Based On Data Mining, Professor Zhao Jinxi's Experience In Treating Hyperuricemia

Background:Hyperuricemia is a disease that caused by a disorder in purine metabolism or a decrease in renal excretion,and manifested of elevated blood uric acid levels.With the development of society,the prevalence of hyperuricemia has also increased.At present,western medicine mainly recommend lifestyle interventions and drugs as regular treatment.However,chemical drugs are limited in quantity and safety.Chinese medicine has advantages in efficacy and safety.It is of great value to learn and inherit the experience of famous Chinese medicine practitioners.Professor Zhao Jinxi of Dongzhimen Hospital has long been engaged in study of endocrinology.He has formed a deep understanding of hyperuricemia and accumulated rich experience in treatment.Objective:This research intends to conduct data mining in Prof.Zhao’s clinical cases of hyperuricemia,so as to inherit Prof.Zhao’s academic experience and promote clinical practice with Chinese medicine methods.Methods:Researcher collects patients from the Nephrology and Endocrinology Department of Dongzhimen Hospital between May 2007 and November 2017,who were definitely diagnosed as hyperuricemia and prescribed by Prof.Zhao.By the means of "Chinese medicine case database system",SPSS Modeler 14.1 and SPSS Statistics 22.0 software,researcher counts and analyzes the pathogens,disease locations,pathogenesis,symptoms,TCM syndromes,treatment and medication.Results:89 medical records from 59 patients are included in this research,including 33 asymptomatic hyperuricemia cases(42 medical records),23 gouty arthritis cases(41 medical records),and 7 gouty nephropathy cases(17 medical records).4 patients have both gouty arthritis and gouty nephropathy.Major patients are young males,then aged males and middle-aged females.The ratio of men and women is 4.9:1.Common comorbidities include hypertension,hyperlipidemia,type 2 diabetes,hepatic adipose infiltration,coronary atherosclerotic heart disease,hepatic dysfunction,cholecystolithiasis,diabetic retinopathy,etc.Main pathogens include endowment,old age,poor diet,drinking,smoking,menopause,and chronic illness.Disease locations involves viscera(such as spleen,liver,kidney,and stomach)and body parts(such as the zygomatic,metatarsophalangeal joint,head,knee,waist,and other parts of the foot).The most important pathogenesis is dampness-heat.Asymptomatic hyperuricemia is often accompanied with the pathogenesis of viscera disorders while gouty arthritis with dampness-heat blocking collaterals and gouty nephropathy with kidney essence deficiency.The clinical symptoms of hyperuricemia are diverse.There are no typical symptoms in asymptomatic hyperuricemia patients.Fatigue,back pain,poor sleep,thirst,dry mouth,slimy moss,yellow moss,red tongue,and dark red tongue seems to occur frequently.Gouty arthritis often shows pain,redness and swelling in toe joints and ankle.Gouty nephropathy often shows dizziness,poor appetite,blurred vision,pale and dark tongue,deep and moderate pulse.Asymptomatic hyperuricemia often performs as syndrome of qi and yin deficiency,syndrome of dampness-heat,as well as syndromes of deficiency of the spleen,kidney and liver,and demonstration of liver and stomach.Gouty arthritis mainly performs as syndrome of dampness-heat blocking collaterals.Gouty nephropathy often performs as syndrome of qi deficiency and blood stasis,syndrome of kidney deficiency,syndrome of spleen and kidney deficiency,syndrome of dampness and turbidity,and syndrome of kidney deficiency.As the research shows,Prof.Zhao attaches great importance to the therapeutic method of eliminating dampness-heat,dispelling the pathogen by purgation and diuresis.Tufuling(Smilacis Glabrae Rhizoma),Bixie(Dioscoreae Spongiosae Rhizoma),Huzhang(Polyconi Cuspidati Rhizoma el Radix),Jinqiancao(Lysimachiae Herba)are commonly used.Other methods include soothing the liver,clearing heat,replenishing qi,nourishing yin,invigorating the spleen,removing dampness,promoting qi,dissipating phlegm,eliminating stagnation,and tonifying the kidney.For gouty arthritis,it is important to dredge the channels and collaterals,soft tendon and relieve pain.Chuanniuixi(Cyathulae Radix),Niuxi(Achyranthis Bidentatae Radix),Jixueteng(Spatholobi Caulis),Qinjiao(Gentianae Macrophyllae Radix),Weilingxian(Clematidis Radix et Rhizoma),Rendongteng(Lonicerae Japonicae Caulis),Baishao(Paeoniae Radix Alba),Chishao(Paeoniae Radix Rubra),Gancao(Glycyrrhizae Radix et Rhizoma)are commonly used.For gouty nephropathy,it is vital to tonify qi,engender blood and activate circulation,as well as ascend clear and descend turbidity.Huangqi(Astragali Radix),Danggui(Angelicae Sinensis Radix),Chuanxiong(Chuanxiong Rhizoma),Danshen(Salviae Miltiorrhizae Radix et Rhizoma),Chantui(Cicadae Periostracum),Jiangcan(Bombyx Batryticatus),Jianghuang(Curcumae Longae Rhizoma),Dahuang(Rhei Radix et Rhizoma)are commonly used.Conclusion:Prof.Zhao believes that the onset of hyperuricemia is related to constitution,over-taking of greasy,surfeit flavor and emotional disorders.The disease originates from the spleen and stomach and is closely related to the liver and kidney.The core pathogenesis is the spleen and stomach’ dysfunction with dampness-heat emerging.Treatment should be focused on the core pathogenesis and the substantial method is to harmonize the viscera and dispel dampness-heat by purgation and diuresis.Gouty arthritis should further dredge the channels and collaterals,soft tendon and relieve pain,while gouty nephropathy should further tonify qi,engender blood and activate circulation,as well as ascend clear and descend turbidity.Prof.Zhao’s dialectical thinking of Chinese Medicine reveals throughout the syndrome differentiation and treatment process.