM syndrome differentiation standards for wind-phlegm-stasis syndrome: formulated based on the "Guidelines for Diagnosis and Treatment of Common Diseases in TCM Internal Medicine" and the relevant standards for dizziness and wind-phlegm-stasis syndrome in "Practical Internal Medicine" issued by the China Association of Traditional Chinese Medicine.

[0033] Main symptoms: recurrent dizziness and vertigo; Secondary symptoms: headache, chest tightness, nausea and vomiting, numbness or tingling in the limbs; Tongue: dark red tongue, or with petechiae on the edges, with greasy white tongue coating; Pulse: stringy, slippery, slow, and astringent.

[0034] (3) Research plan A total of 97 patients with VM who visited the outpatient or inpatient department of encephalopathy at Nanjing Hospital of Traditional Chinese Medicine between March 2022 and February 2025 were enrolled. Using a randomized controlled design, the patients were divided into a control group (48 cases) and a treatment group (49 cases). Both groups received conventional medical treatment for VM.

[0035] 1) Control group: Flunarizine hydrochloride tablets (Weifang Zhongshi Pharmaceutical Co., Ltd., National Medicine Approval No. H20023860) 10 mg once daily, before bedtime, for two weeks. 2) Treatment group: Traditional Chinese medicine for vestibular migraine of the wind-phlegm-stasis type. The formula includes Gastrodia elata 10g, Pinellia ternata 6g, Tangerine peel 6g, Poria 20g, Chuanxiong 6g, Bombyx batryticatus 10g, Angelica dahurica 6g, Pueraria root 20g, Atractylodes macrocephala 20g, and Asarum 3g. The herbs were decocted twice with water, the combined decoction was concentrated to 400 mL, and taken twice daily, morning and evening, for two weeks.

[0036] 3. Efficacy indicators 3.1 Observation indicators 3.1.1 TCM syndrome scoring The Traditional Chinese Medicine (TCM) syndrome scoring scale was used to quantitatively assess symptoms based on the "Guiding Principles for Clinical Research of New Traditional Chinese Medicines." Primary symptoms (dizziness and vertigo) were scored as 0, 2, 4, and 6, respectively, for absence, mild, moderate, and severe. Secondary symptoms (headache, chest tightness, nausea and vomiting, and limb numbness) were scored as 0, 1, 2, and 3, respectively, for absence, mild, moderate, and severe. Both groups of patients were assessed for TCM syndrome scores before and after treatment. The total TCM syndrome score was the sum of the individual scores.

[0037] 3.1.2 Dizziness Handicap Inventory (DHI) score The DHI scale was used to assess the degree of vertigo in both groups before and after treatment. The DHI scale includes a total vertigo index and three scores: physical (P) (28 points), emotional (E) (36 points), and functional (F) (36 points), with a total score of 100 points. Higher scores indicate more severe vertigo.

[0038] 3.1.3 Visual Analog Scoring (VAS) for headache The VAS was used to assess headache severity in both groups before and after treatment. Patients drew a mark on a given horizontal line to indicate their pain level based on their perceived level of pain. The score ranged from 0 to 10, with higher scores indicating more severe headaches.

[0039] 3.1.4 Serum 5-HT and CGRP indicators Before treatment and 2 weeks after treatment, 3 mL of fasting venous blood was collected from the patients and centrifuged at 3000 r / min to obtain serum. 5-HT and CGRP levels were detected using enzyme-linked immunosorbent assay kits.

[0040] 3.1.5 Short Form 36 (SF-36) The SF-36 questionnaire was used to assess the quality of life of the two groups before and after treatment. The SF-36 questionnaire includes eight dimensions: Role-Physical (RP), Physical Function (PF), Bodily Pain (BP), Vitality (VT), Social Function (SF), Role-Emotional (RE), Mental Health (MH), and General Health (GH). Each dimension is scored out of 100 points. Each dimension is evaluated separately; higher scores indicate higher quality of life.

[0041] 3.1.6 Adverse reactions Record the occurrence of adverse reactions related to oral medications (such as blood pressure, heart rate, nausea and vomiting, fatigue, abnormal blood routine and liver function, etc.) in the two groups of patients during treatment 3.1.7 Number and duration of vertigo attacks The frequency of vertigo attacks and the duration of each attack were followed up in both groups one month after treatment and compared with those before treatment.

[0042] 3.2 Criteria for determining efficacy of TCM syndromes Based on the "Guiding Principles for Clinical Research of New Traditional Chinese Medicines," criteria for evaluating TCM syndrome efficacy were established. Efficacy was assessed in both groups after the completion of treatment. TCM syndrome improvement rate (%) = (pre-treatment syndrome score - post-treatment syndrome score) / pre-treatment syndrome score × 100%. Clinical efficacy was categorized as follows: markedly effective: clinical symptoms and signs significantly improved, with a ≥70% reduction in TCM syndrome score; effectively effective: clinical symptoms and signs improved somewhat, with a 30% or less reduction in TCM syndrome score <70%; ineffective: clinical symptoms and signs showed no significant improvement or even worsened, with a 30% reduction in syndrome score <30%. Total effective rate (%) = [(number of markedly effective cases + number of effective cases) / total number of cases] × 100%.

[0043] 3.3 Statistical methods In this study, data processing was carried out using R (4.3.2) software. For count data, chi-square test was used for analysis; for measurement data, mean ± standard deviation was used. Statistical descriptions were provided. For continuous dependent variables, analysis of variance was performed. Measurement data were tested for normality. If the data conformed to a normal distribution, two independent sample t-tests were used for comparisons between groups; if not, nonparametric tests were used. A P value of < 0.05 was considered statistically significant.

