To Explore And Analyse The Regulation Of Prescription Drug-used Of Professor Xinmin Li In The Treatment Of Primary Nephrotic Syndrome In Children

Objective: Through data mining method and connecting with Professor Li Xinmin’s experience,this paper explores and summarizes the rules of prescription and medication in the treatment of primary nephrotic syndrome(PNS)in children,so as to inherit and carry forward,and provide new ideas for the clinical treatment of PNS in children with traditional Chinese medicine.Methods:The cases of children with primary nephrotic syndrome diagnosed and treated by Professor Li Xinmin in the pediatric outpatient department of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine from September 2018 to December2020 were collected,and the complete prescriptions of 31 children with primary nephrotic syndrome diagnosed and treated by the unified and standardized syndrome differentiation and treatment scheme that met the inclusion criteria were explored.Microsoft office word and Microsoft Office Excel were used to collect the data,then the database was established,and the frequency of drug use,drug category,four Qi and five flavor meridian tropism were statistically analyzed.SPSS statistical 22.0 and SPSS moldeler 18.0 software were used to analyze the association rules and cluster analysis of 44 commonly used drugs whose frequency of use was more than or equal to 5%,so as to summarize Professor Li Xinmin’s experience in treating pediatric nephrotic syndrome.Results:After statistical analysis,the gender distribution of PNS children is more male than female,which is close to the proportion of male and female in current research;The age of onset mainly concentrated in 3-7 years old preschool children.According to the statistical results of the frequency distribution of TCM syndromes,the main syndromes treated by Professor Li Xinmin in children’s nephrotic syndrome were the syndrome of deficiency of the root,among which the proportion of the syndrome of dampness of spleen deficiency was 80.21% at most.There are three types of water dampness syndrome,exogenous syndrome and blood stasis syndrome,among which water dampness syndrome accounts for 65.36%,the most common,followed by exogenous syndrome.According to the statistical analysis of drugs,a total of 485 prescriptions were obtained from 31 children who met the inclusion criteria,involving 79 traditional Chinese medicines(licorice was excluded in the statistical process).Among them,The high frequency drugs used more than 40% were as follows: Bran Fried hovenia dulcis,Platycodon grandiflorum,Scutellar-ia baicalensis,Qing pinellia,Poria cocos,Coix seed fried with bran,Poria cocos,Oldenlandia diffusa,Sculellaria barbata,bupleurum chinense,Astragalus membranaceus,rhizoma anemarrhe nae,periostracum cicada,dried tangerine or orange peel,rhizoma alismatis,radix pseudostellaria e.Among the 44 commonly used drugs with a frequency of more than or equal to 5%,the main efficacy categories were heat clearing drugs,diuretic and dampness infiltrating drugs,cough,phlegm and asthma relieving drugs,exterior resolving drugs,deficiency tonifying drugs and Qi regulating drugs;the cold drugs were the most common in the four Qi,followed by warm drugs,and the mild and cool drugs were less;the bitter,sweet and pungent drugs were the most common in the five flavors;the drugs were mainly classified into spleen channels of foot-taiyin,stomach meridian of foot-yangming and the lung meridian of hand-taiyin.According to the association rule analysis of 44 commonly used drugs with the frequency of more than 5%,the two commonly used drug combinations of Professor Li Xinmin in the treatment of children with nephrotic syndrome were as follows:Bran Fried hovenia dulcis-Platycodon grandiflorum;Scutellaria baicalensis-Platycodon grandiflorum;Scutellaria baicalensis-Bran Fried hovenia dulcis;Scutellaria baicalensis-Qing pinellia,Poria cocos;Platycodon grandiflorum-Qing pinellia,Poria cocos;Bran Fried hovenia dulcis-Qing pinellia,Poria cocos;Poria cocos-Coix seed fried with bran;Qing pinellia,Poria cocos-Coix seed fried with bran;Platycodon grandiflorum-Coix seed fried with bran;Bran Fried hovenia dulcis-Coix seed fried with bran;Scutellaria baicalensis-Coix seed fried with bran.The three commonly used drug combinations are:Scutellaria baicalensis-Platycodon grandiflorum-Bran Fried hovenia dulcis;Bran Fried hovenia dulcis-Qing pinellia,Poria cocos-Platycodon grandiflorum;Scutellaria baicalensis-Qing pinellia,Poria cocos-Platycodon grandiflorum;Scutellaria baicalensis-Qing pinellia,Poria cocos-Bran Fried hovenia dulcis;Scutellaria baicalensis-Coix seed fried with bran-Qing pinellia,Poria cocos;Poria cocos-Coix seed fried with bran-Qing pinellia,Poria cocos;Platycodon grandiflorum-Coix seed fried with bran-Qing pinellia,Poria cocos;Bran Fried hovenia dulcis-Coix seed fried with bran-Qing pinellia,Poria cocos.The four commonly used drug combinations are:Scutellaria baicalensis-Qing pinellia,Poria cocos-Platycodon grandiflorum-Bran Fried hovenia dulcis;Coix seed fried with bran-Qing pinellia,Poria cocos-Platycodon grandiflorum-Bran Fried hovenia dulcis.Cluster analysis was used to analyze 44 commonly used drugs whose frequency of use was more than or equal to 5%,and 4 main drug combinations were obtained: C1:bupleurum chinense-Qing pinellia,Poria cocos-Poria cocos-rhizoma alismatis-grifola-Coix seed fried with bran-Bran Fried atractylodes-Astragalus membranaceus-radix pseudostellariae-Oldenlandia diffusa-Sculellaria barbata-periostracum cicada-rhizoma anemarrhenae-dianthus superbus-golden cypress-Radix Ophiopogonis-lalang grass rhizome;C2:Pogostemon cablin-folia perillae acutae-dried tangerine or orange peel-Officinal Magnolia Bark-caulis bambusae in taeniam-Fry Perilla-Fry Perilla-The focal medicated leaven-scorched hawthorn fruit-Fried radish seed;C3:fructus forsythiae-Lonicera japonica-mint-ching-chieh-fermented soybean-radix isatidis-Fresh rehmannia root-Fried bitter almond-Fry fructus arctii-Thunberg Fritillary Bulb-Common hogfenne I root-Honey tatarian aster-Honey,white mulberry root-bark-blackberry lily;C4: bran Fried hovenia dulcis dulcis-Platycodon grandiflorum.Conclusion: Professor Li Xinmin is a famous traditional Chinese medicine in Tianjin.He learned from Professor Li Shaochuan,a famous traditional Chinese medicine in China.Based on Li’s theory of "treating the kidney from the spleen",and combined with the physiological and pathological characteristics of children,he paid special attention to the spleen and lung in the treatment of this disease.He treated it by invigorating the Qi and strengthening the spleen,clearing up the heat and damp,releasing the lung and relieving the surface,stoping cough and turning phlegm,dredging the Shaoyang and regulating the Qi flow,so that Qi flow is water flow.Strengthening the healthy and eliminating the evil,attacking and tonifying at the same time.The prescription lightweight flexible and the curative effect is remarkable.