| Purpose:To summarize Professor Song Liqun’s clinical experience in the treatment of chronic kidney disease(CKD-MBD)with mineral and bone disorders,explore the medication patterns of his mentor in the treatment of CKD-MBD,summarize the core prescription,and explore the possible mechanism of action of his core prescription using online pharmacology.Method:1.Summarize and summarize the tutor’s clinical experience and academic viewpoints on the treatment of CKD-MBD by sorting out the cases of chronic kidney disease with mineral and bone abnormalities diagnosed and treated by the tutor.2.Collect visits from January 2015 to January 2021 based on inclusion and exclusion criteria407 cases of CKD-MBD patients treated by Professor Song Liqun in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine;Standardize the included cases,organize and upload the case data to the traditional Chinese medicine inheritance computing platform(V3.0).Use functional modules such as frequency analysis,association rules,and cluster analysis to conduct data mining,and summarize the medication rules and core drug combinations of the mentor in treating CKD-MBD.3.Analyze the core prescription obtained from the mentor’s clinical experience in treating CKD-MBD using online pharmacology,search the TCMSP database to obtain the chemical components and potential action targets of the core prescription drugs;Screening CKD-MBD disease targets in GeneCard,DrugBank,and other databases;After extracting the intersection targets of drugs and diseases,import them into a String database for protein interaction analysis and build a PPI network;Using DAVID database to analyze GO biological function and KEGG pathway enrichment;A network pharmacological regulatory network model of "core component target pathway disease" was constructed based on the results of the core effective component action target,CKD-MBD disease target,and KEGG signal pathway obtained through Cytascape 3.8.2.Result:1.Statistical results of TCM syndrome types:Of the 407 cases of CKD-MBD,325 cases were of spleen and kidney qi deficiency syndrome,accounting for 79.97%,23 8 cases were of drowning syndrome,accounting for 5 8.57%,167 cases were of damp heat syndrome,accounting for 41.09%,94 cases were of blood stasis syndrome,accounting for 23.09%,63 cases were of water dampness syndrome,accounting for 15.45%,59 cases were of liver and kidney yin deficiency syndrome,accounting for 14.60%,15 cases were of phlegm dampness syndrome,accounting for 3.74%,11 cases were of qi and yin deficiency syndrome,accounting for 2.72%,10 cases were of yin and yang deficiency syndrome,accounting for 2.55%,and 4 cases were of spleen and kidney yang deficiency syndrome,Accounting for 1.02%.2.Statistical results of symptoms:Among 407 cases of CKD-MBD,the frequency of symptoms ranged from high to low:fatigue and fatigue(73.34%),limb edema(51.27%),frequent nocturnal urination(47.3 7%),body pain(42.28%),poor sleep(40.07%),nausea and vomiting(34.47%),dizziness(32.77%),turbid urine(25.81%),waist and knee tenderness(24.62%),chest tightness and shortness of breath(14.60%),etc.3.Statistical results of drugs:In the 407 first prescriptions,the proportion of the four gases of drugs ranked from high to low in order:warm,calm,cold,cool,and hot;From high to low,the proportion of the five flavors of the drug is sweet,bitter,spicy,sour,and salty;From high to low,the proportion of meridian tropism of drugs is in the order of spleen,liver,stomach,kidney,lung,large intestine,heart,bladder,gallbladder,pericardium,small intestine,and triple energizer meridians;The drugs ranked in the top 10 in terms of frequency of use were At racty lodes macrocephala,Astragalus membranaceus,Eucommia ulmoides Oliv,Apocy num venetum,Rhubarb,Cattail grass,Centella asiatica,Taraxacum mongolicum,Euryale ferox,Rosa laevigata.4.Based on association rule analysis and follow-up experience,the number of support factors was set to 3 5 0,and the confidence level was set to 0.9.It was concluded that Professor Song Liqun’s core drug combinations for the treatment of CKD-MBD were:Atractylodes at racty lodes,Astragalus,Eucommia ulmoides,Apocy num,Rhubarb,Centella asiatica,Tuckahoe,Achyranthes bidens,keel,Oyster,bone shatterbud.5.Research results on drug action pathways in network pharmacology:Core prescription KEGG enrichment analysis:The main enrichment pathways are:Lipid and atherosclerosis pathway,AGEs-RAGE signal pathway,PI3K-AKT signal pathway,IL-17 signal pathway,TNF-related signal pathway,multiple cancer related pathways,etc.It is speculated that the core prescription may be through intervention in multiple mechanisms such as blood lipid,glucose regulation,apoptosis,bone metabolism,vascular calcification,etc.in the course of CKD-MBD,Delay the progression of the disease.Conclusion:Professor Song Liqun’s differentiation and treatment of mineral and bone abnormalities in chronic kidney disease is based on the theory of visceral signs and qi transformation.He believes that the key pathogenesis of chronic kidney disease is insufficiency of the liver,spleen,and kidney,dampness,stasis,toxin,and obstruction.The treatment is to tonify the kidney,benefit the liver,strengthen the spleen,dissipate dampness,promote blood circulation,and dissipate blood stasis,and dredge the internal organs and remove turbidity.Professor Song Liqun’s core drug combinations for the treatment of mineral and bone abnormalities in chronic kidney disease include:Atractylodes macrocephala,Radix Astragali,Eucommia,Apocynum venetum,Rhubarb,Centella asiatica,Poria cocos,Achy ranthes bidentata,keel,Oyster,Drynaria.The mechanism of the core prescription in treating CKD-MBD may be through Quercetin,kaempferol,Baicalein β-The Active ingredient of carotene and other drugs regulate the Lipid and atmosphere pathway,AGEs-RAGE signaling pathway,PI3K-AKT signaling pathway,IL-17 signaling pathway,TNF related signaling pathway,multiple cancer related pathways and other multi-target,multi-channel realization. |
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