A. What is cream formula Cream formula is named by its dosage form, also known as cream, cream, belongs to Chinese medicine in the pill, powder, paste, Dan, wine, soup, ingot one of the eight types of dosage, is the splendid culture of the Chinese nation pearl, a long origin. The meaning of ointment is wide: such as referring to things, to grease for the ointment; such as referring to the form, to condense but not solid called ointment; such as referring to the taste, to sweet and smooth for the ointment. In the “Shanhaijing”, it is said: “the good taste of the words are slippery for the paste”. If you refer to the content, think of the essence of things; if you refer to the role, to nourish the ointment for a long time. There are two kinds of ointment: external and internal. External ointment is a common form of medicine in the external treatment of Chinese medicine, and is used in internal medicine and gynecology, in addition to skin and sore diseases. It is widely used in internal, external, gynecological, pediatric, orthopedic, eye, ear, mouth, nose and other diseases, as well as for the physically weak after a serious illness. Poultice, in Chinese medicine theory, is a kind of medicine with advanced nutritional tonic and therapeutic and preventive effects. It is a thick, semi-liquid or jelly form made by decocting and mixing with certain excipients on the basis of large compound tonics and establishing different prescriptions according to different physical conditions and clinical manifestations of people. Paste prescriptions have strict requirements on herbs and the production process, and only the finely processed ones can eventually become top quality. The use of TCM poultices and the practice of TCM “treating the untreated” are gradually becoming the preferred means of disease prevention and treatment. However, there are many problems with the traditional cream making technology, such as the complexity of the degree, the loss of medicinal effects, and the difficulty of manipulation, all of which deeply restrict the further development of cream prescriptions. With the progress of science and technology, modern cream-making technology has been able to realize the functions of rapid concentration, retention of medicinal effects, automatic packaging, standardization of dosage, etc., and improve the production efficiency and scale of cream-making to meet the needs of more patients, which has promoted the development and progress of Chinese medicine cream prescriptions. Second, the origin of cream prescriptions Creams have a long history, tending to the Han and Tang dynasties. In the Yellow Emperor’s Classic of Internal Medicine, there are records about creams, such as horse cream, mainly for external use. In the Eastern Han Dynasty, Zhang Zhongjing’s “The Essentials of the Golden Horoscope” recorded that the decoction of the big ocimum and the decoction of pig paste was the earliest record of the internal use of ointment. The individual “decoction” in “Qianjin Fang” of Tang Dynasty was already in general agreement with modern creams, such as Su Zi Decoction, and “six decoction recipes” in Wang Tao’s “Secret Essentials of Wai Tai”. In the Song Dynasty, cream gradually replaced decoction, basically following the style of the Tang Dynasty, and its use became more and more extensive, such as the Qiongyu cream contained in the Southern Song Dynasty’s “Hong’s Collection of Experimental Formulae”, which is still used today. In Ming and Qing dynasties, the prescriptions were more perfected and matured, manifested by the formal naming and standardized production of the prescriptions, the creams referred to tonic prescriptions, the decoction referred to water decoction; the number was greatly increased, and the clinical application was more extensive. Ming and Qing dynasties cream prescriptions are widely recorded in all kinds of prescription books, the composition is more simple, and the creams that have been handed down to this day are Hongji “General Essentials of Health” “Tortoise and Deer Erxian Cream”, Gong Tingxian “Shou Shi Bao Yuan” “Fu Ling Cream” and Zhang Jinyue’s “Two Yi Cream “two yi cream” by Zhang Jinyue and so on. In the Qing Dynasty, cream recipes were not only circulated among the people, but also widely used in the court, such as the “Cixi Guangxu Medical Recipe Selection” with nearly 30 internal cream recipes. In the late Qing Dynasty, the composition of cream prescriptions became more complicated, such as Zhang Iqing’s “cream prescription” in which the medicine used in cream prescriptions often had reached 20 or 30 flavors, or even more, and the collection of creams often selected gum, deer horn gum, etc., and emphasized the administration of discriminating evidence, which had a great influence on later generations of medical practitioners. In modern times, cream prescriptions are widely used in Shanghai, Jiangsu, Zhejiang, Fujian and Guangdong. Firstly, it has two characteristics of tonic and cure. Some spring and summer diseases, such as asthma, are less likely to attack if the body is well nourished in winter, as the saying goes: “If the righteousness is inside, the evil cannot dry up”. Chinese folk have the habit of winter tonic, there is a saying that “three nine tonic a winter, the next year less disease pain”, “winter tonic, come spring fight tiger”. From the perspective of modern medicine, the winter temperature is low, heat dissipation is more, the gastrointestinal tract function is relatively stronger than other seasons, the physiological function of the exuberance is conducive to the absorption and utilization of nutrients, can be more transformed into