Analysis Of Professor Song Liqun’s Medication In The Treatment Of Senile Idiopathic Membranous Nephropathy

Objective:To discuss and analyse Professor Song Liqun’s treatment of idiopathic membranous nephropathy(IMN)in the elderly by discussing and analysing his medical cases,and to explore the rules of medicine used by Professor Song Liqun in the treatment of IMN in the elderly.Methods:Through collecting,sorting,analyzing and refining the tutor’s clinical cases for many years,the academic experience of the tutor in treating chronic kidney disease was summarized,and then the basic information,symptoms,diagnosis,prescriptions and medicines of 305 patients meeting the inclusion criteria were entered using the Traditional Chinese Medicine Inheritance Computing Platform(TCMICP V3.0)provided by the Chinese Academy of Traditional Chinese Medicine,and the system of double entry and double review was used to ensure the accuracy of the data.A database of cases of Professor Song Liqun’s treatment of IMN in the elderly was established.The data in the database were analysed using statistical analysis,association rule analysis and entropy clustering of complex systems to obtain the frequency of symptoms,frequency of drugs,categories of drugs used,core prescriptions,commonly used pairs of drugs,correlation between drugs and symptoms and new prescription combinations,etc.The relevant network display diagrams were formed,and the results of the analysis could be exported to Excel to produce tables,bar charts or pie charts.The pattern of medication used by Professor Song Liqun in the treatment of IMN in the elderly was summarised.Results:The 305 cases included in the study were processed through the data of the TCMICP v3.0 system,allowing the following results to be obtained.1.Results of general conditions such as gender and age:154 cases were male,accounting for about 50.49%of the total number of cases;151 cases were female,accounting for about 49.51%;the ratio of male to female was 1.019:1.The youngest age of the cases was 60 years old and the oldest was 87 years old,with an average age of 68.53 years2.Pathological type results:Stage Ⅱ had the highest number of cases,254 cases,accounting for 83.28%,followed by stage I and stage III,each accounting for about 8.12%.3.Results of concomitant symptoms:189 cases of nephrotic syndrome;56 cases of concomitant diabetes mellitus;48 cases of concomitant hypertension;12 cases of asymptomatic proteinuria.4.Chinese medicine frequency results:the number of Chinese medicine flavours reached 194,of which 13 had a frequency of 200 or more,namely,fried Atractylodes macrocephala;cherry,gorgonian,astragalus,chasteberry,raspberry,white fruit,salvia,cuscuta,jiao hawthorn,fried wheat sprout,shengqu,poria.5.Drug clustering results:three groups of core combination drugs,namely:Combination 1:Gorgonzola,Astragalus,Radix Astragali,Panax notoginseng,Fried Atractylodes;Combination 2:Gorgonzola,Radix Astragali,Fried Atractylodes,Golden cherry,Astragalus;Combination 3:Fried Atractylodes,Golden cherry,Gorgonzola,Astragalus,Radix Astragali.6.Drug association results:selected with 80%support,244 number of supports,and 0.99 confidence level,111 data were obtained,with 207 drug association rules.7.Results for the Four Flavours of drugs:the highest frequency of 1731(about 41.24%)was for pacific drugs,followed by warm drugs with a frequency of 1656(about 39.46%).8.The results of the five tastes of drugs:sweet drugs were the most frequent,with a frequency of 3544 times,accounting for 53.03%,followed by bitter drugs,with a frequency of 1429 times,accounting for 21.38%.9.Results of drug meridians:The top four drugs in order were:drugs entering the kidney meridian 2722 times,accounting for 26.24%;drugs entering the liver meridian 1918 times,accounting for 18.49%;drugs entering the spleen meridian 1890 times,accounting for 18.22%;drugs entering the lung meridian 1270 times,accounting for 12.24%.10.Drug efficacy results:the top 4 were:1605 times(38.24%)for tonifying deficiency;955 times(22.75%)for collecting astringency;313 times(7.46%)for resolving phlegm,relieving cough and asthma;and 275 times(6.55%)for inducing diuresis.Conclusion:1.Prof.Song Liqun’s treatment of chronic kidney disease proposed that positive deficiency is based on the three organs of the lung,spleen and kidney,and evil reality is based on dampness,phlegm,stasis and toxicity as the symptoms.He also put forward the treatment principle of "treating both the symptoms and the root cause and eliminating the evil first",and proposed that the theory of the pathogenesis of chronic kidney disease is related to three aspects:the five organs,the unfavourable qi-transformation of the three jiao and the imbalance of the qi flow.2.Professor Song Liqun believes that the physical characteristics of the elderly are the gradual deterioration of the internal organs,the gradual deficiency of yin and yang,and the susceptibility to external evil.It is suggested that the onset of the disease in the elderly is attributed to the deficiency of the spleen and kidneys and the invasion of evil Qi,and that the onset of the disease is a mixture of deficiency and reality,with the original deficiency being the main cause.3.In treating elderly patients with IMN,Prof.Song Liqun has attributed the disease to deficiency of the spleen and kidneys,invasion of evil qi and weakness of the internal organs.In most of the cases,the deficiencies of the spleen and kidney,water and dampness and blood stasis are the main symptoms.The overall treatment is based on tonifying deficiency throughout the treatment of the disease,with different emphasis on different types of symptoms.Treatment of deficiency of both spleen and kidney should be based on tonifying the spleen and benefiting the kidney;treatment of water-dampness infiltration should be based on tonifying the lung and promoting water-dampness;treatment of internal obstruction of blood stasis should be based on removing blood stasis and activating blood circulation.4.Professor Song Liqun’s treatment of elderly patients with IMN is based on the following herbs:fried Atractylodes macrocephala,cherry blossom,gorgonian,astragalus,chasteberry,raspberry,white fruit,salvia,cuscuta,jiao hawthorn,fried wheat sprout,shengqu,and poria.5.The core prescription of Prof.Song Liqun for the treatment of IMN in the elderly is,Combination 1:Gorgonzola,Astragalus,Radix Astragali,Rhizoma Atractylodis Macrocephalae,Fried Atractylodes;Combination 2:Gorgonzola,Radix Astragali,Fried Atractylodes Macrocephalae,Radix Angelicae Sinensis,Astragalus.The medicinal properties of the drugs used by Professor Song Liqun in the treatment of elderly IMN patients are mostly flat and warm;the taste of the drugs is mostly sweet and bitter;the drugs are often classified into the four meridians of the kidney,liver,spleen and lung;the drugs are mostly chosen to tonic deficiency and astringent drugs.