Study On TCM Syndromes And Medication Rules Of Systemic Lupus Erythematosus (active Stage

Objective: To explore the TCM syndromes and medication rules of systemic lupus erythematosus(SLE)(active stage),in order to provide ideas for the TCM clinical diagnosis and treatment of SLE(active stage).Data and methods:This retrospective study collected and collated the case data of hospitalized patients in the Department of Rheumatology,all of whom were from the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine(from January 2017 to November 2022).A total of 217 patients were included through strict screening according to the exclusion criteria.The patient’s medical record number,name,year of hospitalization,gender,age,course of disease,TCM syndrome type,laboratory indicators,symptoms,tongue and pulse,and TCM situation were respectively input into WPSOffice,and SPSS25.0 and SPSSModeler18.0 software were used for statistical analysis,so as to explore the distribution of TCM syndrome types of SLE(active stage).The relationship between TCM syndrome types and patients’ general conditions,laboratory indicators,as well as medication rules,and finally draw conclusions.Results:1.(1)A total of 217 cases were collected in this study,and the distribution of syndrome types was as follows: heat toxin blazing(29.03%)> rheumatic heat bi(19.82%)> spleen-kidney Yang deficiency(18.89%)> Yin deficiency internal heat(16.59%)> liver and kidney Yin deficiency(15.67%).(2)General information: there were 21 males and 196 females,with a ratio of 1:9.33.There was no statistical difference in the distribution of TCM syndrome types between genders(P > 0.05).The maximum age was 81 years old,the minimum was15 years old,and the average age was 44.82±13.69 years old.The age of heat toxin incandescent syndrome was the minimum,which was statistically significant compared with liver and kidney Yin deficiency syndrome(P < 0.05).The longest course of disease was 30 years,and the shortest was 5 days.The shortest course of disease was heat toxin incandescent syndrome,and the difference was statistically significant compared with liver-kidney Yin deficiency syndrome and spleen-kidney Yang deficiency syndrome(P < 0.05).(3)Laboratory indicators: the CRP value of heat toxin incandescence syndrome was the highest,and there were statistical differences compared with liver-kidney Yin deficiency syndrome and Yin deficiency internal heat syndrome(P < 0.05).The ESR value of heat toxicity syndrome was the highest,followed by rheumatic heat bi syndrome,and there was statistical difference between them and liver-kidney Yin deficiency syndrome(P < 0.05).The WBC of heat toxin incandescent syndrome was the lowest,and the difference was statistically significant compared with spleen-kidney Yang deficiency syndrome(P < 0.05).The PLT value of heat toxin incandescent syndrome was the lowest,and there were statistical differences compared with Yin deficiency syndrome,spleen and kidney Yang deficiency syndrome,liver and kidney Yin deficiency syndrome(P < 0.05).The 24-hour urinary protein value of spleen-kidney Yang deficiency syndrome was the highest,and there were statistical differences compared with rheumatic heat bi syndrome,heat toxin incandescent syndrome,Yin deficiency internal heat syndrome,liver and kidney Yin deficiency syndrome(P < 0.05).SLEDAI score of heat toxin incandescency syndrome was the highest,followed by spleen-kidney Yang deficiency syndrome,rheumatic heat bi syndrome,and there were statistically significant differences among them with liver-kidney Yin deficiency syndrome and Yin deficiency syndrome of internal heat(P< 0.05).2.(1)A total of 282 prescriptions were collected in this study,involving 247 traditional Chinese medicines,and the total frequency of medication was 3640 times,with a total of 8 drug categories.Radix rehmanniae,peony bark,ophiopogon ophiopogon,artemisia annulosa,glycyrrhiza,trionychia sinensis,rhizome rhizome,red peony root,yam,gypsum and other traditional Chinese medicines with high frequency were common drugs in the treatment of SLE(active stage).The main drugs for SLE(active stage)are clearing heat,tonifying deficiency,enhancing water and dampness,relieving surface,promoting blood circulation and removing blood stasis.(2)Cluster analysis was performed on the Chinese medicines with more than 30 drug frequency,and four cluster drug groups were obtained,including Radix sophora,forsythia,Scutellaria scutellaria,Radix platycodon,Radix paeoniae,Radix glycyrrhiza,Radix moutan bark,Radix rehmanniae,gypsum and buffalo horn.Class 2:Paeony,Angelica sinensis,Qianghua,Parsnips and ligusticum chuanxiong;Class 3:Phellodendron phellodendron,Coix seed,turtle shell,Ligustrum fructus,yam,dogwood,Codonopsis codonopsis,ophiopogon ophiopogon,Artemisia annua,alisma rehmanniae,Stir-fried atractylodes with bran,Astragalus,Poria,Aconite,cassia twig;Class 4 Roasted licorice,dried ginger,Chinese sand ginseng,Radix oxyssop and Salvia Miltiorrhiza.(3)33 association rules were obtained by association analysis of traditional Chinese medicines with ≥30 drug frequency,among which the drug combinations with the highest support were Moutan pericarp and Radix rehmanniae and Radix Rehmanniae.Conclusion:1.SLE(active stage)is the most common syndrome of heat toxicity.2.Patients with SLE(active stage)were more likely to have increased CRP,ESR and SLEDAI scores,and decreased WBC and PLT values.Patients with spleen-kidney Yang deficiency syndrome are more likely to have increased urinary protein value in24 hours.3.High-frequency drugs for SLE(active period): Rehmannia rehmanniae,peony bark,ophiopogonis ophiopogonis,artemisia annua,licorice,turtle shell,rhizome,red peony root,yam,gypsum,etc.;The application frequency of heat-clearing drug was the highest.The commonly used drug combinations were Moutan bark-Zhimu,radix rehmanniae-Zhimu.