| Chronic nephritis is a common chronic kidney disease in China.Its clinical incidence is relatively high,and it has the characteristics of concealment.It is not easy to be detected in the early stage,and it is difficult to effectively treat the disease with repeated delay,which often brings health hazards to the patients and causes huge medical burden.He is good at treating all kinds of common diseases with the addition and subtraction of Tongzhi prescription,especially in the treatment of chronic nephritis with his own unique understanding and experience.By using traditional Chinese medicine inheritance computing platform(V3.0),this study analyzed the medical records of patients with chronic nephritis treated by Yu Lao,combined with literature research,summarized the medication rules of Yu Lao in the treatment of chronic nephritis,enriched and improved the academic thoughts of Yu Lao in the treatment of chronic nephritis,and provided references for future related research.PurposeThe medical records of patients with chronic nephritis treated by professor Yu Ying-ao in the Outpatient Department of China Academy of Chinese Medical Sciences were collected and sorted out.The diagnosis and treatment data were entered and statistically analyzed using the traditional Chinese Medicine Inheritance computing platform(V3.0),and the medication rules and academic thoughts of professor Yu Yingao in the treatment of chronic nephritis were summarized.This project for the first time uses the analysis method of data mining to study Professor Yu Ying-ao’s medication rules in the treatment of chronic nephritis,and summarizes Professor Yu Ying-ao’s traditional Chinese medicine ideas and unique experience in the treatment of chronic nephritis with the help of data mining method,so as to provide reference for future related research.MethodsLiterature research method:Cnki,Wanfang and other databases were used to collect the literature related to the graduation thesis,and the search keywords were "Yu Yingao","Yu Yingao treated chronic nephritis","Yu Yingao+chronic kidney disease","chronic nephritis","edema","waist pain","urine blood" and "proteinuria",etc.Ancient Chinese medicine books related to this study were retrieved by Chinese medical dictionary,reading show retrieval and other resources.According to the search results,the related content was consulted by using the library of China Academy of Chinese Medical Sciences and the National Library of China.The medical records,treatises and papers of Yu Yingao’s diagnosis and treatment of chronic nephritis and the relevant research results of his academic successors were collected and sorted out.Case Study Method:The research group collected the diagnosis and treatment records of Professor Yu Ying-ao when he was attending the TCM Outpatient Department of China Academy of Chinese Medical Sciences from January 1,2015 to December 31.2019,and sorted out the patient’s name,gender,age,four diagnosis information,name of western medicine disease,name of TCM disease,TCM syndrome,treatment principles and methods of TCM,composition of prescription and other information.According to the key content of western medicine disease name,TCM disease name,and TCM syndrome four diagnosis information,whether it meets the diagnostic criteria of chronic nephritis was judged,and the effective medical records were screened.Data mining method:The Traditional Chinese Medicine Inheritance Computing Platform(V3.0)software was used for data analysis.The software was developed by the Traditional Chinese Medicine Variety Alliance.The platform had multiple functions,such as data entry,data management,data query,data analysis,result export,K-means algorithm and regression model cluster analysis,visual display,etc.At the same time,it also creates objective database and summarizes and inherits the famous TCM medication experience and academic thought,so as to provide new technology and new ideas for mining the experience of various doctors.ResultsA total of 508 effective medical records were screened out in this research,and the analysis showed that:General information Results:Gender statistics:279 male patients,accounting for 55%;There were 229 female patients,accounting for 45%,and the male-female ratio was about 1.2:1.In terms of the number of patients,male patients were slightly larger than female patients.Among the 508 patients,the youngest was 17 years old,the oldest was 89 years old,and the average age was 44 years old.The patients were mainly between 25 and 46 years old,and the incidence group was mainly young and middleaged.Results of drug information study:A total of 225 drugs with a total frequency of 7185 were statistically analyzed.Among them,there were 55 drugs with frequency≥30 times,and the cumulative frequency was 6120 times,accounting for 85.18%of the total frequency.There were 19 drugs with frequency≥100 times,with a total frequency of 4198 times,accounting for 58.43%of the total frequency,which were the core drugs