Professor Wang Yaoguang’s Medication Rule Analysis In Treating CKD3-4 And Clinical Observation Of 64 Cases

Objective: The first part was to use data mining and analysis to summarize Professor Wang Yaoguangs clinical medication rules and experience in treating chronic kidney disease(CKD)3-4,and to provide effective prescriptions of this disease.The second part was to observe the clinical efficacy and safety of treating Spleen-kidney Deficiency with Dampness Turbid Syndrome of CKD3-4 by the retrospective study of the Method of Ascending Lucidity and Eliminating Dampness and Descending Turbidity,in order to provide reference for clinical treatment of CKD3-4.Method: The first part was to analyze the medication rule of Professor Wang Yaoguang in the treatment of patients with CKD3-4 from July 2012 to July 2017 through data mining methods,analyze and summarize the frequency of medication,the type of efficacy,the four Qi and five flavors,channel tropism,core prescription,and compatibility of Chinese Medicine.The second part was to select patients who were diagnosed as CKD 3-4 in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,the Chinese Medicine Hall and the ward from July 2017 to April 2020.They were screened in strict accordance with the admission criteria and reviewed.Using retrospective research methods,64 cases that meet the criteria were included in the study.It was treated with conventional treatment and the Chinese medicine decoction of Ascending Lucidity and Eliminating Dampness and Descending Turbidity,3 months for 1 cycle,observation for 2 cycles,and before and after self-control.Recorded the patient’s TCM symptom scores and related laboratory indicators before and after treatment,included that glomerular filtration rate,renal function,blood routine,24-hour urine protein quantification,liver function.The data were all Use SPSS 23.0 for analysis.Recorded adverse reactions and analyzed clinical efficacy.Result:1.In the first part,a total of 1196 cases of CKD 3-4 patients treated by Professor Wang Yaoguang from July 2012 to July 2017 were collected.There were 4347 prescriptions of Chinese medicines,381 Chinese medicines,and the total frequency of medications reached69204 times.Among them,57 high-frequency drugs were used 48473 times,accounting for70.04%.The most commonly used one was Astragalus membranaceus.The commonly used compatibility of Chinese Medicine included: Astragalus membranaceus and Saposhnikovia and Tetrandrine,Radix Astragali and Bighead atractylodes rhizome,Herba Artemisiae Scopariae and Trogopterus Dung and Carbonized Pollen Typhae,Smilax glabra and Kochia scoparia,Flos sophorae and Fructus aurantia,Perilla leaf and Coptis Chinensis,Loquat leaf and Caulis bambusae,Hyacinth bean and Coix Seed and Rhizoma Dioscoreae,Pheretima and Bombyx batryticatus and Periostracum cicadae,Rosa Laevigata Michx and Semen Euryales,Rhizoma Acori Tatarinowii and Dioscorea spongiosa and Bulbus Iphigenias.There were three core prescriptions: the first group included: Radix Astragali,Atractylodis Macrocephalae,Rhizoma Atractylodis Macrocephalae,Eupatorium adenophorum,Smilax glabra,Flos Sophorae,calcined Concha Ostreae,Fructus aurantia,Kochia scoparia,Laminaria,Herba Artemisiae Scopariae,Trogopterus Dung,Carbonized Pollen Typhae,Wine-treated Rhubarb,Perilla leaf,Coptis Chinensis,Loquat leaf,Caulis bambusae,Pinellia ternate,Pericarpium Citri Reticulatae,Eupatorium fortunei Turcz,Radix et Rhizoma Rhei.The second group included: Pheretima,Saposhnikovia,Tetrandrine,Bombyx batryticatus,Myrobalan,Semen astragali complanate,Psoralen,Gingko seed,Pomegranate rind,Alpinia Oxyphylla,Raspberry,Polygonatum,Semen Euryales,Rosa Laevigata Michx,Lotus Stamen.The thrid group included: Eucommia ulmoides,Dipsacus asper Wall,Achyranthes bidentata,Pyrola decorate,Radix Rubiae,Hyacinth bean,Rhizoma Dioscoreae.The commonly used basic prescriptions included: Yupingfeng San,Tetrandra and Astragalus Decoction,Yinchen-Wuling powder,Suye Huanglian Decoction,Fish Poison Yam Clear-Turbid Separation Beverage,Land and Water Two Immortals Elixir.In the second part,a total of 64 patients were included.The western medical effects for 3months and 6 months were 81.25% and 84.38% respectively.The efficacy of Chinese medicine for 3 months and 6 months were 85.94% and 92.19% respectively.The whole points of TCM syndromes of 3 months and 6 months were obviously lower than before(P<0.01).After 3months and 6 months,GFR was obviously higher than before(P<0.01).The quantitative levels of Scr,Urea,UA,HGB and 24 h urine protein were obviously reduced after 3 and 6 months(P<0.01).After 6 months,the TP level was obviously lower than before(P<0.01).During the6-month,no adverse reactions were found.Conclusions: 1.The key pathogenesis of CKD3-4 is Spleen-kidney Deficiency with blood stasis,dampness,turbidity and toxin.All in all,Spleen-kidney Deficiency is in origin.And blood stasis,dampness,turbidity and toxin are in superficislity.All in all,we should take into account both the origin and the superficislity,and the crucial treatment points are strengthening the spleen and tonifying the kidney,clearing away turbidity.There are five commonly used treatments.To treat the root cause,we should take care of healthy qi,regulate Qi,invigorate spleen and kidney,and mainly use drugs with sweet and pungent herbs,warm and peaceful herbs,lung and spleen and kidney channels;to treat the symptoms,we should eliminate dampness and turbidity,remove blood stasis and detoxification,and mainly use drugs with bitter and pungent herbs,cold and peaceful herbs,liver and spleen and stomach channels.The characteristics of medication include: taking into account both the origin and the superficislity,taking protecting the spleen and kidney seriously,regulate Qi of the spleen and stomach,the use of Qi-Invigorating Herbs,and taking tonifying kidney seriously.The commonly used basic prescriptions included: Yupingfeng San,Tetrandra and Astragalus Decoction,Yinchen-Wuling powder,Suye Huanglian Decoction,Fish Poison Yam ClearTurbid Separation Beverage,Land and Water Two Immortals Elixir.2.The Method of Ascending Lucidity and Eliminating Dampness and Descending Turbidity method was effective in treating Spleen-kidney Deficiency with Dampness Turbid Syndrome of CKD3-4,improved the patient’s quality of life,protected kidney function,and had a certain degree of safety.