their own substances. The metabolic rate of the human body is relatively slow in winter, when proper nourishment can mediate and improve the physiological functions of the human organs, enhance resistance, and achieve the role of disease prevention and treatment. Second, “Yin and Yang secret, to balance for tonic”, fully reflects the overall concept of traditional medicine Chinese medical theory that human life activities based on Yin and Yang Qi and blood, Yin and Yang organs and blood balance can be healthy, prolong life, so “Su Wen – angry Tong Tian Lun” said: “Yin and Yang secret, the spirit is to cure “. There are yin and yang evils, and there are also yin and yang qi in the human body. The occurrence of disease is the result of yin and yang losing their relative balance and having yin and yang bias or yin and yang bias decay. Therefore, to correct the imbalance of yin and yang qi and blood in the human body by using the superiority of drugs, “the spirit is cured when yin and yang are secret” is the basic idea of Chinese medicine in health care and disease treatment, and also the main principle of formulating cream prescriptions. The role of poultice formula (1) to make up for deficiency of qi and blood, loss of five organs, physical weakness or various symptoms of weakness due to surgery, postpartum and recovery from serious illness, chronic wasting diseases, should take poultice formula in winter, which can effectively promote the recovery of health, enhance physical fitness and improve the quality of life of the weak. (2) Anti-aging and prolonging the life of the elderly, the decline of qi and blood, lack of energy, the function of the internal organs is low, can be in the winter tonic cream medicine, in order to resist aging and prolong the life of the elderly. Middle-aged people, due to the function of the organs of the body gradually decline with age, dizziness, lumbar pain, leg weakness, fatigue, palpitations, insomnia, memory loss, etc., can enhance the body to prevent premature aging. (3) Correction of sub-healthy state The role of poultices in regulating the balance of yin and yang, correcting the sub-healthy state and restoring the body to the best state is more significant, working in a fast-paced, stressful environment, many young people due to energy overdraft, dizziness, lumbago, fatigue, early gray hair and other sub-healthy state, poultices can be used to restore their normal state. (4) Prevention and cure The poultices prescribed for different diseases of patients can indeed prevent and cure diseases, especially for cancer patients in recovery and patients with low immunity who are prone to repeated colds, taking Fu Zheng poultices in winter can not only improve immune function, but also store rich nutrients in the body, which can help prevent recurrence, resist metastasis, prevent colds and enhance resistance in the coming year. The production of traditional poultices goes through several processes, such as soaking, decoction, concentration, paste collection and storage. (1) Soaking First, check all the ingredients and pick out the gums and put them separately. Then put all the other drugs into a clean casserole of comparable capacity, add appropriate amount of water to moisten the herbs to make them fully absorbed and swollen, and later add water to about 10 cm above the surface of the herbs and soak for 24 hours. (2) Decoction Put the soaked herbs on the fire and decoct them. First, boil it on high fire, then boil it on low fire for about 1 hour, then turn to light fire to boil for about 3 hours, when the juice is getting thick, you can filter out the first juice with gauze, then add water to moisten the original dregs and then decoct on fire, the decoction method is the same as before, this is the second decoction, and when the smell is thin, after filtering the juice, the dregs will be discarded (if the juice is still thick, it can be decocted again). Mix the juice from the first three decoctions in one place, let it stand and then precipitate and filter it, so that the less the dregs, the better. (3) Concentration of the transitional clean juice into the pot, concentrated, you can first decoction with high fire to accelerate the evaporation of water, and skim out the froth at any time, so that the juice slowly become thick, and then change to low fire to further concentrate, this time should be constantly stirred, because the juice turned thick easily sticky bottom burn, stirring to the degree that the juice drops on the paper does not fall apart, at this point can suspend the decoction, which is concentrated and become a clear paste. (4) Collecting the paste Put the steamed and melted gelatinous medicine and sugar (rock sugar and honey are good) into the clear paste, put it on a small fire and simmer slowly, stirring constantly with a spade until it can be pulled into a flag or drip into a pearl (the paste is condensed into a pearl in water and does not fall apart). (5) Storage After the collected paste has cooled down [should be while it is hot], put it into a clean and clean porcelain container, first without cover, cover the mouth of the container with clean gauze and leave it overnight, after it has cooled down completely, then cover it and put it in a cool place. In addition, it should be noted that while collecting the paste, you can put the prepared medicine powder (such as deer antler powder, ginseng powder, pearl powder, amber powder, placenta powder), which is required to be extremely fine, and smear it well in the paste. Also, the juice can be taken when decocting walnut meat, cinnamon meat, red date meat, etc. together as needed, and put them