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Online Submissions: http://www.journaltcm.com J Tradit Chin Med 2015 June 15; 35(3): 355-360 [email protected] ISSN 0255-2922 © 2015 JTCM. All rights reserved.

REVIEWTOPIC Review of the powder and decoction formulae in Traditional Chi- nese based on pharmacologically active substances and clinical evidence

Liu Qihua, Wen Jin, Peng Zhiping, Liu Fenglin, Tong Xiaolin aa Liu Qihua, Wen Jin, Peng Zhiping, Tong Xiaolin, Depart- tions; ; Medicine, Chinese traditional; ment of Pharmacy and Endocrinology, Guang'an men Hospi- Review tal, China Academy of Chinese Medical Sciences, Beijing 100053, China Liu Fenglin, Department of Medical, Harbin Emergency INTRODUCTION Center, Harbin 150020, China Supported by National Basic Research Program of China Most crude drugs used in Traditional Chinese Medi- (Dose-Effect Relationship Study of Classical famous Prescrip- cine (TCM) are natural products. Some come from en- tion, No. 2010CB530601), Beijing Science Society Project dangered species, which means their supply is very lim- (Common technology Demonstration and Research for Boil- ited and the supply of some crude drugs is constrained ing Powders of Chinese Materia Medica, No. by their exhaustibility. The use of power formulae is an Z121102001112010) effective way to conserve these crude drug resources. Correspondence to: Prof. Tong Xiaolin, Department of En- Study indicates that the use of powder formulae can docrinology, Guang'an men Hospital, China Academy of Chi- save up to two-thirds of each drug used compared with nese Medical Sciences, Beijing 100053, China. xiaolin- decoction formulae, while achieving identical therapeu- [email protected] tic efficacy. Cai et al 1 conducted a retrospective review Telephone: +86-10-60214943 on the dosages of 28 processed herbal com- Accepted: June 8, 2014 monly used in powder and decoction formulae created by herbalists from the Song to the Qing Dynasty (AD 1644-1911). They found that for all 28 drugs, the dos- ages used in powder formulae were smaller than those Abstract in decoction formulae. For the same processed medi- Powder formulae are an indispensable part of pre- cine, the dosages in terms of powder were scription in Traditional Chinese Medicine. Powder 20.9%-41.9% those in decoction. The ratio of dosages formulae are characterized by good therapeutic ef- of the medicines used in powder to those in decoction formulae is 1 5 to 2 5. Therefore, research on tradi- ficacy and low dose used for their preparation. ∶ ∶ tional powder formulae could allow for further develop- Analysis of the therapeutic application and materi- ment of TCM therapeutics. al basis of pharmacological active substance in power formulae can enable the development of new powder formulae. This in turn can contribute HISTORY OF POWDER FORMULAE to reduction of wastage of drug material, relief of IN TCM shortage of herbal medicinal resources and sustain- Powder formulae in TCM consist of single or a few me- able development of Traditional Chinese Medicine. dicinal materials, and are the basis of dosage forms in both traditional and modern Chinese medicine. For ex- © 2015 JTCM. All rights reserved. ample, traditional honeyed pills, water pills, and con- temporary tablets in chunk or capsule form are all Key words: Powders; Decoctions; Drug prescrip- based on medicinal powders.2 As early as the Eastern

