| Objective:Systematically summarize national famous doctor of TCM-Professor XX’s clinical experience, symptom-distinguishing ideas, diagnosis and treatment laws and academic thoughts on diagnosing and treating chronic kidney diseases (CKD). With the guidance of basic law of treating CKD created by Professor Xbased on clinical experience-clearing and descending, supplements, dredge collateral, summarize Professor Cao’s diagnosing ideas, treating methods and medicine-using laws. Carry out the research of clinical study on clearing and descending, supplements, dredge collateral diagnosing and treating CRF, enriching the content of treating chronic kidney disease in traditional Chinese medicine therapy. Through summarizing and inheritance of the old Chinese medicine clinical experience and academic thought and combined with the scientific method to study, this topic inherits and carries forward the essence of the old Chinese medicine academic, aiming to promote the development of Chinese medicine.Method:By the following tutor clinical diagnosis and writing diagnosis and treatments CRF of tutor’s medical cases arrange, research, understand and summary, summarized the professor XX’s diagnosis and treatments CRF of clinical experience, syndrome differentiation of thinking, dialog’s law and academic thought. Adopt the medical records of 220 cases of tutor’s treatments CRF, according to the differentiation and prescription combined with date mining and statistic analysis, summarize the basic prescription and the common drugs in each differentiation instructed by "clearing and descending, supplements, dredge collateral", observe and research the distribution, using traditional Chinese medicine frequency and relationship with drugs and differentiation, also the law of each differentiation prescription, in this way. Carry out the research of "clearing and descending, supplements, dredge collateral" Select 120 cases nondialytic, divided into the treatment group of 60 cases and control group of 60 cases. Treatment group take basic prescription, and the control group take uric poisonous clear grain treatment, with 12 weeks of treatment. Observe and record the Scr, BUN, serum of two groups of patients before and after treatment of Cys C change before and after treatment clinical curative effect and TCM syndrome integral value changes. And select 55 SD (Sprague wrote-Dawley) rats, divided into normal group, model group, and basic party group and valsartan group. Prepare UUO rats models, observe between groups of rats serum levels of Scr, BUN, and renal pathological changes, and to detect UUO rat kidney growth factor beta (TGF-β) and hepatocyte growth factor (HGF) and alpha smooth muscle actin (α-SMA) protein and fiber connection (FN) immunohistochemical semi-quantitative score rating condition.Results:Professor XX deems that the course of disease of CRF has a long duration, multifarious etiology and pathogenesis, thus on clinical matters basis should be on the spleen and kidney deficiency for the pathogenesis, especially turbidity toxin diffuses the triple warmer (triple energizer) is the key of pathogenesis, pathological changes of the viscera organs, based on the triple warmer (triple energizer) of the clinical manifestations and the variable relationship, explore the certificate law, and establish from the triple warmer (triple energizer) in the clinical syndrome differentiation of chronic renal failure evidence law. Evil committed on coke is divided into lung and kidney empty, the wind and cloud poison intrinsic, on cardiopulmonary two types. Lung and kidney deficiency type, wind evil invasion to jade screen powder to make up for lung and benefiting kidney treatment; Turbidity toxin implication, type make cardiopulmonary and points on cardiac dampness heat and wet soft imagination pericardium two certificates, wet muddy on pericardium certificate to calamus depressive jintang wenpi tonga subtraction, wet soft hot, inside defect pericardium certificate when to bezoar bearing gas tonga subtraction. Evil committed medium including spleen and kidney deficiency, dampness turbidity type intrinsic, spleen and kidney Yang deficiency, cold dampness of obstacles and the spleen and kidney deficiency type, damp and hot accumulate knot, for most of the lesions in patients with chronic renal failure process, clinical, for clinical syndrome differentiation. Spleen and kidney deficiency type, wet muddy intrinsic to Xdivision and subtract from qing filling material with spleen and kidney, material to cure; Spleen and kidney Yang deficiency and dampness type of obstacles to cure spleen dry wet, the material and the stomach, to Xfrom qing I drop soup to add and subtract; Spleen and kidney deficiency, damp and hot accumulate knot type with Xdivision since the proposed clear soup II number, material, and the stomach for cure. Evil committed and hardness are divided into liver and kidney Yin deficiency, Yang wind disturbance and two empty, turbidity toxin diffuses two type of Yin and Yang. To Wen Yang Yi gas-solid for governance, liver and kidney Yin deficiency and Yang type one in town on the liver wind extinguish wind tonga subtraction ziyin latent Yang, town liver extinguish wind; Yin and Yang are two empty, turbidity toxin diffuses party with ginseng with soup and black tin Dan and subtract WenYangYi gas-solid for cure. Xteacher make a diagnosis and give treatment of chronic renal failure with the sanjiao (triple energizer) is dialectical, parting syndrome differentiation. But at the same time, Xteacher stressed in the clinical needs to pay attention to the "careful card machine, knowledge is often change, compound legislation" principle, to catch the basic pathogenesis of chronic renal failure, founded "tonic t2dm reduction method" as the fundamental rules of treating