Research On Professor Zhang Xikui’s Prescribing Rules In The Treatment Of Nephrotic Syndrome Based On Complex Network Rules

Objective:Through a variety of data mining techniques,this study focuses on the construction of complex network system to analyze professor zhang xikui’ s medication pattern and diagnosis and treatment thinking based on nephrotic syndrome.Methods:By collecting and sorting out the medical records of patients with nephrotic syndrome in the Second People’s Hospital affiliated to Fujian University of Traditional Chinese Medicine,the Third People’s Hospital affiliated to Fujian University of Traditional Chinese Medicine and Professor Zhang Xikui’s outpatient clinic of the Chinese Medicine Hall from January 2015 to December 2022,we established a clinical data database,performed frequency analysis and summarized the attributes of traditional Chinese medicine,and performed association rule analysis,systematic clustering and K-means clustering through IBM SPSS Modeler 18 and SPSS 26,and then used Gephi0.9.2 9.Result:1.A total of 132 traditional Chinese medicines were included in the study,with 218 prescriptions,and the total use frequency reached 2,776 times,including 36 medicines with the use frequency more than 10%;2.In terms of drug attributes,cold drugs are the most widely used in the four qi meridians,followed by flat and warm drugs.The five medicines mainly included sweet medicine and bitter medicine,followed by mild medicine,pungent medicine and sour medicine.The meridian tropism for kidney and spleen was mainly used,followed by liver meridian,lung meridian,bladder meridian and stomach meridian.In efficacy classification,a total of 18 drugs were classified,among which deficiency-tonifying drugs occupied the first place,with the use frequency reaching 28.64%,and the drugs with the other use frequency greater than 5% were classified as follows: diuretic(18.52%),heat-clearing drugs(9.19%),digestion-promoting drugs(8.86%),astringent(6.48%),exterior-relieving drugs(5.62%),and hemostatic(5.12%);3.In terms of compatibility of Chinese herbs,Radix Astragali seu Hedysari,Poria,Fructus Ligustri Lucidi,and Ecliptae Herba are closely related and often used in combination in the prescription.The core medicinal pair comprise fructus hordei germinatus-fructus oryzae germinatus,herba ecliptae-fructus ligustri lucidi,bupleuri radix-scutellariae radix,radix aconiti lateralis preparata-radix paeoniae alba,and semen euryales-fructus rosae laevigatae;4.There were five basic prescriptions groups,which were as follows: Group 1:Radix Astragali seu Hedysari,Poria,Cortex Dictamni,Semen Euryales,Rhizoma Imperatae,Kochiae Fructus,Periostracum Cicadae,Radix Notoginseng,Herba et Gemma Agrimoniae,Radix Codonopsis,Herba Epimedii,Fructus Alpinae Oxyphyllae,Herba Ephedrae,and Fructus Schisandrae Chinensis;The second group comprise radix astragali,fructus hordei germinatus,fructus oryzae germinatus,endothelium corneum gigeriae galli,poria,rhizoma alismatis,concha ostreae,herba taxilli,semen plantaginis,radix aconiti lateralis preparata,rhizoma atractylodis macrocephalae,radix paeoniae alba,herba agrimoniae,rhizoma gastrodiae,semen ziziziphi spinosae,Group III: Radix Astragali seu Hedysari,Ecliptae Herba,Fructus Ligustri Lucidi,Eucommiae Cortex,Achyranthis Radix,Coicis Semen,Pericarpium Citri Reticulatae,Bulbus Lilii,Rhizoma Smilacis Glabrae,Caulis Lonicerae,Semen Lablab Album,and Herba Siegesbeckiae;Group IV: Radix Astragali seu Hedysari,Semen Euryales,Rhizoma Alismatis,Poria,Pericarpium Citri Reticulatae,Herba Leonuri,Fructus Rosae Laevigatae,Radix Rehmanniae,Herba dendrobii,Radix Puerariae,Fructus Corni,Rhizoma Dioscoreae,Cortex Moutan,and Radix Scrophulariae;Group 5: Pericarpium Citri Reticulatae,Radix Paeoniae Alba,Radix Bupleuri,Ramulus Cinnamomi,Rhizoma Pinelliae,Radix Scutellariae,Radix Glycyrrhizae,Fructus Forsythiae,Flos Chrysanthemi,Caulis Perillae,Flos Lonicerae,Semen Armeniacae Amarum,Herba Artemisiae Annuae,and Radix Ginseng;5.The drugs with complex network degree value greater than 90 were Radix Astragali seu Hedysari,Poria,Herba Ecliptae,Cortex Dictamni,Fructus Ligustri Lucidi,Rhizoma Alismatis,Fructus Hordei Germinatus,Fructus oryzae,Pericarpium Citri Reticulatae,and Cortex Eucommiae,and the core drugs with K-core≥35 were Radix Astragali seu Hedysari,Poria,and Herba Ecliptae.Conclusion:1.In terms of medication for nephrotic syndrome,cold,neutral and warm herbs are commonly used,together with sweet and bitter herbs.The herbs that go to the meridian mostly belong to spleen and kidney.The deficiency-tonifying herbs and diuretic and dampness-infiltrating herbs are often used.Huangqi(Radix Astragali)and Fuling(Poria)are widely used,and they are often combined with Fructus Ligustri Lucidi and Ecliptae Herba.The commonly used pairs of herbs are: Fructus Hordei Germinatus-Fructus oryzae,Ecliptae Herba-Fructus Ligustri Lucidi,Radix Bupleuri-Radix Scutellariae,Radix Aconiti Lateralis Preparata-The core drugs with complex network were Radix Astragali seu Hedysari,Poria,and Herba Ecliptae,which were most widely used in combination with other drugs.The secondary core drug are cortex dictamni radicis,fructus ligustri lucidi,rhizoma alismatis,fructus hordei germinatus,fructus oryzae germinatus,pericarpium citri tangerinae,and cortex eucommiae;2.In terms of diagnosis and treatment thoughts,the basic principles are tonifying spleen and kidney,removing dampness and blood stasis.The main prescription drugs are tonifying qi and invigorating spleen,nourishing kidney and yin,and draining water and dampness.The concomitant drugs include dispelling wind and removing dampness,invigorating stomach and promoting digestion,regulating qi and activating spleen,and tonifying yang.According to the different clinical manifestations of patients,the main contradictions are judged and the drugs are used flexibly.