The Academic Characteristic Collation And Experience Summary Of Processor Wei On Treating Diabetic Nephropathy

Object:Applying data mining technology, with Professor Wei'feedback opinions, to find out his clinical thought on treatment of DN;By arrangement of ancient and contemporary literatures on the diagnosis and treatment of DN, to finish the traceability and analysis of Professor Wei' theoretical basis;At last, combined with data mining, to achieve the academic characteristic collation and experience summary on treatment of diabetic nephropathy of Zixiao Wei.Method:Using the SQL Server system which was exploited by China Academy Of Chinese Medicine Sciences and the System Science Institute of China Science Academy, applying kinds of data mining technologies, such as frequency statistical, association analysis, and so on, input, unify and mine the 95 medical cases on DN which were treated by Professor Wei Zixiao. Study on the ancient literatures consisted of etiology and pathogenesis of DN, treatment based on syndrome differentiation.Study on the modern literatures was composed of differentiation for syndrome classification,specific prescription for certain illness, single medicine and Chinese patent medicine and other treatment. At last, analyze the three parts and comprehensively summarize Professor Wei'academic characteristic and clinical experience on treatment of diabetic nephropathyResult:Data mining of the 95 medical cases on DN suggested that in the TCM diagnosis, edema (50 cases) and turbid urine (37 cases) was the most, and there were retention of urine, pruritus, vomit, consumptive diseases.The main symptoms were edema, foam in the urine, hypodynamia and so on. One quarter of cases manifested high serum creatinine. The main conditions of the tongue and coating and pulse-taking were White and greasy tongue coating (51 cases), plump tongue (50 cases), dark red tongue (23 cases), thin pulse (16 cases) and tant pulse (16 cases). The main Chinese medicine syndromes contained water retention syndrome, blood stasis syndrome, spleen-deficiency syndrome, kidney-deficiency syndrome, and so on. The association analysis diagram suggested that the most common therapeutic method were the combination, whose center was invigorating blood circulation, of supplementing the kidney, strengthening the spleen and eliminating retention of fluid.The 95 prescriptions included 129 Chinese herbal medicine, and the most common one was medicinal cyathula root.account for 69.5%.The top 20 drugs were mainly for eliminating retention of fluid, invigorating blood circulation, supplementing the kidney and strengthening the spleen. The dosage had some regular patterns, for example, the ratio of the rhizome of large-headed atractylodes to Chinese atracty lodes was 1 to 1. The ratio of Pericarpium Citri Reticulatae to radix astragali was 1 to 3.In the turbid urine cases, the most common herbal medicine was cicada slough, china root, motherwort and so on. Many drugs had tight associations, especially cicada slough, china root, motherwort and beef-steak plant leaf. The common drugs used in the spleen-kidney deficiency syndrome were Tuckahoe, yam, dogwood fruit, astragali radix, radix pseudostellariae, dried rhizome of rehmannia, account for 100% 100%,85.7%,85.7%,57.1%. In the edema cases, drugs which had tight associations contained Asiatic plantain seed and medicinal cyathula root. The common drugs used in edema due to spleen-deficiency were Tuckahoe, the rhizome of large-headed atractylodes, Chinese atractylodes, Alisma orientale, cassia twig, radix codonopsitis. Drugs commonly used in edema due to kidney-deficiency were radix cyathulae, Asiatic plantain seed, radix achyranthis bidentatae, yam, dogwood fruit, root bark of the peony tree and so on. Drugs commonly used in edema due to spleen-kidney deficiency were Pericarpium Citri Reticulatae, radix astragali, radix codonopsitis, old arable soil, dogwood fruit and so on. Herbal medicines used in blood stasis causing water retention were angelica, red paeonia, Tuckahoe, Alisma orientale, Asiatic plantain seed, radix cyathulae and so on.Conclusion:(1) The clinical experience on treatment of diabetic nephropathy of Professor Wei:①Referring to pathogenesis, the key point was asthenia in origin and asthenia in superficiality. It contained spleen-deficiency, kidney-deficiency, water retention, blood stasis and so on.②Emphasize combined use of the four diagnostic methods, especially conditions of the tongue and coating and pulse-taking.③Use the special way of thought, which was "differentiation of disease——differentiate the root cause and symptoms of a disease——grasp primary symptom——differentiation of symptoms and signs——formulate the basic prescription——addition or subtraction of changes"④Put emphasis on invigorating blood circulation to eliminate retention of fluid and pay attention to dietotherapy. When the primary syndrome was edema, spleen- deficiency syndrome was treated by Chunze Decoction, while kidney-deficiency was Jishengshenqi Decoction. Spleen-kidney deficiency syndrome was treated by Shenqidihuang Decoction, while blood stasis causing water retention syndrome was Dangguishaoyao Decoction. When the primary syndrome was turbid urine, the common basic prescription was Shenqidihuang Decoction. Professor Wei applied herbal medicines according to both traditional usage and the modern pharmacology research.(2)Combination of data mining and the way of apprenticeship can better summarize the clinical experience of famous TCM doctors, and data mining will have an extensive future in TCM.