Research Progress on the Treatment of Encephalopathy by Chloriti Lapis

: Chloriti Lapis is a kind of mineral medicine. Traditional Chinese medicine believes that it has the effects of purging qi and eliminating phlegm, calming liver and relieving convulsion. It can treat stubborn phlegm cementation, cough, asthma, epilepsy, irritability, chest tightness, convulsions, etc. M Modern medicine believes that Chloriti Lapis has the function of scavenging oxygen free radicals, protecting the membrane, regulating the content of excitatory neurotransmitters and inhibitory neurotransmitters in the brain, and is widely used in cerebrovascular diseases. Based on this, the author reviews the pharmacological effects and clinical application of Chloriti Lapis in the treatment of encephalopathy in the past 10 years, in order to provide some reference for clinical and related researchers.


Introduction
Chloriti Lapis, sweet and salty, its nature is flat, non-toxic, belongs to the lung and liver meridians, with the effect of eliminating phlegm and calming the liver, belongs to a kind of mineral medicine [1], which was first recorded in 'Jiayou Bencao'.It is mainly used for the treatment of dyspepsia, retention of viscera, and long-term indigestion.In the 'Compendium of Materia Medica', it is recorded: ' Its nature is downward, and Yin is also heavy, which is the medicine of Jueyin.The wind wood of the liver meridian is too much to make the spleen soil.Qi does not transport and transform, accumulates and generates phlegm, obstructs the upper and middle energizers, and becomes windheat diseases.Therefore, it is appropriate to make this medicine heavy to eliminate stones.Its nature is loose and fast, so that the wood is flat, and the phlegm accumulates and dredges, and the syndromes are self-eliminated.Modern pharmacological studies have also shown that Chloriti Lapis has antiepileptic [2], regulation of intestinal flora [3], anti-arrhythmic [4] and so on.The main components of Chloriti Lapis are Si, Fe, Mg, Al, Ca, K, Na, etc [5]., which can enhance the antioxidant activity of brain tissue, scavenge oxygen free radicals, protect membrane function, maintain the dynamic balance of ion concentration in the brain, inhibit abnormal discharge in the brain, reduce the content of excitatory neurotransmitters, and increase the content of inhibitory neurotransmitters in the brain.month of follow-up, the symptoms were not repeated.