together when collecting the paste, which can give full play to their effects. The production of poultice is complicated, with a specific degree of strict operation process, in order to achieve the desired effect, generally do not advocate homemade. Sixth, the composition of the cream formula (a) according to the nature of the drug can be divided into three parts, namely, drinking tablets, gum and sugar. Drinking tablet is the main therapeutic effect of Chinese medicine, generally need to identify and treat, according to individual conditions. Gum is used to collect paste during the production process, and has tonic effects such as gum to nourish blood and stop bleeding, nourish yin and moisten lung, and deer horn gum to warm kidney and help yang, produce essence and marrow, activate blood circulation and disperse knots. Sugar is mainly used to improve the taste, in addition, it can tonic the middle and slow down the emergency. (2) According to the role of drugs in the cream formula, it can be divided into four parts: tonic, allopathic, spleen-strengthening drugs and auxiliary ingredients. The tonic medicine has the functions of benefiting qi, nourishing blood, nourishing yin or warming yang, etc. Commonly used are ginseng, astragalus, rehmannia, maitong, cordyceps, placenta, etc., together with the use of agents to regulate qi, resolve dampness, clear heat and eliminate blood stasis, etc., to enhance the effect of tonic. The allopathic medicine is the medicine for the main disease of the patient at that time, taking into account both disease elimination and nourishment. Most of the tonic medicines in the cream formula are sticky and stagnant, which affect the spleen and stomach’s transportation and digestion, and tend to close the door and keep the koan. Therefore, Chen Pi, Sha Ren, Jiao Shanzha, Fried Wheat Sprout, Atractylodes Macrocephala and other spleen-strengthening medicines should be added to enhance the absorption and achieve the effect of tonicity without stagnation. The auxiliary ingredients mainly include sugar for flavoring and gum for paste collection. Seven, the preservation of the cream formula in order to make the cream formula can be taken during the period of quality and give full play to the medicinal power to achieve the purpose of tonic, its storage methods, is crucial. First of all, after the preparation of the cream, let it cool down sufficiently before it can be covered. It can be stored in a porcelain jar (pot, bowl), or in an enamel pot, but it is not advisable to use an aluminum or iron pot as a container. Because of the long duration of the cream, although the time of winter for more, but in the event of a warm winter should be careful of mildew. In general, more in a cool place, better if put in the refrigerator refrigeration. If put in a cool place and meet the warm winter temperatures rise for days, should be allowed to close the high-temperature steam over water, but do not directly steam the paste pot after closing, must open the lid until completely cooled, before covering. Do not let the water of the pot lid fall on the surface of the paste, otherwise mold will appear in a few days. A fixed spoon should be placed when taking poultices every day to avoid bringing moisture into the pot and causing mold and mildew. Once the climate is humid, or the weather is warm, there are some mold spots on the paste, it is advisable to use a clean fruit knife to scrape off the layer of mold, and then close with high temperature steam in water. Of course, if there is a lot of mold and mold is also seen in the depths of the paste, so it can not be taken. Eight, the traditional cream-making technology problems (1) the traditional copper pot concentration extraction of active ingredients, application limitations, can not meet the special requirements. (2) Traditional copper pot concentration and extraction process, part of the active ingredients lost, and reduce the efficacy, a waste of resources. (3) The traditional copper pot concentration process is as long as 2-4 hours, and this long time (100 degrees) boiling evaporation and concentration method is like steaming steamed bun water, and long time boiling, one is that the activity of water is reduced, and water will become hard; the other is that water boiling for a long time will produce harmful substances. (4)The process of manual paste making is long and requires manual non-stop stirring, if the stirring is not timely and uniform, it is easy to paste the pot and coking. (5) The dosage is not accurate, and it is not specific to take a tablespoon of exactly how many milliliters. (6) The cream is mainly in traditional porcelain jars and bottles, which must be stored at low temperature, inconvenient to carry, short retention period and easy to mold. Modern ointment making technology Modern ointment making technology refers to the modern ointment making technology that uses advanced decoction machine to make decoction, multi-functional concentrator to concentrate and collect ointment, and automatic packaging with evenly divided packaging machine. Modern ointment making technology greatly simplifies the work of ointment making, except for prescription review, blending and soaking which are the same as traditional ointment making technology, all other processes are carried out with the help of modern instruments. (1) Decoction Modern ointment making uses a closed herbal decoction machine for decoction. The soaked herbs are put into the airtight decoction machine. The advanced airtight decoction machine can realize automatic two decoctions, so the juice can be taken out in a single decoction for more than 1 hour, and