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Han Dynasty (AD 25-220), the Treatise on Cold during the decoction process. Qingdai (Indigo Natura- Pathogenic Diseases and Synopsis of Golden Cham- lis) is a product formed by precipitation from water bers,3 compiled by Zhongjing, included more during processing, and nearly all constituents are insol- than 40 powder formulae. Powder formulae became uble in water. Bingpian (Borneolum Synthcticum) is the more popular by the Five Dynasties (AD 907-979) and crystal obtained from the distillate of sambong leaves, Song Dynasty (AD 960-1279), during which the use and is volatile and labile in heat. Luhui (Aloe) are the of powder formulae largely replaced that of decoction concentrated and dried extracts of leaf fluid. Addition- formulae. In the Shanghan Zongbing Lun,4 it was pro- ally, other herbal medicines that have volatile oils as posed that, "decoction formulae are prepared in pow- their main active constituents are suitable for powder der form for direct consumption." The herbalist Li Shi- formulation for infusion. This is because the volatile zhen of the Ming Dynasty (AD 1368-1644) compiled components are largely evaporated during the decoc- the compositions and indications of many medicinal tion process, which diminishes thery potency. Exam- formulae in the Compendium of Materia Medica.5 The ples of these drugs include strongly fragrant herbs such book put great emphasis on the use of powder formu- as Doukou (Fructus Amomi Rotundus), Sharen (Fructus lae, of which there are more than 3200 types. Amomi), Muxiang (Radix Aucklandiae), Jiangxiang (Lig- The powder formulae proposed by Zhang Zhongjing num Dalbergiae Odoriferae), Tanxiang (Lignum Santali are categorized as orally or externally administered Albi), Rougui (Cortex Cinnamomi Cassia), Dingxiang .6 Orally administered formulae are divided (Flos Syzygii Aromatici), Xiaohuixiang (Fructus Foenicu- into blended type and decocted one. External formulae li), and Hujiao (Fructus Piperis Nigri). Some herbal are divided into topical forms and suppositories. In medicines that contain coumarins with low water solu- powder formulae for blending, the drug powder is bility and small amounts of volatile components are mixed with different fluids according, which facilitates suitable for both decoction and powder formulae. oral administration. The fluids suggested by Zhang's However, powder formulae are more advantageous work include water, fermented vegetable infusion, than decoction formulae. Examples include Baizhu wine, porridge, chicken egg yolk, and medicated infu- (Rhizoma Atractylodis Macrocephalae), Cangzhu (Rhi- sion. In powder formulae for decoction, a suitable zoma Atractylodis Lanceae), Houpu (Cortex Magnoliae amount of drug powder is boiled with water before Officinalis), Foshou (Fructus Citri Sarcodactylis), Qiang- oral administration. This method proposed by Zhang huo (Rhizoma et Radix Notopterygii), Duhuo (Radix An- combines the advantages of both powder and decoc- gelicae Biserratae), Baizhi (Radix Angelicae Formosanae), tion formulae. Examples include decoction with Banx- Fangfeng (Radix Saposhnikoviae), Wuzhuyu (Fructus ia (Rhizoma Pinelliae), Ganjiang (Rhizoma Zingiberis) Evodiae Rutaecarpae), Chuanxiong (Rhizoma Chuanx- powder, Yiyiren (Semen Coicis), Fuzi (Radix Aconiti iong), and Jianghuang (Rhizoma Curcumae Longae). Lateralis Preparata), Baijiangcao (Herba Patriniae Sca- Naphthoquinones found in Zicao (Radix Lithospermi) biosaefoliae) powder. Topical powders are directly ap- possess hemostasis, anti-bacterial, anti-viral, and an- plied or rubbed on lesion sites. For example, the indica- ti-tumor effects, and are largely insoluble in water. tion for cowherb seed powder is for "spreading on mi- Danshen (Radix Salviae Miltiorrhizae) contains hydro- nor sores." For suppositories, the drug powder is philic phenolic acids and lipophilic phenanthrenequi- wrapped inside cotton and then plugged into the le- sion site. An example is the common Cnidium fruit nones. The phenanthrenequinone tanshinone has ther- powder used for treating genital coldness in women. apeutic effects on tumors, cardiovascular diseases, bac- terial infections, and inflammation.7 The choice of herbal medicines with both hydrophilic