Professor Sun Wei’s Unique Features In Treating Idiopathic Membranous Nephropathy Based On Data Mining

Objective:The medical transcriptions from Professor Sun Wei,related to the treatment of idiopathic membranous nephropathy(IMN),are the research object,and the data was processed with analysis methods.After analyzed Professor Sun’s drug characteristics of treating IMN,the conclusion of professor sun’s academic thoughts of treating IMN can be used to exploring the diagnosis and treatment of traditional Chinese medicine for IMN.Meantime,it provides an objective basis for the disease’s clinical treatment,inherits and spreads the honored and traditional Chinese doctor’s clinical experience.Methods:Based on the China Kidney Disease Big Data Application Innovation Alliance Big Data Platform,to compose a database,medical cases that met the inclusion and exclusion criteria were strictly screened,and the medical transcription of 78 patients with idiopathic membranous nephropathy diagnosed who were treated by Professor Sun Wei were collected,with a total of 498 consultations.To summarize professor Sun’s drugs for the treatment of the disease and academic concept,the data processing tools were R language programming system,SPSS 21.0,and SPSS Modeler 18.0,frequency analysis,factor analysis,association rules,and the relationship between the drug network analysis method,as well as analyzed justify treatment,drug compatibility,core prescription,and combined with the study of the typical medical records.Results:(1)General information:78 patients who conform to the inclusion and exclusion criteria were included,with a total of 498 consultations.There were 40 males and 38 females,and the oldest was 83 years old,and the youngest was 19 years old.The average age was(48.92± 15.12)years old.(2)Four diagnosis distribution:In the 498 medical records,the symptoms occurring more than 50 times were as follows:foamy urine(291 times),lower limb edema(139 times),tiredness and weakness(131 times),insomnia(105 times),waist and knee pain and weakness(100 times),fecal insufficiency(72 times),frequent night urination(66 times),dry mouth(56 times).In the tongue image,the more common tongue coating was:thin and greasy(150 times),thin and greasy(133 times),white and greasy(78 times),thin and yellowish(48 times);The more common tongue types were:red tongue(206 times),fat tongue(93 times),light tongue(63 times),fat tongue(59 times),light tongue(58 times);The more common sublingual colerates were:stasis 2/3(261 times),stasis>2/3(167 times),and stasis 1/3(63 times).The more common pulse manifestation was:pulse small string(239 times)and pulse fine string(217 times).(3)Syndrome type distribution:According to the 498 medical transcriptions,the main syndrome of this deficiency was the syndrome of qi deficiency of spleen and kidney(97.19%).The main empirical findings were blood stasis syndrome(92.77%),dampness and turbidity syndrome(69.08%)and damp-heat syndrome(21.69%).The common witness types were spleen-kidney qi deficiency combined with dampness and turbidity and blood stasis(56.63%)and spleen-kidney qi deficiency combined with dampness heat and blood stasis(17.07%).(4)Drug analysis:①Distribution of drugs and sexual flavors:In the 498 medical records,frequently used drugs were milkvetch root(100.00%)giant knotweed rhizome(100.00%),shearer’s Pyrrosia leaf(100.00%),Fried atractylodes(99.60%),turmeric(99.40%),eucommia bark(97.59%),codonopsis pilosula(95.78%),perilla stem(95.18%),Fried angelica(93.57%),rhizoma atractylodis(92.97%),yam(90.96%),glabrous greenbrier rhizome(88.96%)and rhizoma chuanxiong(86.95%),dodder(82.13%),radix dipsaci(81.12%),spreading hedyotis herb(77.91%),climbing nightshade(67.07%),Alisma Orientalis(67.07%),hirsute shiny bugleweed herb(66.87%),Root of Kiwifruit(65.26%),Radix Achyranthes Orientalis(61.24%),and Fried Red Paeonia lactiflora(60.44%).The main medicinal properties were cold(33.03%),warm(32.11%),and flat(23.85%).The main medicinal tastes were sweet(47.71%),bitter(47.71%),and spicy(40.37%).The main drug channels were liver(57.80%),spleen(40.37%),kidney(38.53%),lung(34.86%),and stomach(30.28%).Among the categories of drugs,thermal-clearing drugs(17.41%),water-moistening drugs(16.73%),drugs to promote blood circulation and remove blood stasis(14.24%),qi-tonifying drugs(11.77%),Yang tonifying drugs(10.61%),and relieving superficies syndrome drugs(5.32%)were the main drugs.②Drug factor analysis:42 drugs with frequency≥50 times other than the necessary drugs Astragalus membranaceus,Polygonum knotatum,and Radix Diaphysalis were removed for factor analysis,and 11 common factors were extracted.For example,factor 1 was composed of glabrous greenbrier rhizome,fried peony root,climbing nightshade,oriental waterplantain rhizome,kiwifruit root,and twotoothed achyranthes root;Factor 2 was composed of Caulis spatholobi,Flos Abelmoschus manihot,Corn Stigma,Tuckahoe peel,Black Soybean Cloth,Calabash Gourd,and Centella asiatica.Factor 3 is composed of virgate wormwood herb,ghost arrow feather,lotus leaf,and silkworm sand.③Drug association rule analysis:Common drug pairs were obtained through drug-drug association rule analysis,such as fried Atractylodes-dodder,turmeric-sichuan lovage rhizome,etc.Analysis of relationship between symptoms and medication use association rules,such as:have vinegar is closely related to hedyotis,scorpion,sichuan lovage rhizome,Radix achyranthis bidentatae,stigma,epimedium herb,virgate wormwood herb,Kiwi fruit root,Fried angelica,himalayan teasel root;With lower limb edema related drugs have Huang shu sunflower,scorpion,hedyotis,Kiwi fruit root,yam.The association rules were used to analyze the relationship between syndrome types and drugs.For example,spleen-kidney qi deficiency syndrome was closely related to Codonopsis codonopsis,rhizoma atractylodis,stir-fried angelica,and dodder seed,sichuan lovage rhizome,stir-fried Atractylodes tractylodes,and glabrous greenbrier rhizome.Spleen and kidney qi deficiency combined with dampness and turbidities,blood stasis syndrome,was closely related to semen euryale,vinegar bupleurum,Pinellia tuber,Epimedium,pueraria root,dried ginger,fried red peony root,fried and frozen silkworm,Perfoliote Knotweed Herb,virgate wormwood herb,lotus leaf,lilac pink herb,alisma,centella asiatica,cuscuta,hirsute shiny bugleweed herb and Chinese yam.④core prescription:The core of prescription drugs including astragalus,codonopsis,Fried atractylodes,rhizoma atractylodis,perilla stem,turmeric,rhizoma ligustici wallichii,Fried angelica,giant knotweed,eucommia bark,pyrrosia leaf,glabrous greenbrier rhizome,yam.Conclusion:Professor Sun Wei believes that the pathogenesis of idiopathic membranous nephropathy is kidney deficiency and dampness(heat),and blood stasis.The deficiency of the spleen and kidney is the basic pathogenesis.The dampness and turbidity(dampness and heat)and blood stasis are the key factors.Pathological plasmogenic deficiency and solid are mainly in the spleen and kidney and related to the five viscera.Professor Sun Wei stressed that grasping the pathogenesis of the disease,strengthening the health and dispelling the evil,combining disease and syndrome differentiation,syndrome differentiation and symptom differentiation,macroscopic and microscopic,and using the method of "tonifying kidney,clearing heat,draining dampness and activating blood",with dispelling pathogenic wind,to supplement the vital qi and eliminate the pathogenic factor from multiple angles,methods,and approaches.