Comparison Of The Similarities And Differences In The Medication Rules Of TCM Between Diabetic Retinopathy And Diabetic Kidney Disease Based On Data Mining Technology

Objective Using data mining technology to analyze and sum up the rule of prescription drugs for diabetes retinopathy(DR)and diabetes kidney disease(DKD)in the Chinese literature database and the lianzhong system of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine(hereinafter referred to as "our hospital").Then comparing the similarities and differences of medication rules in the treatment of these two diseases in order to provide a reference for the treatment of DR and DKD with TCM.Methods1.Constructing the prescription database of DR and DKD in literature data from December 2011 to December 2021 and the Lianzhong system of our hospital from June 2019 to June 2022.2.Data mining and data analysis,including drug frequency statistics,four qi,five flavors and meridian tropism frequency statistics,complex network graph analysis,association rule analysis and cluster analysis of the top30 high-frequency drugs.3.Comparing the data mining results of treating DR and DKD in the two kinds of databases respectively,and the similarities and differences of medication rules between treatment DR and DKD were summarized.Results1.In the literature database,149 TCM prescriptions in the treatment of DR were finally included,including 171 kinds of TCM with a total frequency of1579 times,and containing 29 kinds of herbs with a total frequency of ≥10% with a total frequency of 1021 times.There were 253 DKD compound prescriptions included in the literature database,including 210 kinds of herbs with a total frequency of 2868 times,containing 30 kinds of herbs with a frequency ≥10% were used,with a total frequency of 1940 times.In the clinical data,there were 56 prescriptions of TCM for the treatment of DR included,including 139 kinds of TCM with a total frequency of 863 times,and containing 41 kinds of herbs with a frequency of ≥10% were used,with a total frequency of 646 times.There were 69 DKD compounds prescriptions included in the clinical data,including 201 kinds of TCM with a total frequency of 1056 times,and containing 44 kinds of Chinese medicines with a frequency of ≥10% with a total frequency of 729 times.2.In the literature database,the herbs in treating both DR and DKD in high frequency are cornus,dioscoreae rhizoma,ligusticum chuanxiong,ligustrine,salvia miltiorrhiza,rehmannia,Angelica sinensis,safflower,Ophiopogon,Radix Paeoniae Rubra,Cortex moutan,alisma,Poria,wolfberry,peach kernel,leonuri,Astragali,and Radix Rehmanniae.The special TCM for the treatment of DR is panax notoginseng,trichosanthin,scrophulariae,cassia seed,anemarrhena,coptis,chrysanthemum,pueraria,Puhuang,and Moxa lotus.Rhubarb,Schisandra chinensis,Radix Pseudostellariae,Atractylodes macrocephala,Dilong,Euryale seed,Sakurako akira,Codonopsis and Cuscuta are unique in the treatment of DKD.In the data of our hospital,the TCM treating both DR and DKD in high frequency are jam,chuanxiong,radix pseudostellariae,psyllium,Salvia miltiorrhiza,White peony root,Rehmannia,Angelica sinensis,Ophiopogon,Red Peony,Cortex moutan,Tangerine peel,alisma,poria,guizhi,bupleurum,codonopsis,wine rhubarb,Bran fried Atractylodes macrocephala,astragalus,scutellaria,coptis,Pinellia sinensis,pueraria.The characteristics of TCM for the treatment of DR are Panax notoginseng,terrapin,leech,scrophulariae,scorpion,oyster,wolfberry,xanthine,chrysanthemum.Treatment of DKD high-frequency TCM is Schisandra,Dendrobium,gypsum,cinnamon,Eucommia,Caulis spatholobi,Anemarrhena,Magnolia,peach kernel,bran fried Atractylodes,bran fried Fructus Aurantii,Porcine jelly.3.No matter the literature data or clinical data,the high-frequency TCM for the treatment of two kinds of complications are yam,chuanxiong,Salvia miltiorrhiza,Radix Rehmanniae,Angelica sinensis,Radix Ophiopogonis,Radix Paeoniae Rubra,Cortex moutan,Rhizoma Alismatis,Poria cocos and Radix Astragali.4.No matter the literature data or the clinical data,the five flavors of TCM for the treatment of these two complications are mainly sweet,bitter and pungent taste,and the meridians are mainly liver,kidney,spleen and lung meridians.In the literature database,the four qi of traditional Chinese medicine in the treatment of DR is mainly cold,followed by