Schizophrenia
Chang's Research [14] showed that on the basis of chlorpromazine combined with Wendan Decoction, the addition of traditional Chinese medicine such as Qingmengshi can effectively alleviate the symptoms of schizophrenia and significantly reduce the amount of antipsychotic drugs.Fan's [15] treated schizophrenia with Anshen Decoction (Qingmengshi, Longgu, Muli, Shigao, Gancao, Dannanxing, Juhong, Beimu, Changpu, Fuling, etc., and found that it was superior to antipsychotic western medicine in anti-anxiety depression and psychomotor retardation, and had fewer side effects.It was similar to western medicine in controlling hostile suspicion.Dr Wang [16] is good at treating schizophrenia, anxiety, depression and other mental diseases with calcined Lapis Micae.In clinical practice, calcined Lapis Micae 15-90 g is used, according to syndrome differentiation, combined with other traditional Chinese medicine high-dose water decoction.Long-term clinical observation has definite curative effect, and no adverse reactions have been found.Lin's [17] treated 30 cases of schizophrenia with Modified Dianmang Mengxing Decoction, and compared with 30 cases of chlorpromazine in the western medicine group.The results suggest that Chinese medicine has the same effect as western medicine in controlling the onset of chronic schizophrenia, and speculate that its possible mechanism is to promote the secretion of BDNF through the repair and protection of brain neurons.Hong [18] treated 30 cases of schizophrenia with modified Dianmang Mengxing Decoction, and compared with 30 cases of chlorpromazine in the western medicine group.The results showed that the traditional Chinese medicine had the same effect as the western medicine in controlling the attack of chronic schizophrenia, and speculated that the possible mechanism was to promote the secretion of BDNF by repairing and protecting brain neurons.Song [19] Using the combination of traditional Chinese and Western medicine, Mengshi Guntan Pill combined with perospirone in the treatment of 150 cases of schizophrenia was compared with the simple use of perospirone.The results showed that Mengshi Guntan Pill combined with perospirone had a significant therapeutic effect on patients with schizophrenia, and its mechanism may be related to the reduction of serum Cor, NGF, BDNF levels and the increase of serum 5-HT levels.Ruscher [20] and other traditional Chinese medicine Jieyu Kaiqiao pill combined with western medicine in the treatment of 125 cases of schizophrenia.The results showed that the total effective rate of the combination of Chinese and Western medicine in the treatment of schizophrenia was as high as 95.3 %, and the adverse reaction rate of the combination of Chinese and Western medicine in the treatment of schizophrenia was only 12.3 %.It can be seen that the effect of the combination of Chinese and Western medicine in the treatment of schizophrenia is significant, and the adverse reaction rate of the patients is low.Liu [21] adopted the principle of purging and purging before tonifying, and self-made Sansheng Mengshi Decoction with Qingmengshi as the main drug was used to treat 58 patients with first-episode schizophrenia.After 4 weeks of treatment, the total effective rate was 92.86 %, and the curative effect was better.Hu's [22] randomly divided 96 patients with schizophrenia into two groups.The treatment group was treated with Mengshi Ditan Decoction on the basis of western medicine.The study found that Mengshi Ditan Decoction had a therapeutic effect on schizophrenia, and the curative effect of integrated traditional Chinese and western medicine on schizophrenia was better than that of western medicine alone, and its toxic and side effects were lighter than those of western medicine alone.Hu's [23] treated 60 cases of first-episode schizophrenia with Jiawei Diankuang Mengxing Decoction, including 30 cases of Chinese medicine group and 30 cases of western medicine clozapine.The results showed that Jiawei Diankuang Mengxing Decoction could effectively treat schizophrenia, and its curative effect was equivalent to that of western medicine clozapine.It is speculated that Jiawei Dianmang Mengxing Decoction can regulate the body's disordered immune function by adjusting the state of TH1 / TH2 imbalance, so as to achieve the purpose of treating schizophrenia.Yang [24] made Mengshi Decoction with Qingmengshi as the main drug, which was used to treat 67 patients with schizophrenia and achieved remarkable curative effect.Shen's [25] used Shugan Jieyu capsule combined with Mengshi Guntan pill to treat 60 patients with schizophrenia of liver depression and phlegm stagnation type, and achieved good clinical results.Yu's [26] used Qingmengshi as the main prescription of the self-made Qudian Decoction (Qingmengshi, Shenglonggu, Shichangpu, Dannanxing, Quandanggui, Guangyujin, Zidanshen, Guangdilong, Chuanhuanglian, Shuizhi, Borneol) combined with low-dose clozapine in the treatment of schizophrenia, 4 cases were cured, 15 cases were markedly effective, 12 cases were improved, the markedly effective rate was 61.24 %, the effective rate was 100 %, and the curative effect was better than that of the western medicine group.Less side effects.Yang [27] dopted the hospital preparation Jieyu Kaiqiao pill combined with western medicine treatment, the party to the green mengshi, yejiaoteng, pearl mother, magnet, raw keel, raw oysters each 30 g, bupleurum, white peony root, scutellaria baicalensis, rhizoma coptidis, rhubarb each 15 g, turmeric, acorus tatarinowii, alum, buffalo horn, earthworm each 10 g, artificial bezoar 2 g, clinical effective rate was 90.9 %.Chua [28] used Guntan Decoction to treat the manic syndrome of mental disorders caused by great changes in family business.The syndrome belongs to long-term depression of liver fire, stomach heat and fu-organ excess, phlegm fire burning heart, disturbing the spirit, and the treatment should be purging fire and expelling phlegm, laxative and clearing turbidity.It was treated with Qingmengshi 30 g, Dahuang 12 g, Huangqin 2 g, Chenxiang 3 g, Mangxiao 30 g (closed), decocted in water, 1 dose a day.After 2 doses of diarrhea, a large number of dry feces and dilute water samples were taken with mucus stool.After diarrhea, the amount of mirabilite was reduced to 15 g, and the loose stool was maintained 2-3 times a day.After half a month, the mind was stable, the diet and sleep were as usual, and then the liver and qi were adjusted for half a month, as usual.After half a year of follow-up, the work and life were normal.