and lipophilic RESEARCH ON POWDER FORMULAE components for powder or decoction formulae de- BASED ON PHARMACOLOGICALLY pends on the clinical indication and the exact composi- tion of active ingredients. Some herbal medicines con- ACTIVE SUBSTANCES AND CLINICAL taining soluble active substances are also suitable for EVIDENCE powder formulae. Huanglian (Rhizoma Coptidis) con- tains water-soluble alkaloids, berberine, coptisine, pal- Herbal medicines matine, and jatrorrhizine. Sun et al 8 reported that Herbal medicines containing insoluble or sparingly sol- when Huanglian (Rhizoma Coptidis) powders were dis- uble active substances are not suitable or contraindicat- solved in gastric juice, then berberine and jatrorrhizine ed in decoctions. Instead, they are pulverized for medi- dissolution was about 50% higher that of its decoc- cal use. Examples include Hupo (Succinum), Ruxiang tion. Wei et al 9 found that oral administration of (Olibanum), Moyao (Myrrh), Anxixiang (Benzoinum), Huanglian (Rhizoma Coptidis) powder facilitates intesti- Suhexiang (Storax Liquidambaris Orientalis), Awei (Resi- nal absorption of not berberine but jatrorrhizine. Sanqi na Ferulae), and Xuejie (Sanguis Draconis). These medi- (Radix Notoginseng) contains water-soluble Panax no- cines have main active ingredients like resins and vola- toginseng saponins (PNS). Han et al 10 found that PNS tile oils. Resins are insoluble in water, and oils are lost is poorly absorbed in small intestine after oral adminis-

JTCM | www. journaltcm. com 356 June 15, 2015 |Volume 35 | Issue 3 | Liu QH et al. / Review tration. Low membrane permeability may be a more in febrile disease with fluid retention, and edema important factor for dominating absorption extent. caused by retention of dampness. Jin et al 13 compared In powder formulae, the drug particles are small and the effectiveness of decoction and powder formulae of therefore easily absorbed during oral administration. five ingredients with Fuling (Poria) in the treatment of Drugs are fast acting, have good therapeutic effects on edema in patients with nephrotic syndrome. The re- digestive system diseases, and have a wide scope of ap- sults showed that the powder formula was superior to plication.11 For example, Rougui powder has pungent the decoction formula in the relief of edema. and warm properties, and can warm the stomach and kidney. Therefore, it can be used to treat abdominal or Animal parts stomach pain caused by exposure to coldness with a Those parts contain more protein and protein hydrolyt- dose of 0.6-1.5 g. The analgesic effect of Rougui pow- ic products, such as amino acids, animal peptide tox- der can be augmented by combination with Yanhusuo ins, enzymes, and glycoproteins. Many clinically used (Rhizoma ) powder. Combination animal parts include Shuizhi (Hirudo), Wugong (Scolo- with Baishao (Radix Paeoniae Alba) powder can warm pendra), Quanxie (Scorpio), Dilong (Pheretima Aspergil- the middle energizer and calm the , thus treating lum), Tubiechong (Eupolyphaga), Jiangcan (Bombyx Ba- abdominal colic. Combination with Huanglian pow- tryticatus), and Mayi (Polyrhachis). A decoction prepara- der can treat insomnia caused by flaring -fire or tion of animal parts would destroy their active ingredi- the breakdown of coordination between heart and kid- ents, and some active ingredients are insoluble in wa- ney. Conversely, Hupo (Succinum) powder has sweet ter. Shuizhi (Hirudo) contain hirudin, heparin, hista- 14 and mild properties, which can tranquilize the mind mine, 17 amino acids, and other peptides. Other small molecules found in Shuizhi (Hirudo) are pteri- and heart, activate yang, and induce diuresis. A dose of dines, glycolipids, unsaturated fatty acids, and steroids. 