the exact time should depend on the herbs. (2) Concentration The decoction is put into the concentrator, which can concentrate at a speed of 3000-8000MI per hour in a closed vacuum, and the concentration time depends on the amount and viscosity of the medicine. (3) Paste collecting Adopt paste adjusting machine, or adopt traditional paste collecting technology. (4) Packing and cooling the paste The prepared paste is put into the automatic packing machine, which can be packed in equal portions of 10-50ml according to the dosage. The vacuum-packed cream can be stored naturally or refrigerated. (1) The more expensive the cream is, the better it is; whether the cream is effective depends on whether the evidence is accurate, and it cannot be a big tonic for small diseases. (2) Correct understanding of tonic method: tonic can be divided into five categories: flat tonic, tonic, clear tonic, warm tonic and severe tonic. (3) The processing of poultices should be careful: the quality of herbs should be guaranteed, coarse and fine ingredients should be decocted separately, and the fire should be mastered. (4) Regular dosage: Paste formula contains high amount of medicine and should not be taken in excessive dosage. (5) Discriminate in the application of tonic: the formula should be used for one person, and the tonic should be adjusted according to the individual’s physical condition and symptoms. (6) Adapt to local conditions: take different methods of tonic according to different people, different seasons and different regions. (7) Proper storage: Poultices do not contain preservatives and must be stored properly. It can be kept in the refrigerator or in a cool and dry place, not in a warm and humid environment. (8) Attention to avoid eating: during the period of taking medicine, attention should be paid to a reasonable diet, avoid cold, greasy, spicy, indigestible and stimulating food. 10. How to take the cream The amount of cream for each dose is one tablespoon (about 15-20 ml), which can be brewed, mixed or held. Take it, that is, take the appropriate amount of cream, put it into a cup, stir the water into it, make it dissolve and then take it. Tune, that is, add yellow wine or water to the cream, stewed in a bowl or cup over hot water, mix well and then take; if the cream is sticky and difficult to melt, use boiling water to stew and melt before taking. Holding, also known as containing, the cream in the mouth, slowly dissolve in the mouth after swallowing. Eleven, the time to take the cream formula for tonic, all seasons, but to winter is appropriate, so called winter cream formula. Usually from the winter solstice that is “one nine” start, “nine nine” end. There are specific times to take poultices, such as on an empty stomach, before meals, after meals and before bedtime. For those who are suffering from gastrointestinal diseases or poor spleen and stomach function, as well as those who are sick in the lower jiao and want to make the medicine reach down quickly, it is advisable to take it one hour before meals. For heart and lung diseases and diseases in the upper jiao, to make the medicine stay in the upper jiao for a long time, it is appropriate to take the medicine within 15-30 minutes after meals; to supplement the heart and spleen, calm the mind, sedative drugs to help sleep should be taken 2-3 hours before bedtime. Twelve, the cream taking contraindications When using the cream, first of all, we should pay attention to the drug with the “eighteen anti” “nineteen fear”, in addition to the cream with contraindications, pregnancy contraindications and contraindications to take medicine. The cream should prevent “deficiency without tonic” and “loss of yang and injury to fluid”, not just dull tonic, but also to take care of the smooth operation of qi and blood. XIII, the cream is suitable for which people (1) no chronic diseases, but poor health, spring and summer or summer and autumn season often cold, including all ages of old, middle-aged, young people and children over 3 years old. (2) Sub-healthy people. Sub-health is a state in which the organism has no organic pathology but has some functional changes. (3) The regulation of patients with chronic diseases. (4) Post-surgery, patients in the recovery stage after trauma and bleeding, which also includes tumor patients after surgery, chemotherapy and radiotherapy. (5) Middle-aged and elderly people who pay attention to health and have anti-aging needs. (6)Menopausal women. (7) Others: those who are considered suitable by doctors. (1) Pregnant women and healthy minors. (2)Acute attack and active period of chronic diseases. (3) Acute diseases and those with infections, including respiratory system, digestive system, urinary system, etc. Patients with poor immunity, such as diabetic patients, hematological diseases, and patients with malignant fluid when there is a large area of skin and mucous membrane infection. (4) Patients with active infectious diseases such as hepatitis and tuberculosis. (5) Patients with severe mental disorders or diseases. (6)Others: those who are considered unsuitable by doctors. In case of various acute infections during the period of taking ointment medicine, it is necessary to stop taking it temporarily. For mild colds suffering only from nasal congestion and sneezing with no systemic symptoms, you can stop taking it or not. If you have a heavy cold, headache, sore throat, cough, chills, or even fever and other systemic symptoms, you must stop taking it and continue to take it only after the systemic symptoms are eliminated. When gastritis and diarrhea occur, it is necessary to stop taking it temporarily.