Dementia
He [39] created Zengzhidan (Chloriti Lapis, Acorus tatarinowii, Curcumae Radix, Zhuru, Ligustrum lucidum, Eclipta prostrata, Rehmannia glutinosa, Rehmannia glutinosa, Alpinia oxyphylla, Pheretima, Beauveria bassiana) with Chloriti Lapis as the main prescription.The clinical treatment of children with vascular dementia and cerebral palsy has achieved satisfactory results.Yan [40]used Mengshi Guntan Decoction combined with Xuefu Zhuyu Decoction to treat 1 case of dementia of phlegm-qi stasis type, and the effect was remarkable.He [41]used the method of regulating triple energizer to treat 1 case of frontotemporal dementia.Medicinal Chloriti Lapis 20 g, Perrin 10 g, Lotus leaf 10 g, Lotus stem 10 g, Citrus aurantium 10 g, Amomum villosum 10 g, Magnolia officinalis 10 g, Radix Polygoni Multiflori 15 g, Polygonati Rhizoma 15 g, Angelica sinensis 15 g, Rehmanniae Radix 10 g, Bupleuri Radix 10 g, Acorus calamus 10 g, Curcumae Radix 10 g, Polygala tenuifolia 10 g, Agarwood 5 g, Scutellaria baicalensis 10 g, Coptis chinensis 10 g, Licorice 10 g.A total of 4 doses, water decoction, 1 dose a day, divided into 2 warm clothes.After 1 course of treatment, the mental state of the patients described by the family members was significantly better.After 2 courses of treatment, the patients described by the family members responded more sensitively than before, their memory was improved, and they began to establish trust in their spouses.Continue to adhere to the combination of acupuncture and medicine for half a year, the patient has been as normal, with a good relationship with the spouse, no longer suspect others ; peaceful and cheerful, good communication with people, sensitive response ; memory and computing power returned to normal ; no recurrence and deterioration occurred during the follow-up of half a year.Zhang 's [42]treatment of 1 case of memory cognitive dysfunction caused by the death of his wife, syndrome differentiation for qi stagnation and blood stasis, phlegm and blood stasis, blinding clear orifices.The treatment is to promote qi and blood circulation, remove phlegm and remove blood stasis, open the orifices and wake up the mind.Medicinal Chloriti Lapis (first decoction) 10g, peach kernel 30g, bupleurum 15g, cyperus 20g, akebia 10g, red peony root 15g, pinellia 15g, green peel 15g, large abdominal skin 15g, tangerine peel 15g, mulberry bark 15g, perilla 20g, turmeric 20g, acorus tatarinowii 15g, polygala 15g, salvia miltiorrhiza 20g, chuanxiong 15g, dannanxing 15g, rhubarb 3g, Licorice 15g.Decoct in water, 1 dose / day, warm clothes in the morning and evening.After taking 14 doses, the manic symptoms were significantly improved, and the phenomenon of swearing and destroying things was significantly reduced.After taking 30 doses, the thinking was clear.They could go home on their own, no longer lost their direction, and could normally carry out housework activities within their ability.However, after overwork, they felt weak and weak in the waist and knees, and asked to continue taking the medicine to consolidate the curative effect.They took 60 doses of Bushen Tianjing decoction again, with strong energy and quick thinking.They were followed up so far and were in stable condition.Wang 's [43]treatment of Lewy body dementia in 1 case, with raw Rehmannia 30 g, cooked Rehmannia 30 g, wine Cornus 30 g, wine Cistanche 20 g, Schisandra 10 g, Angelica 20 g, Codonopsis 30 g, Atractylodes 30 g, licorice 15 g, Platycodon 15 g, Astragalus 45 g, Gastrodia 10 g, centipede half, raw keel 30 g, calcined Qingmeng stone 30 g, raw magnet 20 g, Anemarrhena 15 g, Phellodendron 20 g. 14 doses, water decoction, 1 dose a day, warm in the morning and evening.After 21 doses, the patient did not have hallucinations again, and there was no progressive decline in cognitive ability.The original prescription Huangqi was changed to 30 g, and the centipede was removed for half a year.After half a year of follow-up, the patient's condition was stable, and tremor and cognitive decline did not progress.

