Source 出处 · Sanyin Jiyi Bingzheng Fanglun · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Ren Shen Yang Rong Tang is conventionally attributed to Sanyin Jiyi Bingzheng Fanglun, compiled by Chen Yan in 1174. Song-dynasty formularies borrowed freely from one another and attributions inside this family of formulas are not always clean, so this library states the conventional one and does not pretend to have settled the question. The most useful way to read the formula is as Shi Quan Da Bu Tang with a substitution: drop chuan xiong, and add tangerine peel, polygala and schisandra. That single exchange moves the target. Out goes the herb that moves blood; in comes one aromatic that keeps a heavy formula from binding the digestion, one that addresses the phlegm-orifice rather than the vessels, and one astringent that holds rather than disperses. The classical indication is therefore not simply depletion but depletion that has reached the heart: palpitations, poor sleep, forgetfulness, a person who is exhausted and cannot rest.
Which brings the first thing that has to be said plainly. The picture this formula is aimed at - exhaustion, weight loss, pallor, palpitations, broken sleep, failing memory - is also produced by anaemia, thyroid disease, diabetes, depression, obstructive sleep apnoea, chronic kidney disease, heart failure, and by the ordinary grief and overwork of a hard year. Several of those are separated from the classical picture by one blood count, one TSH, one ferritin. A formula that makes someone feel a little more capable while an undiagnosed anaemia or hypothyroidism continues underneath is not a neutral outcome, and this library does not describe it as one. The classical label and the modern differential are two different maps of the same tired person.
On safety, three items lead. Schisandra fruit is the one most likely to matter to a specific group of people: its lignans inhibit CYP3A4 and P-glycoprotein, and the interaction with the immunosuppressants tacrolimus and cyclosporine is documented in human studies, not only in vitro. Anyone taking a transplant regimen, or any drug with a narrow therapeutic window, needs their own doctor to know before schisandra enters the picture. The herb is also traded under two names: northern schisandra (Schisandra chinensis) and southern schisandra (Schisandra sphenanthera) are different materials, and products are not always explicit about which is inside. Polygala root, yuan zhi, is a herb where the processing is not a formality: the raw root irritates the throat and the stomach, with nausea and vomiting as the common result, which is why the pharmacopoeia specifies honey-fried or licorice-water-processed material. Honey-fried licorice is in the formula as well, and with it the glycyrrhizin problem - prolonged intake can produce low potassium, raised blood pressure and oedema, and the risk rises with diuretics, digoxin and corticosteroids. Cassia bark carries coumarin, and the same distinction between a cooking pinch and a daily medicinal amount applies here as elsewhere. The formula is warm, and is traditionally avoided where there is heat from yin deficiency and during an acute illness. Angelica has case reports of potentiating warfarin.
人参养荣汤通行归于《三因极一病证方论》，陈言编于 1174 年。宋代方书互相抄录，这一族方剂的归属并不总是干净，故本库采用通行说法，不假装已把这个考据问题判死。读此方最有用的方式是把十全大补汤拿来做对照：去掉川芎，加陈皮、远志、五味子。这一换，靶子就移了。去的是行血的一味，来的是三味 —— 一味芳香使大补之方不至于滞住脾胃，一味对「痰」与心窍而不对血脉，一味酸收以守而不散。因此它所对应的古典证不只是虚，而是虚到了心：心悸、失眠、健忘、一个疲惫却无法安睡的人。
这就引出了必须先说白的第一件事。此方所对的画面 —— 疲乏、消瘦、面色苍白、心悸、眠差、健忘 —— 同样由贫血、甲状腺疾病、糖尿病、抑郁、睡眠呼吸暂停、慢性肾病、心力衰竭，以及一年沉重劳作与普通哀伤所产生。其中若干项与古典画面之间只隔着一次血常规、一次 TSH、一次铁蛋白。一首方让一个人在未诊断的贫血或甲减持续存在的情况下「感觉好一点」，不是中性结果，本库不把它写成中性结果。古典标签与现代鉴别是同一个疲惫之人的两张不同地图。
安全方面以前三条为主。五味子最可能对特定人群产生影响：其所含木脂素抑制 CYP3A4 与 P-糖蛋白，与免疫抑制剂他克莫司、环孢素的相互作用有人体研究记载，不只是体外实验。正在用移植后抗排异方案、或任何治疗窗窄的药物的人，必须先让医生知道五味子进入了这个组合。此药还有一名两物的问题：北五味子（Schisandra chinensis）与南五味子（Schisandra sphenanthera）是不同材料，产品未必标明是哪一种。远志的炮制不是形式：生远志刺激咽喉与胃，常见恶心呕吐，故药典规定蜜炙或甘草水制。方中另有炙甘草，随之而来的是甘草酸问题 —— 长期服用可引起低钾、血压升高与水肿，与利尿剂、地高辛、糖皮质激素同用则风险更高。肉桂含香豆素，「烹饪用一小撮」与「每日药用剂量」的区别在这里同样成立。本方偏温，阴虚有热者及外感急性病期传统上不用。当归与华法林相互作用的病例报告有文献记载。