Research On Medication Rules And Mechanism Of Kaixuan Tongluo Method In The Treatment Of Gouty Nepropath

ObjectiveThis topic is a retrospective study of the tutor’s treatment of GN medical records;through the traditional Chinese medicine inheritance calculation platform V3.0,the medication characteristics of the tutor in the treatment of GN were excavated and analyzed,and the etiology and pathogenesis of GN and the theoretical connotation of “Kaixuan Tongluo” method were discussed.Through network pharmacology research,the mechanism of action of core drugs was explored;summarize the clinical experience of the tutor in treating GN based on syndrome differentiation.Methods1.From June 2017 to September 2022,218 complete medical records of GN patients who met the inclusion criteria were collected from the nephrology clinic and ward of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine;2.Using the traditional Chinese medicine inheritance calculation platform3.0 to complete the entry of the first diagnosis related information;the basic information of patients,drug frequency,taste and meridian tropism,common drug combination and drug core combination were obtained;3.Network pharmacology research: Through TCMSP,TCMIP and HERB databases,the effective components of core drugs and their targets were screened;Uniprot database was used to standardize the target proteins of drug active ingredients;The gene targets of GN were searched through Gene Cards,Drugbank and OMIM databases;The intersection targets of core drugs and diseases were obtained by Venn online production tool,which were imported into STRING database for PPI network analysis,and the core target proteins were screened by Cytoscape 3.8.2;GO and KEGG enrichment analysis was performed on the intersection targets using R 4.1.2;To explore the mechanism of core medication in the treatment of GN.Results1.Basic information: Among the 218 GN cases,137 were male and 81 were female;the youngest was 39 years old,the oldest was 71 years old,107 were under 55 years old,and 111 were over 55 years old.Syndrome statistics showed: 93 cases of spleen and kidney qi deficiency,damp heat syndrome;52 cases of damp-heat syndrome;qi and Yin deficiency,damp heat syndrome 45 cases;yin and Yang deficiency,blood stasis syndrome in 17 cases;spleen and kidney yang deficiency,cold dampness obstruction syndrome in 11 cases.2.Drug statistics: There were 218 prescriptions for the first diagnosis,involving 192 kinds of traditional Chinese medicine.The top ten flavors were as follows: glabrous greenbrier rhizome,rhizoma dioscoreae septemlobae,radix gentianae macrophyllae,radix clematidis,talcum,caulis lonicerae,herba siegesbeckiae,rhizoma chuanxiong,astragalus membranaceus and chinese yam;The frequency of use of the four qi of the drug is: flat,cold,warm,cool,hot;the frequency of use of the five flavors is: sweet,bitter,spicy,salty,sour;the frequency of meridian use is: liver meridian,kidney meridian,spleen meridian,stomach meridian,lung meridian,etc;Commonly used drug combinations such as astragalus membranaceus and chinese yam,glabrous greenbrier rhizome and rhizoma dioscoreae septemlobae;The drug core combinations were 4 groups.3.Research on network pharmacology: There were 82 effective components in the core drugs,and the main effective components of the core drugs were quercetin,hederagenin,β-sitosterol,etc.There were 332 related gene targets,2612 disease targets,114 drug and disease intersection targets,among which the core targets were ALB,AKT1,INS,etc.GO enrichment analysis obtained 1419 biological processes,34 cell compositions,and 129 molecular functions.There were 105 KEGG biological pathways,such as lipid and atherosclerosis,NF-κB signaling pathway,insulin resistance,etc.Conclusions1.The pathogenesis of GN lies in the deficiency of spleen and kidney,the accumulation of damp-heat turbidity,the stagnation of Xuanfu,the obstruction of kidney collaterals,which is the syndrome of deficiency in origin and excess in superficiality,and the mixture of deficiency and excess.When the tutor was in clinical practice,the treatment method was established due to the pathogenesis,and the “Kaixuan Tongluo” method was established as its fundamental treatment.2.The tutor diagnosed and treated GN,and the core drugs were mainly glabrous greenbrier rhizome,rhizoma dioscoreae septemlobae,radix gentianae macrophyllae,radix clematidis,talcum,caulis lonicerae,herba siegesbeckiae,rhizoma chuanxiong,astragalus membranaceus and chinese yam,and the clinical products were mostly sweet,flat,bitter and cold,and the right drugs and horn drugs were taken well.3.The network pharmacology study predicts the mechanism of action of core drugs,which may play a role in anti-oxidative stress,anti-inflammatory and analgesic,immune regulation,and uric acid lowering through multi-component,multi-target,multi-pathway,and systematic regulation,so as to regulate the function of endothelium and vasomotor,reduce renal tubular interstitial fibrosis,and protect renal function.