0.6-1 g can treat refractory insomnia, palpitation, or Wugong (Scolopendra) contain two toxins similar to api- difficulty in diuresis. Sanqi powder is sweet and slight- toxin, one of which is similar to histamine, while the ly bitter in flavor. Sanqi can stanch bleeding, relieve other is a hemolytic protein.15 Other substances in cen- blood stasis, and relieve pain at a dose of 1.5-2.0 g. It is tipedes are tyrosine, leucine, formic acid, cholic acid, indicated for upper gastrointestinal tract bleeding, he- and various trace elements. Scorpion bufotoxin is a pro- moptysis, hematuria, and chronic relapsing pain in the tein toxin.16 Other compounds found in Quanxie (Scor- abdomen and chest from blood stasis. To treat upper pio) are trimethylamine, betaine, tauric acid, lecithin, gastrointestinal bleeding or hemoptysis, Sanqi (Radix and ammonium salts. Li et al 17 reported the extraction Notoginseng) is combined with Baiji (Rhizoma Bletillae efficiency of active ingredients in Shuizhi (Hirudo) by Striatae) while it is combined with Yanhusuo for anal- various methods. Pepsin extraction yielded 80%, tryp- gesia. A dose of 0.6-1.5 g can relieve symptoms includ- sin extraction yielded 38.75%, and water yielded 31%. ing productive cough caused by chronic bronchitis and Therefore, enzymatic extraction was most efficient. nausea and vomiting caused by gastritis and peptic ul- Meng et al 18 reported that the total protein yield and cer. For resolving phlegm and cough suppression, pre- extract yield of Quanxie (Scorpio) was higher using ho- pared Banxia (Rhizoma Pinelliae) powder should be mogenization compared with water reflux, alcohol re- combined with Chuanbeimu (Bulbus Fritillariae Cir- flux, or enzymatic extraction. However, these methods rhosae) powder or Chenpi (Pericarpium Citri Reticula- are not suitable for clinical prescription. The preferred tae) powder. For the management of nausea, vomiting, method for medication is the preparation of powder thirst, and yellow tongue coating, prepared Banxia formula for direct oral administration. Furthermore, (Rhizoma Pinelliae) should be combined with Huangli- gastrin, the spleen-invigorating and appetite-promot- an (Rhizoma Coptidis) powder. Shi et al 12 used Baiji ing substance in Jineijin (Endothelium Coreneum Gigeri- (Rhizoma Bletillae Striatae) powder in hemostasis dur- ae Galli), is inactivated by heat. The use of Jineijin in ing surgery. They found prominent effects on the re- powder formulae allows a smaller er dosage, and is duction in bleeding during and after surgery, amount therefore more efficient than decoction one. Qishe (Ag- of blood transfusion needed after operation, operation kistrodon) and Wushaoshe (Zaocys) mainly contain pro- time, and rinsing time after operation. For some herbal teins, lipids, and trace elements. Shell drugs including drugs, therapeutic efficacy could be improved by ad- Guijia (Carapax et Plastrum Testudinis) and Biejia (Car- ministration in powder formulae, while a decoction apax Trionycis) contain active ingredients such as ani- preparation can diminish the therapeutic effect. Repre- mal gelatin, keratin, amino acids, and trace elements. sentative examples include diuretics such as Fuling (Po- The decoction process affects the extraction of these ac- ria), Zhuling (Polyporus), and Zexie (Rhizoma Alisma- tive ingredients. When decocted with other crude tis); purgatives such as Dahuang (Radix et Rhizoma drugs, the active substances released from the shell may Rhei Palmati). The powder of five ingredients with Ful- be partially adsorbed by the other drugs decoded to- ing (Poria）was first proposed in Treatment and Diag- gether. Furthermore, the shell that is not completely nosis of Taiyang Diseases and Pulse Signs in Treatise on dissolved during the decoction process is usually dis- Cold Damage Disorders. This formula is mainly used carded, which would waste the valuable drug material.