for Yu Lao’s treatment of chronic nephritis.The core drugs with frequency of more than 100 times were as follows:Raw Rehmannia(461),Poria cocos(437),flesh of Fructus officinalis(436),bark of peony(430),yam(411),Astragalus membranaceus(258),salviorrhiza miltiorrhiza(239),cooked Rehmannia(232),small thistle(199),Gorgon Gorgon(132),plantain herb(120),mulberry seed(113),red bean(108),fried sour jujube kernel(114),Coptis coptidis(103),Shi Wei(102),Salt Zhimother(101),scrophulariae Scrophulariae(101),Salt Phellodendri(101).The proportions of the four qi were cold,flat,warm,cool and hot in order from high to low,among which cold drugs accounted for 40.51%,warm drugs accounted for 28.70%,flat drugs accounted for 25.19%,cool drugs accounted for 5.37%,heat drugs accounted for 0.23%.The proportion of five tastes was sweet,bitter,octinent,sour and salty successively from high to low.Sweet drugs accounted for 43.88%,accounting for the first place,followed by bitter drugs accounted for 32.87%,octinent drugs accounted for 15.83%,sour drugs accounted for 5.12%,and salty drugs accounted for 2.29%.The top 5 channels were liver channel(19.99%),kidney channel(19.78%),lung channel(14.98%),spleen channel(14.74%)and heart channel(14.39%),accounting for 83.88%.The top 10 kinds of efficacy of TCM were:replenishing deficiency(1,530),clearing heat(1225),improving water and dampness(1,144),promoting blood circulation and removing blood stasis(514),retracting astringent(350),stopping bleeding(302),dispelling surface(239),dispelling rheumatism(228),regulating qi(188)and dispelling dampness(134).Four kinds of drugs,including tonifying deficiency,clearing heat,promoting water and dampness,and promoting blood circulation and removing blood stasis,accounted for about 77.27%,and were the most commonly used four kinds of drugs in the treatment of chronic nephritis in Yu Lao.Drug combination and correlation analysis:When the number of support was 120,namely the minimum support was about 24%and the confidence was 0.8,273 highfrequency combinations were obtained,involving 10 traditional Chinese medicines:raw Rehmannia Rehmannia,cooked Rehmannia Rehmannia,fructus officinalis meat,miltiorrhiza miltiorrhiza,peony bark,yam,astragalus,poria coia,artichokes and gorgon gorgon.Drug cluster analysis:k value was selected several times to determine k=5 from the original prescription data,and five core prescriptions were extracted:core combination 1:Poria cocos,peony bark,yam,rehmannia,fructus officinalis meat,astragalus;Core combination 2:Moutan bark,poria cocos,yam,Rehmannia,thistle,Cornus officinalis meat;Core combination 3:Poria cocos,peony bark,yam,raw Rehmannia,cooked Rehmannia,Astragalus;Core combination 4:Yam,poria,peony bark,cooked Rehmannia,Cornus officinalis meat,raw Rehmannia;Core combination 5:Yam,Poria cocos,peony bark,raw Rehmannia,Fructus officinalis and scrophulariae.The five core combinations are closely related to Yishen invigorating spleen and Tongluo Decoction and Yishen Huoturbidity decoction commonly used by Yu Lao in treating chronic nephritis.Conclusions1.Professor Yu Yingao believed that the pathogenesis of chronic nephritis was deficiency of the primary organs denoted by deficiency of the three viscera of the lung,spleen and kidney,especially the two viscera of the spleen and kidney,which were closely related to the liver and heart.The standard substance is the pathological product of phlegm,blood stasis and interjunction caused by the disease.2.The main ideas of Professor Yu Yingao’s treatment of chronic nephritis were strengthening the spleen and tonifying the kidney,clearing heat and cooling blood,and regulating collagals and water,which were commonly used in clinical treatment.At present,it can be seen that there were two kinds of regulating remedies,one was Yisheninvigorating and spleen-invigorating Tongluo Decoction,and the other was Yishennourishing and turbidizing decoction.The former focuses on the treatment of severe edema,stasis and heat interjunction patients,the latter treatment of proteinuria more patients have a good effect.3.According to data mining analysis,Yu Lao often used cold and warm drugs,mainly focusing on clearing heat,nourishing Yin and promoting fluid.The main drugs for the meridian are liver,kidney,lung,spleen and heart meridian,and the drug efficacy mainly includes four kinds:tonifying deficiency,clearing heat,benefiting water and oozing dampness,promoting blood stasis.4.According to data analysis,the common drugs used by Yu to treat chronic nephritis mainly focus on the compatibility of poria cocos,peony bark,yam,raw rehmannia,cornus officinalis meat,salvia miltiorrhiza,cooked Rehmannia,astragalus,thistle and eurygorgon.The five groups of core combination drugs were closely related to Yishenjianpi Tongluo Decoction and Yishenhuoturu decoction,the first two Tongzhi prescriptions,which confirmed the clinical thinking of Yu Lao’s clinical use of Tongzhi prescriptions for the treatment of diseases. |
PDF Full Text Request