Epilepsy
Liu 's [44]experimental studies have shown that Qingmengshi has a clear intervention effect on PTZ rats, which can reduce the toxic effect of excitatory neurotransmitters on brain tissue neurons and inhibit the development of brain tissue inflammation to maintain the biological function of brain cells and slow down the occurrence of epilepsy.Wang Shouchuan [45] believes that epilepsy is often difficult to stop, and it is most important that phlegm and wind intersect and accumulate.Therefore, the treatment of epilepsy is based on the main method of extinguishing wind and eliminating phlegm.If the wind is flat, the phlegm is calm, the qi is smooth, the zang-qi is flat, the wind is flat and the phlegm is eliminated, the qi flow is smooth, and the yin and yang qi can be connected smoothly, then the epilepsy can be stopped.He advocates the use of mineral and animal drugs such as Mengshi Guntan Pills, and the use of gold stone drugs.Ma [46]used Qingmengshi as the main drug to treat 1 case of epilepsy with phlegm-dampness phlegm-epilepsy syndrome, and the effect was good.
Deng [47] used the combination of traditional Chinese and Western medicine to treat 34 cases of epilepsy.Ditan Dingxian Decoction combined with sodium valproate was used as the treatment group.The control group only took sodium valproate.The total effective rate of seizure frequency and seizure degree in the treatment group was higher than that in the control group, indicating that the efficacy of the treatment group was better than that of the control group.The effective rate of the treatment group was 94.12 %, and the effective rate of the control group was 80.00 %.

Other encephalopathy
Xu's [48]self-made Quyu Ditan Decoction was used to treat 180 cases of cerebral infarction.The basic prescription was composed of basic prescriptions: angelica 15 g, chuanxiong 15 g, peach kernel 10 g, safflower 10 g, scorpion 15 g, centipede 2, leech 10 g, tangerine peel 9 g, pinellia 12 g, green Mengshi 30 g, Tianzhuhuang 18 g, Zhuru 18 g.Decoction in the morning and evening 2 times a day, 1 agent, 20 d for a course of treatment, the general medication 2-3 courses.Results : Among them, 111 cases were basically cured (paralyzed limb muscle strength returned to normal, muscle strength reached grade IV, various neurological symptoms disappeared, self-care, and able to engage in light physical labor) ; markedly effective (muscle strength of paralyzed limbs increased by more than grade II, neurological symptoms basically disappeared, basic self-care in life, walking on crutches) 45 cases ; improvement (paralyzed limb muscle strength and neurological symptoms improved) in 20 cases ; ineffective : symptoms (no improvement) in 4 cases .

Experience
Foreign research on Chloriti Lapis is almost blank.Domestic research on Chloriti Lapis mainly focuses on clinical observation and clinical experience.Among them, clinical research is mostly compound research.The research on single drugs is also very limited, and there is also a lack of highquality randomized controlled clinical research.We need our next scholars to study and explore, and the compound with Chloriti Lapis as the main drug has a definite effect in the treatment of encephalopathy, but its specific mechanism is still not clear enough.The drug research is not perfect enough, and the research space of clinical application is large, which has a very broad research prospect.