| Chronic glomerulonephritis (CGN), shortly referred to chronic nephritis, is a group of primary glomeruar diseases which is clinical characterized with the symptom of proteinuria, hematuria, hypertension, and edema. The disease is associated with the slow development of renal failure. In U.S.A. and Europe, chronic nephritis is the third leading cause of end stage renal disease (ESRD). In developing countries including China, chronic nephritis is the main leading cause of ESRD. Therefore, the treatment of chronic nephritis disease is an important direction of medical researches nowadays. Until now, the pathogenesis of this disease is not clearly, no specific treatment on this disease is available. However, there are several advantages to apply Traditional Chinese Medicine (TCM) syndrome differentiation treatment for chronic nephritis. In this study, we summarized the cognition of chronic nephritis etiology and pathogenesis and basic ideas on diagnosis of this disease which were developed by Prof. Nie Lifang. We also made retrospective analysis of clinical data by using support vector machines, complex networks and theme model in data mining. The syndrome differentiation rule, therapeutic principle and method and the experience in herbal prescription of how Prof. Nie Lifang treated chronic nephritis disease were further summarized in this paper for clinical application.1. Review of TCM masters’experience on diagnosis and treatment of chronic glomerulonephritis.We summarized the experience of a number of modern TCM masters and made a critical review from the pathogenesis diagnosis, treatment and recuperation of chronic nephritis experience of disease, pathogenesis, diagnosis, treatment and recuperation of the chronic nephritis.2. The cognition and basic ideas on diagnosis of chronic nephritis developed by Prof. Nie Lifang.The cognition and the basic ideas on diagnose of chronic nephritis developed by Prof. Nie Lifang:(1) Liver, spleen, kidney is the center of asthenia of healthy energy, qi-yin asthenia is main zhenghou.(2) Usually accompanied by exogenous evil, moist, damp, toxic heat, haemostasis and so on.The basic ideas on diagnosis:(1) Grasp cardinal symptom.(2) Be serious on the method of supporting body resistance.(3) Experience of zheng differentiation classification were summarized as qi-yin asthenia, liver kidney yin insufficiency and spleen kidney qi deficiency.3. Data mining research based on Prof. Nie Lifang’s experience of chronic glomerulonephritis treatment.General characteristics of cases:the cases which were diagnosed and treated by Prof. Nie Lifang were from the Xiyuan Hospital Nephrology Department. The cases of hospitalized patients with chronic nephritis were ranged from2007to2011. And the cases of out patients were ranged from2010to2012. A total of194cases and354visits were enrolled. Male to female ratio was1.02:1, mean age were38.15±13.72years, mean disease duration were65.82±74.03months.107cases had pathology report, pathological diagnosis of89cases was IgA nephropathy,15cases were mesangial proliferative glomerulonephritis,2cases were membranous nephropathy, and1case was focal ball and segmental glomerulosclerosis.Data mining:in this research, we make use of support vector machine (SVM), complex network (CN), topic model (TM) methods to do further study and review of the diagnose and treatment experiences on glomerulonephritis which were developed by Prof. Nie Lifang.Summary of supervisor’s experience:(1) Diagnosis regularity of regularity:For qi-yin asthenia patients, the major symptoms are acratia, easy to catch cold, pulse presentations show deep and thin and so on. For liver and kidney yin insufficiency, the major symptoms are protect against heat, pulse presentations show thin, fast and like strings, dizzy, tinnitus pulse presentations show deep, thin and fast and so on. At the mean time, emphasize comprehensive analysis by the four examination methods.(2) Therapeutic principles and methods:Firstly, the combination of differentiating diseases and differentiating zheng was based on the zheng differentiation-treatment, with consideration of the characteristic of haematuria and proteinuria, hemostasis and consolidating semen herbal medicines were added. Secondly, supporting body resistance, associated with dispelling exogenous pathogen. Treating secondary symptoms for emergency, treatment of chronic disease was aiming at the principal aspect. Supporting body resistance was serious on methods such as nourishing yin, invigorating the kidney, invigorating the kidney, benefiting vital energy, nourishing blood and liver, regulating vital energy, regulating stomach. Dispelling exogenous pathogen often use the methods of dispelling wind and heat, antipyresis detoxicant, relieving sore-throat, removing dampness and promoting dieresis, activating blood circulation to dissipate blood stasis, inducing diuresis for treating strangurtia, excreting turbid pathogen, calm the liver and subdue yang and so on.(3) The characteristic of medication:①Invigorating the kidney, to make flexible use of liuweidihuangtang. For qi-yin asthenia, the prescriptions were often based on shenqidihuangtang. For liver kidney yin insufficiency, the prescriptions were often based on zhibaidihuangtang or majudihuang tang.②Reconstruction tonifying spleen and stomach, be skilled on use of sijunzi tang. If the diseased region lay particular emphasis on spleen, the prescriptions were often based on shenlingbaizhusan. If the diseased region lay particular emphasis on stomach, the prescriptions were often based on xiangshaliujunzitang.③Symptomatic treatment was administered, having rules to follow.④Use medicine mildly, be serious on the protection of the spleen and stomach.The innovation of this study is:(1) Use support vector machine analysis methods to summarize the syndrome differentiation rule of Prof. Nie Lifang in treating chronic glomerulonephritis;(2) Use complex network approach and topic modeling approach to summarize the experience in herbal prescription of Prof. Nie Lifang on treating chronic glomerulonephritis. |
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