chronic renal failure. The method according to chronic renal failure "deficiency, dampness, blood stasis" pathogenesis theory, with the "drop, qing qing in blood know luo" method of syndrome differentiation, Xteacher since the proposed clear soup I and clear drop soup II party is the application of the law. Xteacher think at the same time due to blood stasis resistance network throughout the course of the chronic kidney disease is the disease of pathological products, but also become the new pathogenic factors, put forward of "promoting blood circulation to remove blood stasis t2dm" when needed throughout the course of the chronic kidney failure treatment and specimens of the actual situation according to the disease centralizer is often used to remove blood stasis and activating blood eliminate pathogenic treatment. Xteacher think kidney disease in kidney, but closely related to the spleen and kidney, "all diseases are born of spleen failure", so the nephrotic syndrome differentiation should pay attention to complementing the spleen and stomach, put forward "from the spleen treating chronic renal failure can be" point of view. Xteacher pointed out that insect drugs is sexual flavor, salty, can, can do it, qi and feasible; "Salt into kidney" first, can bring the medicine through renal collaterals, blood know luo, up to protect the kidney. Chronic renal failure is the end-stage kidney disease, not a drug can, therefore, clinical practice with scorpion, earthworm, batryticated silkworm and cicada matching use. Xteacher think the chronic renal failure mechanism based on virtual, filling method is the common treatment, but at the moment, spleen and kidney deficiency, has lost its transport and controlling actions, repair, easy injury Yin moving blood, block qi activity, lead to kidney failure, so the need to "use light spirit", should be with nourishing advisable, removing of avoid by all means, don’t make coke indicates lag.Application of data mining technology for Xteacher make a diagnosis and give treatment of chronic renal failure basis research analysis to "qing tonic t2dm reduction" as the core of the specific treatment prescription, core agent including raw rhubarb, calcined keel, calcined oyster, sophora japonica, glabrous greenbrier rhizome, earthworm, astragalus, scorpion, batryticated silkworm and rhizoma atractylodis, a total of 10 taste traditional Chinese medicine (TCM).Analyzed the CRF medical records of professor Xdiagnosis and treatments with date mining (DM) technique to conclude the core prescription who’s specific treatments of the "clearing and descending, supplements, dredge collateral". The 10 core Traditional Chinese medicine is Rhubarb, Calcined keel, Calcined oyster, Sophora flower bud, Tuckahoe, Earthworm, Astragalus, Scorpion Silkworm and Herb. The results of use the basic prescription treatment based on differentiation of CRF show that treatment group better than control group on clinical effectiveness and effect of TCM syndromes(P<0.05), treatment group shows much better than the clinical effective rate is 90%, Application of treating chronic renal failure according to the results of the basic party in the clinical curative effect and syndrome curative effect of traditional Chinese medicine treatment group were superior to control group (P< 0.05), the clinical total effective rate in treatment group, TCM syndrome total effective rate were 90%,88.33%, significantly higher than that of control group were 75%,73.33%(P< 0.05). SCr, BUN, and the two groups after treatment of CysC are significantly lower than before treatment (P< 0.01), the GFR were significantly increased (P< 0.01), but the treatment group compared with control group, SCr, BUN, and CysC were significantly lower (P< 0.05, or P< 0.01), the GFR were significantly increased (P< 0.01). During the treatment does not appear adverse drug reactions. To explore its mechanism of action, to carry out his own intervention by the qing drop tonic t2dm fermentation UUO renal interstitial fibrosis in rats of experimental research. Research results show that the basic can improve the quality of life of rats, decrease UUO rats blood BUN, Scr and renal tubular mesenchymal damage index(P< 0.05, or P< 0.01), reduce rat kidney pathological damage; Basic party UUO group rats after treatment kidney tissue TGF-beta 1, alpha SMA and semi-quantitative score compared with model group and FN shaded.Conclusion:Professor XX treats chronic renal failure of the organic combination of the classical theory of TCM and clinical experience, on the basis of chronic renal failure of spleen and kidney deficiency, turbid poison the basic pathogenesis of mark yu wenjie diffuse the triple warmer (triple energizer) is put forward from the triple warmer (triple energizer) treating chronic renal failure evidence rule, in the creation of "tonic t2dm reduction method" as the fundamental rules of treating chronic renal failure. By data mining research concluded that "qing tonic t2dm reduction method for treating chronic renal failure, the basic formulas, based on the basic treatment of chronic renal failure clinical and experimental research, experimental and clinical efficacy were significantly," qing tonic t2dm reduction method "and on behalf of the party is treating the dialysis stage an effective treatment for patients with chronic renal failure. At the same time, Xteacher put forward "from the spleen treating chronic renal failure can be", "promoting blood circulation to remove blood stasis t2dm method when throughout the course" the chronic kidney failure treatment and chronic renal failure need to use light spirit "syndrome differentiation theory, enrich the content of traditional Chinese medicine treatment in chronic kidney disease (CKD) to learn. |
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