JTCM | www. journaltcm. com 357 June 15, 2015 |Volume 35 | Issue 3 | Liu QH et al. / Review

To enhance the solubility of the shells, it should be pul- mer heat, resuscitation, relieving pyrexia, and detoxify- verized to increase its surface area. This can facilitate ing is Hongling powder, which contains Xionghuang dissolution and absorption in the stomach and increase (Realgar), Zhusha (Cinnabaris), Pengsha (Borax), and availability on a per-weight basis. In prescriptions, the Jinmengshi (Lapis Micae Aureus). Other powder formu- shell drug material can be prepared in powder form for lae that possess great clinical effectiveness include the infusion or decoction before oral administration. “three treasures”for treating acute and emergency py- Chen19 conducted a clinical trial with shell powder for- retic diseases with syncope and convulsion. One of mulae, which demonstrated good therapeutic efficacies. these formulae is bezoar resuscitating powder, which Animal parts have migratory properties, and possess ef- can remove heat and toxins, relieve panic symptoms, fects including expelling wind and excessiveness, re- and induce resuscitation. Another formula is pharma- moving blood stasis and opening collaterals, relieving ceutical bureau precious powder, which has similar ef- obstructions in and blood circulation, analgesia, fects to bezoar resuscitating powder. Finally, purple and relieving edema. They are helpful for diseases snow powder can remove heat and toxins, relieve caused by the obstruction of channels. Liu et al 20 used spasms, and induce resuscitation. However, because ar- powder formulae consisting of animal parts [Sanqi (Ra- senic and mercury compounds are toxic, formulae con- dix Notoginseng), Dilong (Pheretima Aspergillum), taining these two elements should be strictly controlled Quanxie (Scorpio), and Wugong (Scolopendra)] for the in both dosage and duration of administration. treatment of nerve root cervical spondylosis. Com- pared with aconite-cinnamon granules for treating Precious medicinal materials bone pain, the animal formulae demonstrated good The precious medicinal materials are expensive, rare, or derived from endangered species. They can be adminis- therapeutic effects. Lyu21 reported the use of tered as a decoction or fine powder. They have various milkvetch-leech powder [Huangqi (Radix Astragali pharmacologically active substances. Renshen (Radix Mongolici) powder, Shuizhi (Hirudo) powder, and Dan- Ginseng), Xiyangshen (Radix Panacis Quinquefolii), and (Radix Salviae Miltiorrhizae) powder] for the treat- Sanqi (Radix Notoginseng) contain saponins. Shihu ment of chronic hepatitis in 30 patients. Eleven pa- (Herba Dendrobii Nobilis) and Chuanbeimu (Bulbus tients had completed clinical remission (36.6% ), 15 Fritillariae Cirrhosae) mainly contain alkaloids. Ling- had improvement in clinical course (50% ), and four yangjiao (Cornu Saigae Tataricae), Gejie (Gecko), Hai- patients saw no effects (13.3%). The total effective rate ma (Hippocampus Kelloggi), and Hailong (Solenogna- was 86.6%. A non-prescription Chinese medicine "cap- thus) are all animal drugs. Chenxiang (Lignum Aquilari- sule for reactivating heart and collaterals" contains ani- ae Resinatum) contains volatile oils. According to the mal parts such as powder of Shuizhi (Hirudo), Quanxie indications of precious medicinal materials document- (Scorpio), Tubiechong (Eupolyphaga), and Wugong ed in 2010 version of China Pharmacopeia23 and the 22 (Scolopendra). Qian et al conducted a trial of these second edition of Chinese Materia Medica24 we com- capsules for the treatment of stable angina. The total pared the dosages of 14 processed precious medicinal clinical effective rate was 85%. materials