[0044] 3.4 Treatment outcomes 3.4.1 Comparison of TCM syndrome scores between the two groups before and after treatment Before treatment, there was no statistically significant difference in the total TCM syndrome scores between the two groups (P>0.05). After treatment, the total TCM syndrome scores of both groups were significantly lower than those before treatment (P<0.05, P<0.01), with the treatment group having a significantly lower score than the control group (P<0.01). See Table 2.

[0045]

[0046] 3.4.2 Comparison of DHI scores and headache VAS scores between the two groups before and after treatment Before treatment, there were no statistically significant differences in the DHI scores and headache VAS scores between the two groups (P>0.05). After treatment, the DHI scores and headache VAS scores of both groups were significantly lower than those before treatment (P<0.01), and the improvement in the DHI and headache VAS scores in the treatment group was significantly greater than that in the control group (P<0.05). See Table 3.

[0047]

[0048] 3.4.3 Comparison of the Short Form Health Status Questionnaire (SF-36) scores on different quality of life dimensions between the two groups before and after treatment Before treatment, no statistically significant differences were found between the two groups in scores for eight dimensions: role physical function, physical function, bodily pain, vitality, social function, emotional function, mental health, and overall health (P>0.05). After treatment, both groups showed significant improvements in these eight dimensions of quality of life compared with their pre-treatment counterparts (P<0.05, P<0.01). Furthermore, the treatment group showed significantly greater improvement than the control group in six dimensions: physical function, bodily pain, vitality, social function, mental health, and overall health (P<0.01). See Table 4.

[0049]

[0050] 3.4.4 Comparison of serum 5-HT and CGRP levels before and after treatment between the two groups Before treatment, there were no statistically significant differences in serum 5-HT and CGRP levels between the two groups (P>0.05). After treatment, serum 5-HT levels in both groups were significantly higher than those before treatment (P<0.05), and serum CGRP levels in both groups were significantly lower than those before treatment (P<0.05). The treatment group had a significantly better regulatory effect on 5-HT and CGRP levels than the control group (P<0.05). See Table 5.

[0051]

[0052] 3.4.5 Comparison of TCM syndrome efficacy between the two groups of patients After the course of treatment, the total effective rate of TCM syndromes in the treatment group was 93.88%, significantly higher than the 72.92% in the control group (P < 0.01). See Table 6.

[0053]

[0054] 3.4.6 Comparison of recurrence of vertigo within 1 month between the two groups before and after treatment Before treatment, there was no statistically significant difference in the number of vertigo attacks and the duration of each attack between the two groups (P>0.05). After treatment, the number of vertigo attacks and the duration of each attack in both groups were significantly reduced compared with those in the original treatment group (P<0.05, P<0.01), with the treatment group showing significantly better results than the control group (P<0.01). See Table 7.

[0055]

[0056] 3.5 Adverse reactions in the two groups of patients during treatment During treatment, both groups underwent blood pressure, heart rate, blood routine, and liver and kidney function tests, all of which showed no significant abnormalities. Three patients in the treatment group experienced early diarrhea, with an adverse reaction rate of 6.12%. Two patients in the control group experienced fatigue and two patients in the control group experienced nausea, with an adverse reaction rate of 8.33%. There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05).

[0057] 4. Conclusion In summary, traditional Chinese medicine for the treatment of vestibular migraine of wind-phlegm-stasis type can significantly improve the traditional Chinese medicine symptoms of patients with vestibular migraine of wind-phlegm-stasis type, enhance the clinical efficacy of traditional Chinese medicine, and improve the quality of life.

[0058] The present invention has been described with reference to the above embodiments. However, the above embodiments are merely exemplary embodiments of the present invention. It should be noted that the disclosed embodiments do not limit the scope of the present invention. On the contrary, modifications and improvements that do not depart from the spirit and scope of the present invention are intended to be protected by the present invention.

Claims

1. A Chinese medicine for regulating the levels of 5-HT and CGRP in serum, characterized in that: The invention comprises the following raw materials: Gastrodia elata, Pinellia ternata, dried tangerine peel, Poria cocos, Ligusticum chuanxiong, roasted Bombyx batryticatus, Angelica dahurica, Pueraria root, stir-fried Atractylodes macrocephala, and Asarum.

2. The Chinese medicine for regulating the levels of 5-HT and CGRP in serum according to claim 1, wherein: The weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

3. The Chinese medicine for regulating the levels of 5-HT and CGRP in serum according to claim 1, wherein: The weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

4. A Chinese medicine for treating vestibular migraine of wind-phlegm-stasis type, characterized by: The invention comprises the following raw materials: Gastrodia elata, Pinellia ternata, dried tangerine peel, Poria cocos, Ligusticum chuanxiong, roasted Bombyx batryticatus, Angelica dahurica, Pueraria root, stir-fried Atractylodes macrocephala, and Asarum.

5. The Chinese medicine for treating vestibular migraine of wind-phlegm-stasis type according to claim 4, characterized in that: The weight ratio of the raw materials is 8-12g of Gastrodia elata, 4-8g of Pinellia ternata, 4-8g of dried tangerine peel, 15-25g of Poria cocos, 4-8g of Chuanxiong, 8-12g of roasted Bombyx batryticatus, 4-8g of Angelica dahurica, 15-25g of Pueraria root, 15-25g of stir-fried Atractylodes macrocephala, and 1-5g of Asarum.

6. The Chinese medicine for treating vestibular migraine of wind-phlegm-stasis type according to claim 4, characterized in that: The weight ratio of the raw materials is 10g of Gastrodia elata, 6g of Pinellia ternata, 6g of dried tangerine peel, 20g of Poria cocos, 6g of Chuanxiong, 10g of roasted Bombyx batryticatus, 6g of Angelica dahurica, 20g of Pueraria root, 20g of stir-fried Atractylodes macrocephala, and 3g of Asarum.

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