warm,while the treatment of DKD is mainly warm,followed by cold.In the database of our hospital,the four qi drugs for the treatment of two kinds of complications are mainly cold,followed by warm.5.The association rules show that the commonly used drugs for treating the two complications in literature are astragalus-angelica,astragalus-motherwort,astragalus-yam,astragalus-Rehmanniae,Cornus-Rehmanniae-yam,astragalus-angelica-chuanxiong,etc.The treatment of DR TCM pair is mainly based on tonifying deficiency drugs combined with promoting blood circulation and removing blood stasis,and the treatment of DKD is mainly deficiency-tonifying drugs combined with dampness and diuresis,astringent drugs.The commonly used drugs for the treatment of two kinds of complications in our hospital are Astragalus-Angelica,Poria-yam,Salvia miltiorrhiza-Pueraria,Radix Astragali-Angelica-Bran fried Atractylodes macrocephala,Radix Astragali-Radix Ophiopogonis-Angelica,Radix Astragali-Poria-Angelica.The TCM pair in treating DR in the data of our hospital mainly focuses on the efficacy of tonifying spleen and kidney,promoting blood circulation and removing blood stasis,such as Poria,Radix Astragali,Angelica sinensis,Ligusticum chuanxiong,etc.While the drugs for the treatment of DKD are related to the drugs of tonifying spleen and kidney,permeating dampness and promoting diuresis,such as Radix Astragali,Poria,alisma,Polyporus umbellatus.6.According to the results of cluster analysis,the traditional Chinese medicine for the treatment of DR and DKD in the literature includes Taohong Siwu decoction and Liuwei Dihuang decoction after clustering,Yuquan pills and Qiming granules are added and subtracted in literature for the treatment of DR,Shengmai Powder and Xiaotang Yishen Yin are added and subtracted for the treatment of DKD.The clustering prescriptions for the treatment of two kinds of complications in our hospital include Chaihu prescription and Guizhi Fuling pills,the treatment of DR clustering prescription includes Dahuangzhechong Pill and Gouqizi Pill,and the treatment of DKD clustering prescription includes Shengmai Powder and Wuling Powder.Conclusion1.Diabetic retinopathy’s lesion site is located in the eyes,and is most closely related to the liver.Diabetes kidney disease lesion site is located in the kidney.These two complications have something in common based on the theory of "homology of liver and kidney".In addition,DR and DKD belong to diabetic microvascular disease,which belongs to the category of "collaterals" in traditional Chinese medicine.Therefore,the effects of DR and DKD herbs are mainly based on tonifying liver and kidney and promoting blood circulation and removing blood stasis.When prescribing drugs,pay attention to "cold and heat leveling".2.The lesion site of DR is different from that of DKD,and the pathogenesis is not completely similar in the process of disease progression.In addition to the drugs used in the treatment of DR,such as nourishing liver and eyesight,promoting blood circulation and removing blood stasis,drugs such as cooling blood and stopping bleeding,clearing heat and detoxification will be added as appropriate,such as Puhuang,Clematis chinensis and Coptis chinensis,etc.Some special ophthalmic drugs will also be added,such as cassia seed and chrysanthemum.In the treatment of DKD,some astringent products will be added on the basis of tonifying the liver and kidney,such as golden cherry,Euryale and so on.3.No matter the literature data or the data of our hospital,the treatment of DR and DKD is based on the principle of tonifying liver and kidney,promoting blood circulation and dredging collaterals,but there are some differences in specific prescription selection.According to the clustering results,doctors in our hospital pay more attention to the application of classical prescriptions,such as using Xiao Chaihu decoction to treat DR,Banxia Xiexin decoction to treat DKD,and Dahuangzhechong Pill or Guizhi Fuling Pill to add or subtract when promoting blood circulation and removing blood stasis.4.There are slight differences between clinical data and literature data in the specific prescription and medication,indicating that many doctors have their own unique opinions when using clinical medication,which may be influenced by regional culture,lifestyle habits,environmental climate,etc.