used in powder or decoction formulae. From Table 1, it can be seen that dosages in powder formulae Minerals are usually 20%-50% of those in decoction formulae. Minerals used in TCM include sulfides, carbonates, sul- Therefore, the use of powder formulae can reduce the fates, mercury compounds, magnesium compounds, amount of the drug consumed, lower the cost of drugs, and calcium compounds. Most minerals are hard and and save the resources. heavy, and their active ingredients are sparingly soluble Many precious medicinal materials are orally adminis- or insoluble in water. Nevertheless, they contain essen- tered in powder formulation or melted glue. Examples tial trace elements including iron, copper, zinc, manga- and respective doses include: Lurong (Cornu Cervi Pan- nese, molybdenum, and cobalt. To enhance their oral totrichum) 1-2 g, Zhenzhu (Margarita) 0.1-0.3 g, Xue- bioavailability, they are usually pulverized and then jie (Sanguis Draconis) 1-2 g, Niuhuang (Calculus Bovis) wrapped in a cloth bag during the decoction process. 0.15-0.35 g, Shexiang (Moschus) 0.03-0.1 g, Lujiaojiao This process can enhance the release or dissolution of (Colla Cornus Cervi) 3-6 g, and Guijiaojiao (Colla Cara- them. For external use, powder formulae can facilitate pacis et Plastri) 3-9 g. With increasing price and scarci- distribution and absorption on the applied site. Chishi- ty of resources, the suitability of some endemic herbs, zhi (Halloysitum Rubrum) is composed of aluminum sil- such as Danggui (Radix Angelicae Sinensis), Huangjing icate, while Yuyuliang (Limonitum) is composed of ba- (Rhizoma Polygonati Sibirici), Gouqizi (Fructus Lycii), sic iron oxide. Both of these minerals are adsorptive an- and Duzhong (Cortex Eucommiae) for preparation in ti-diarrhea drugs, and are suitable for oral administra- powder formulation warrants further investigation. tion in fine powders. Mangxiao (Nalrii Sulfas) and Xuanmingfen (Natrii Sulfas Exsiccatus) are composed CONCLUSION of sodium sulfate. These minerals are highly water-solu- ble, and can be administered in decoction or infusion Generally, the properties of processed medicinal materi- forms. One powder formula used for removing sum- als that are suitable for decoction include possession of

JTCM | www. journaltcm. com 358 June 15, 2015 |Volume 35 | Issue 3 | Liu QH et al. / Review

Table 1 Comparison of doses of Chinese herbs used in decoctions and powder formulae (g) Chinese herb Dose in decoction Dose in powder form Renshen (Radix Ginseng) 3-9 1-2 Xiyangshen (Radix Panacis Quinquefolii) 3-6 1-2 Sanqi (Radix Notoginseng) 3-9 2-3 Dongchongxiacao (Cordyceps) 6-10 1-2 Shihu (Herba Dendrobii Nobilis) 6-15 2-6 Chuanbeimu (Bulbus Fritillariae Cirrhosae) 3-9 2-3 Tianma (Rhizoma Gastrodiae) 6-10 2-3 Lingyangjiao (Cornu Saigae Tataricae) 3-6 0.5-l Gejie (Gecko) 5-10 1-2 Lingzhi (Ganoderma Lucidum) 6-12 1.5-3 Jinqianbaihuashe (Bungarus Parvus) 2-5 1-1.5 Haima (Hippocampus Kelloggi) 3-9 1-1.5 Hailong (Solenognathus) 3-9 1.5-3 Chenxiang (Lignum Aquilariae Resinatum) 2-5 0.5-1 water-soluble active ingredients and heat-stability. new products. However, these chemical changes do not However, the powder form is directly administered for occur in powder formulae. Second, powder-form pre- medical purpose that have: heat-labile or water-insolu- ferred formulae contain non-volatile and non-polar ble ingredients; a high content of volatile oils; or pre- substances that are absent in decoction preparations. cious, rare, or endangered animals and medicinal Decoctions lack the combination of non-polar sub- plants. The use of the pulverized medicinal materials stances compared with powder formulae. One reason can reduce the doses, save the resources. Some