Research On The Usage Of Chinese Date Seeds In Treating Insomnia In The Literature Of The Past Dynastie

At present,sleep disorders have emerged as a significant social concern,with insomnia being a globally prevalent disease.In the context of using traditional Chinese medicine(TCM)to treat insomnia,Ziziphi spinosae semen(Suan Zao Ren,酸枣仁,ZSS)stands out as the foremost herb throughout the history.However,there are still some unresolved issues regarding the processing methods,dosage form,administration timing,and preparation methods concerning its application in clinical practice.Ancient Chinese medical literature represents a vast treasure trove of TCM,and the medication approaches and philosophy employed by ancient doctors warrant investigation.This study aims to delve into ancient Chinese medical literature to investigate ZSS and its application in treating insomnia from the perspective of therapeutic efficacy,providing insights for the clinical application of ZSS with more satisfiable efficacy.Objective:Through comprehensive collection and analysis of ancient Chinese medical literature on the application of ZSS in treating insomnia,this paper would systematically examine the application of ZSS in the treatment of insomnia from the aspects of processing methods,administration routes,dosage forms,decoction methods,administration methods,and dosages.By presenting various processing methods and dosage regimen of ZSS,this study aims to contribute to improving the application of ZSS in modern clinical practice,enhance efficacy,reduce potential side effects,alleviate patients burden,conserve medicinal resources,and provide insights into further experimental research and clinical application of ZSS.Methods:Based on preliminary literature search and organization,the Zhonghua Yidian(Chinese medical cannon,中华医典,5th ed.)was chosen as the source for data retrieval.Several names of ZSS in ancient Chinese were used as search terms,such as "Suan Zao"(酸枣),"Ji Shi"(棘实),"Er Ren"(樲仁),"Suan Zao Ren"(酸枣仁),and "Zao Ren"(枣仁).The retrieved results were then cross-checked against printed literature.All formulas containing ZSS for the treatment of insomnia were initially included for statistical analysis by literature research method and content analysis.The inclusion and exclusion criteria were applied for screening,and standardized terminology was employed.The information regarding ZSS’s processing methods,dosage forms,decoction methods,administration timings,dosage intervals,administration methods,and dosages of ZSS were recorded in a spreadsheet(Microsoft Office 2019 software)to establish a database.Statistical methods and comparative research approaches were utilized to analyze the pattern of its usage.Results:(1)Throughout history,stir-fried ZSS has been employed by TCM doctors to treat insomnia.(2)Various dosage forms of ZSS for treating insomnia were identified in ancient Chinese medical literature,including decoctions,alcoholic preparations,pills,powder,and ointment.Specifically,decoctions are further categorized into three types:herbal decoctions,powder decoctions,and cold herbal decoctions,while pills are classified as either honey pills or paste pills.Among these options,decoctions and pills are the most extensively employed dosage forms,followed by powders.(3)Different administration timings were documented in ancient Chinese medical literature,including before meals,after meals,before bedtime,at any time,and on an empty stomach before bedtime.The most commonly used administration timing was taking at any time.(4)Various methods of administration were employed by TCM doctors for the treatment of insomnia using ZSS,including administer with Jujubae fructus decoction,administer with rice water,administer with warm wine,administer with Ginseng radix et rhizoma decoction,administer with porridge,administer with warm water,administer with Schizonepetae herba decoction,administer with Lophatheri herba decoction,administer with Menthae haplocalycis herba decoction,administer with Junci medulla and Jujubae fructus decoction,administer with honey water.(5)There was a wide range of dosages used for ZSS in ancient Chinese medical literature,although the commonly used dosages exhibited relatively minor variations.During the Song,Jin and Yuan Dynasties,the commonly used dosage of ZSS was 40.00 g,while during the Ming and Qing Dynasties,the commonly used dosage was 37.30 g.Conclusion:Throughout ancient Chinese medical literature,the application of ZSS for treating insomnia varied in terms of dosage forms,decoction forms,administration timing,dosage interval,and administration methods.The content was rich and diverse,differing from the commonly used methods in modern clinical practice,such as water decoction,administer with warm water,and administer before bedtime as described in the textbook on Chinese Materia Medica.Based on the usage patterns of ZSS in historical formulas,it was found that the most commonly used forms were decoctions and pills.Zingiberis rhizoma recens,Jujubae fructus,warm wine,Zea mays,Setarie italica,and Cinnamomi ramulus were added during the decoction process to enhance the effect of calming the mind.The administration timing was flexible,often being "in any time",which is more suitable for application in modern life.The choice of administration method could be personalized,including administer with Jujubae fructus decoction,administer with rice water,administer with warm wine,administer with Ginseng radix et rhizoma decoction,administer with porridge,administer with warm water,administer with Schizonepetae herba decoction,administer with Lophatheri herba decoction,administer with Menthae haplocalycis herba decoction,administer with Junci medulla and Jujubae fructus decoction,administer with honey water.With the above findings from ancient literature,our future experimental studies on the use of sour date palm in the treatment of insomnia could be directed towards the following:to determine a more scientific time for taking sour date palm in conjunction with chronological medicine;to conduct further studies on the more appropriate types of dates,wine and rice for delivery;and to further verify whether sour date palm needs to be peeled,pointed and pounded when concocted.