| ObjectiveTo summarize the experience of Professor Yang Nizhi for treating IgAN——academic perspectives,syndrome differentiation and treatment method,diagnosis and treatment technology,syndrome differentiation and classification,prescription law,drug use characteristics,core prescription of nephrosis,based on TCM inheritance support system.MethodsFrom 2017-01 to 2021-01,kidney biopsy was diagnosed as IgAN in the outpatient clinic of Professor Yang Nizhi,Guangdong traditional Chinese Medicine Hospital.And then according to the IgAN diagnostic criteria of traditional Chinese and western medicine,According to the basic data,medical history,diagnosis,prescription of traditional Chinese medicine and so on,the medical records of professor Yang Nizhi’ s diagnosis,treatment IgAN were systematically analyzed,including frequency analysis,descriptive analysis,such as drug frequency,taste frequency,combination frequency.Through unsupervised entropy hierarchical clustering algorithm,to summarize the clinical experience of Professor Yang Nizhi in the treatment of IgAN.ResultsA total of 66 patients were included,with a total of 558 visits.Through statistical analysis of frequency of syndrome type IgAN,it was found that the main syndromes of nephropathy patients including deficiency of spleen and kidney qi,dampness and heat stasis;Qi Yin deficiency,damp heat stasis obstruction;Deficiency of spleen and kidney qi and blood stasis;spleen and kidney qi deficiency,dampness turbid stasis obstruction;deficiency of spleen and kidney qi,water dampness and stasis;Qi and Yin deficiency,dampness turbid stasis obstruction;Qi and Yin deficiency and blood stasis.Through the frequency analysis of IgAN,the clinical symptoms of IgAN are foam,fatigue and lumbar acid as the common clinical manifestations.Through "frequency statistics"analysis,107 prescriptions were found involving 139 flavors of TCM,with a cumulative frequency of 6682 times.According to the frequency of drug use,the order is:Licorice,Ze LAN,Peach kernel,Astragalus,The dodder weed,Cornel meat with salt,Fructus ligustri lucidi,Salvia miltiorrhiza,Dandelion.The most frequently used medicines were blood-activating and stasis-removing drugs,tonics,water-diffusing and damp-permeating drugs,heat-clearing drugs.In the frequency analysis of drug pairs,the combination of Peach kernel-Zeland,Zeland-Astragalus,peach kernelAstragalus was the most widely used.According to the association rules of drug combination,the correlation between Ze Lan-Salt Cornus Cuscuta Astragalus membranaceus,Cornus salt-mountain meat-dodder seed was the strongest.hrough unsupervised entropy hierarchical clustering algorithm,14 core combinations for new clustering were extracted,and seven new prescriptions can be obtained by further clustering-yellow essence＿shepherd’ s purse＿Guanzhong＿plantain;dandelion＿angelica sinensis＿Radix Pseudostellariae＿white flower snake tongue grass＿Shi Wei;Amomum villosum＿Hawthorn＿wood fragrance＿Chen Pei＿Shenqu;Radix Scutellariae - Reed root＿Zelan＿bitter almond＿Banlangen＿honeysuckle;Suxinhua＿Hehuanpi＿Zizyphus jujuba seed＿Yanhusuo;Radix Isatidis＿Radix et Rhizoma Polygoni＿Radix et Rhizoma Rhei＿Rhizoma Rhei＿Rhizoma Atractylodes＿Rhizoma Alizae＿Radix Alizae＿Corni＿Salvia miltiorrhizae＿Radix Astragali＿Radix.Therefore,it can be concluded that Professor Yang Nizhi believes that"Qi deficiency and blood stasis" is the basic pathogenesis of IgA nephropathy.The pathological factors mainly include deficiency,dampness,heat and blood stasis,which are the syndrome of deficiency and solid mixed.Therefore,it is suggested to treat IgA nephropathy with"invigorating qi and promoting blood circulation" as the main method and"clearing heat,benefiting dampness and benefiting water" as the auxiliary method.Core combinations and new prescriptions provide references for clinical drug useand new drug research and development,but new prescriptions must be further evaluated with the combination of traditional Chinese medicine theory and clinical practice. |
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