medical for this is the loss of volatile components from evapora- materials are suitable for both decoction and powder tion during decoction. Additionally, water has a limit- formulation. However, if they possess active ingredi- ed extraction capability for non-polar substances. Even ents that are not water-soluble, heat-labile, or poorly when the solubility-enhancing effects between various absorbed, then the use of powder formulae is encour- solutes are taken into account, some non-volatile, aged. This can enhance bioavailability and reduce dos- non-polar molecules cannot be completely extracted age. Animal bone and mineral drugs are hard and spar- from drug material. Therefore, if the active ingredients ingly soluble and insoluble materials and decoctions of of the drug materials are non-volatile and non-polar, chunks of these drugs limits active substance release. In- then that formula is only suitable for powder formu- stead, these materials are pulverized and then wrapped lation. in a cloth bag during decoction. This is known as a de- Based on clinical efficacy and materialistic basis of coction powder formula. This can increase the drug drug material data, further research on novel powder suspension in the decoction and maximize therapeutic formulae should be carried out. The understanding of efficacy. It can also shorten the time needed for de- scientific principles behind the preference for powder coction. formulae over decoctions could significantly affect the conservation of drug material and improve the clinical Research perspectives for powder formula of efficacy of traditional Chinese herbal medicine. In- Traditional Chinese Medicine creased understanding can also help to solve some ques- Clinical experience demonstrates that for some medici- tions encountered in current clinical practice. For ex- nal formulae used in powder form, an exceedingly ample, the suitability of all or some animal parts in small dosage can achieve the same therapeutic efficacy powder preparations should be investigated for dosage as full dosage decoction. Furthermore, for some formu- and clinical effects. This can help practitioners over- lae, the powder form can exhibit clinical effects that come problems with the use of animal parts in clinic, cannot be achieved by decoction. including the reluctance to prescribe because of toxici- Based on preliminary trials and literature review, Wang ty or harshness, the difficulty in finding suitable dosag- et al 25 proposed two mechanisms that explain the thera- es, or unanticipated clinical outcomes from inappropri- peutic efficacies of powder-form preferred formulae. ate prescriptions. Systematic research on the prepara- First, during the decoction process, the components of tion, qualification, and administration of powder for- individual drugs may react with each other to create mulae can ensure the standardization of manufacturing

JTCM | www. journaltcm. com 359 June 15, 2015 |Volume 35 | Issue 3 | Liu QH et al. / Review and quality assurance, and the rationalization of pre- powder. Shi Yong Zhong Yi Nei Ke Za Zhi 2007; 21(8): scriptions. 69. In conclusion, further research and development of 12 Shi WP, Zhang BX, Li GL, Fei JG. Clinical application of TCM herbal powder formulae and their processing Baiji (Rhizoma Bletillae Striatae) powder for Hemostasis and manufacturing can help save herbal medicine re- during prostatectomy. Zhong Guo Xian Dai Yi Yao Za sources and improve imbalances in the supply and de- Zhi 2007; 9(4): 74-75. mand of drug materials. It can also allow the realiza- 13 Jin RZ, Yu RH, Gao H, Yang CX, Fang F, Wang JN. tion of clinical efficacy with minimal doses, and maxi- Comparative study of Wuling powder and Wuling decoc- mization of used drug materials. Promotion of the use tion for nephrotic syndrome patients of water-damp col- of powder formulae can enable the rational use of herb- lecting internally syndrome. Zhong Yi Za Zhi 2012; 53 al medicine resources in China, the balance of the eco- (7): 572-577. 