| ObjectiveThis topic is a retrospective study of the CGN-related medical records of the tutor ’s previous clinical diagnosis and treatment;through the traditional Chinese medicine inheritance calculation platform V3.0,the medication characteristics of the tutor in the treatment of CGN were excavated and analyzed.To explore the potential mechanism of core drugs through network pharmacology research;summarize the clinical experience of the tutor in treating CGN based on syndrome differentiation.Methods1.From December 2017 to December 2022,a total of 205 complete medical records were collected from the outpatient and ward of nephropathy in the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,which met the diagnostic criteria and inclusion criteria of CGN.2.Using the traditional Chinese medicine inheritance calculation platform V3.0,complete the entry of medical records related information,obtain the basic information of patients,four qi,five flavors,meridian tropism,efficacy,frequency of use,common drug combination and drug core combination and other related information.3.Network pharmacology research,through TCMSP and HERB databases,screened the active ingredients and targets of core drugs;through the Uniprot database,the target proteins of the active ingredients of the drug were genetically standardized;gene targets of diseases were searched in Gene Cards and OMIM databases.Venny 2.1.0 online tool was used to obtain the intersection targets of core drugs and diseases,which were imported into STRING database for PPI network analysis,and the core targets were screened by Cytoscape 3.9.0.GO and KEGG enrichment analysis of target proteins was performed using R 4.1.2 software to explore the mechanism of action of core drugs in the treatment of CGN.Results1.Essential information: Among 205 cases,there were 127 males and 78 females,with a male to female ratio of 1.63 : 1.The youngest was 21 years old,the oldest was 75 years old,and 162 cases were under 60 years old.TCM syndrome results show: Spleen and kidney deficiency,wet turbidity and blood stasis type 67 cases;lung and kidney qi deficiency,water wet overflow type 51 cases;qi and Yin deficiency,damp heat type 46 cases;yin deficiency of liver and kidney,blood stasis type 37 cases;the other 4 cases.2.Pharmaceutical analysis :There were 205 prescriptions involving 192 flavors of traditional Chinese medicine.The frequency of drug use was as follows : astragalus membranaceus164 times,chinese yam 150 times,corn stigma 133 times,imperatae rhizoma130 times,cornus officinalis 126 times,glabrous greenbrier rhizome 125 times,motherwort herb 123 times,chicken’s gizzard-membrane 122 times,euonymus alatus 116 times,caesalpinia 110 times,codonopsis pilosula 110 times,etc.The results of drug four gas showed:Flat 1185 times,warm 986 times,cold 955 times,cold 79 times,hot 23 times.The results of drug five flavors showed:Sweet 2178 times,bitter 1063 times,pungent 760 times,sour 342 times,salty 69 times.Drug meridian results showed that:There were 1407 times of liver meridian,1348 times of kidney meridian,1303 times of spleen meridian,1257 times of lung meridian and 865 times of stomach meridian.Drug efficacy results show:Tonifying deficiency type 1002 times,diuresis and dampness type 407 times,clearing heat type 370 times,promoting blood circulation and removing blood stasis type 356 times.Commonly used drug combinations:astragalus membranaceus-euonymus alatus,codonopsis pilosula-chinese yam-chicken’s gizzard-membrane,glabro us greenbrier rhizome-corn stigma-chinese yam etc.The drug core combination was 4 groups.3.Results of network pharmacology research: There were 66 effective components of core drugs,mainly quercetin,kaempferol,luteolin,taxifolin,etc.There were 246 drug targets,2598 disease targets,and 135 drug-disease intersection targets.The core targets were mainly IL-6,CASP3,IL-1 B,RELA,VEGFA,etc.There were 167 KEGG pathways,and the main signaling pathways were AGE-RAGE,IL-17,HIF-1,TNF,etc.Conclusion1.Tutor believes that the core pathogenesis of CGN is spleen and kidney deficiency,dampness and blood stasis,which is the syndrome of deficiency in origin and excess in superficiality,and the syndrome of deficiency and excess.According to the law,the method of “tonifying kidney and astringent,clearing and promoting blood circulation”was established as the fundamental treatment method,and the prescription was selected according to law and used flexibly.2.The tutor clinical syndrome differentiation and treatment of CGN,pay attention to the spleen and kidney,to support the right;good use of astragalus membranaceus,chinese yam,codonopsis pilosula,cornus officinalis,chicken’s gizzard-membrane and other flat,sweet taste of the product,flat regulation of the spleen and kidney,solid protection of the spleen and stomach qi,so that the body ’s qi smooth,the organs of qi and blood yin and yang deficiency can be improved;it is supplemented by imperatae rhizoma,motherwort herb,euonymus alatus,caesalpinia and other bitter and cold medicines,clearing damp heat,removing blood stasis and dredging collaterals,so that the evil has a way out to improve many clinical symptoms and signs of CGN,reduce urinary protein excretion,and delay the progression of glomerular disease.3.The tutor is good at using the combination of drugs such as Astragalus membranaceus-Euonymus alatus,Codonopsis pilosula-Chinese yam-Chicken’s gizzard-membrane,glabrous greenbrier rhizome-Corn stigma-Chinese yam etc.4.Network pharmacology shows that,The mechanism of action of the core drugs in the treatment of CGN is through its multi-component-multi-t arget-multi-channel,systematic regulation of the characteristics of its antiinflammatory,anti-oxidation,immune regulation and other effects,so as to improve the clinical symptoms and signs of CGN patients,reduce urinary protein,reduce glomerular sclerosis and interstitial fibrosis and other pat hological damage,with obvious renal protection. |
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