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Qishiwei Zhenzhu Wan is a traditional Tibetan medicine first recorded in the Tibetan medicine classic Si Bu Yi Dian. It contains more than 70 ingredients, including myrobalan, pearl, agate, opal, bezoar (cow gallstone), coral, musk, gold, silver, and a mineral mixture called Zuotai. The preparation is rich in trace elements such as copper (>6000 μg/kg), mercury (>6000 μg/kg), lead (>6000 μg/kg), argentum (silver), arsenic, manganese, aurum (gold), strontium, barium chromium and nickel[1][2][5]. The drug is used to treat "Baimai" disease (black and white pulse disease or dragon blood disorder in Tibetan medicine terminology) as well as stroke (including ischemic stroke and cerebral hemorrhage), paralysis (hemiplegia), epilepsy infantile convulsions cerebral concussion postoperative recovery from brain diseases heart disease hypertension autonomic nerve dysfunction and other nervous system diseases[2][5][6]. Its effects include tranquilizing dredging channels activating collaterals harmonizing qi and blood resuscitation opening orifice improving microcirculation inhibiting thrombosis reducing blood pressure sedation inhibition of convulsion improvement of memory[5][6]. The mechanism of action involves multiple pathways likely due to its complex multi-ingredient composition; network pharmacology studies suggest involvement in neuroprotection anti-inflammatory effects modulation of AGE-RAGE signaling TNF signaling pathway among others but specific molecular targets are not fully elucidated[7].
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