14 Liu XF, Yang YJ, Wu LJ, Xu J. Research progress and pros- system, and sustainable development of TCM. pect on pharmacognosy and chemical compostion of Shui- zhi (Hirudo). Huan Qiu Zhong Yi Yao 2012; 5(8): REFERENCES 637-640. 15 Zhou YQ, Han L. Research progress of Wugong (Scolopen- 1 Cai GX, Liu BY. Research on the dosage of 28 Chinese dra). Cai 2008; 31(2): 315-319. herbal pieces with traditional decoction and its powder. 16 Li JS. Authentication of Chinese medicines. Shanghai: Sci- Zhong Guo Shi Yan Fang Ji Xue Za Zhi 2004; 10(2): entific and Technical Publishers, 1999: 594-595. 63-64. 17 Li ZB, Zhao SH, Wang YR, Wang ZY, Zhang YJ. Com- 2 Qiu YY. Application and improvement of Chinese herbal parison of Leech extracts in anticoagulant and fibrinolytic powder. Jiangxi Zhong Yi Xue Yuan Xue Bao 1998; 10(1): activities and the composition of its enzymolysis products. 31. Zhong Cheng Yao 2011; 33(1): 42-45. 3 Tong XL, Peng ZP, Jao YZ, Zhang JC, Liu F, Zhou Q. Re- 18 Meng L, Ji T, Hou L, Tian JZ. Study on homogenate ex- search survey and commentary of Chinese herbal powder. traction of Quanxie (Scorpio). Zhong Cao Yao 2010; 41 Zhong Yi Za Zhi 2013; 54(1): 12-16. (4): 577-580. 4 Pang AS. Shang Han Zong Bing Lun. Beijing: People's 19 Chen FH. Discussion about the use of Guijia (Carapax et Medical Publishing House, 2007: 131. Plastrum Testudinis) and Biejia (Carapax Trionycis) after 5 Zhu SS. Special pharmaceutical technology in compendi- processing to powders. Shi Zhen Guo Yao Yan Jiu 1997; 8 um of materia medica. Beijing: Academy Press, 1996: 88. (6): 538. 6 Li YQ. The application of powder in the treatise on cold 20 Liu B, Zhang H, Lu XH, Zhang LY. Therapy treatment pathogenicand miscellaneous diseases. Shanxi Zhong Yi on the Cervical Spondylotic Radiculopathy of insect pow- 2009; 30(6): 760-761. ders. Hai Xia Yao Xue 2013;25(2): 185-186. 7 Cai LP, Xi ZG, Yang H. Pharmacological research and 21 Lyu YH. Qizhi powder for treatment of 30 cases with clinical progress of Tanshinone. Guangdong Yao Xue Yuan Chronic Hepatitis. Yi Xue Xing Xi 2011; 24(8): 5141. Xue Bao 2008; 24(3): 321-324. 22 Qian XX, Chen YM, Liu Y, Zhou B, Chen L, Wu WK. 8 Sun XJ, Xu LJ, Wei SC, et al. To comparison the dissolu- Effect of Tongxinluo capsule on endothelial function in tion of the active ingredients of Huanglian (Rhizoma Copti- stable angina pectoris patients. Zhong Guo Bing Li Sheng dis) powder and decoction in gastric juice. Shi Zhen Guo Li Za Zhi 2006; 22(9): 1698-1701. Yi Guo Yao 2013; 24(8): 1910-1912. 23 National Pharmacopoeia Committee. Pharmacopoeia of 9 Wei SC, Xu LJ, Zou X, Lu FR, Wang KF. In vivo small in- the People's Republic of China. Beijing: China Medical testinal absorption ofberberine and jatrorrhizine from Rhi- Science Press, 2010: 11. zoma Coptidis powder in rats. Hua Zhong Ke Ji Da Xue 24 Gao XM. Chinese Materia Medica. 2nd ed. Beijing: Chi- Xue Bao 2013; 42(3): 333-337. na Press of Traditional Chinese Medicine, 2007: 42. 10 Han M, Han LM, Wang QS,Bai ZH, Fang XL.Mecha- 25 Wang JN, Zhang GD, Yu RH, et al. Thinking of the pro- nism of oral absorption of panaxnotoginseng saponins.Yao found meaning of the dosage form by the Traditional Chi- Xue Xue Bao2006, 41(6): 498-505. nese Medicine clinical effects difference. Zhong Guo Shi 11 Bi SR. Clinical experience on usage of Chinese herbal Yan Fang Ji Xue Za Zhi 2010; 16(4): 185-187.

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