A Study On The Regularity Of Drug Use In The Treatment Of Chronic Renal Failure By Yu's And Sun's Academic School

Objective: To collect the medical records of Yu's and Sun's academic school in the treatment of chronic renal failure(CRF),to sort out the rules and characteristics of the treatment of chronic renal failure,to sum up the academic thoughts and clinical experience of Yu's and Sun's academic school in the treatment of chronic renal failure.Methods:1.Collect medical records,papers,works,scientific research achievements,etc.of the representative characters of Yu's and Sun's academic school,sort out learning notes,sum up their dialectical methods and the characteristics of prescription use,and clear up their academic thoughts.2.A total of 870 prescriptions collected from 300 out-patient and inpatient cases of chronic renal failure treated by representatives of Yu's and Sun's academic school in accordance with the criteria were entered into the "Traditional Chinese Medicine Inheritance Support System(TCMISS)(V2.5)".By using database setup and data mining,this paper analyzes the statistical methods of data source through frequency,association rules,clustering and so on,and sums up the rules and characteristics of clinical syndrome and treatment drug use in Yu's and Sun's academic schools.Results:1.A total of 300 cases of chronic renal failure were included in this study.The incidence rate of male was higher than that of female,and the ratio of male to female was1.08:1.The age span was between 20 and 86 years old,and the majority of the patients were aged from 40 years old to 69 years old.2.Statistical analysis revealed that:(1)According to the statistics of syndrome and treatment:The most common syndrome of chronic renal failure is deficiency of spleen and kidney qi(62%),followed by deficiency of both qi and yin(16%),deficiency of spleen and kidney yang(13%),deficiency of liver and kidney yin(9%).The most commonconcurrent syndrome is Turbid toxin stasis block(37%),Wet and turbidity resistance(30%),Dampness and stasis resistance(23%),Wet-heat accumulation(10%).The highest frequency of clinicalsymptoms was fatigue,anorexia,urine foam,dry mouth,poor sleep,edema of both lower limbs,waist difficulty,etc.The frequency of tonifying spleen and kidney,activating blood circulation and removing blood stasis,relieving turbidity and detoxification were the highest in the treatment.(2)This research institute input 870 prescriptions,a total of 200 kinds of drugs,a total of 15563 taste.A total of 52 Chinese herbs have been used more than100 times.Among the 52 high-frequency herbs,the first four most frequently used were drugs for tonifying deficiency(33.36%),drugs for invigorating blood circulation and eliminating stasis(14.19%),heat-clearing drug(11.59%),diuretics for eliminating dampness(10.52%).Among the four types of drugs mentioned above,invigorating qi(18.08%),promoting blood circulation and regulating menstruation(7.37%),clearing heat and detoxifying drugs(5.13%),inducing diuresis to alleviate edema(9.40%)had the highest frequency.(3)The proportion of four natures of drugs was as follows: warm(45.49%),cold-natured(26.65%),mild in nature and taste(22.03%),cool(4.33%),heat(1.5%);the proportion of five flavours was: sweet(37.73%),spicy(26.85%),bitter(26.09%),salty(4.45%),acid(3.17%),astringent(1.71%);the top five drugs channel tropism: spleen,liver,kidney,lung,stomach.(4)A total of 61 groups of core drug combinations with frequency ?217 were obtained by association rule analysis,including 17 herbs,The core prescription consists of Astragalus mongholicus,Angelica sinensis,Codonopsis pilosula,Poria cocos,Semen coicis,Pberetima,Prepared rehmannia root,Carthamus tinctorious,Rheum officinale etc.get 60 rules with confidence ? 0.9 have been derived.(5)Based on entropy clustering statistics for complex systems,four new prescriptions are obtained:Prescription 1is composed of rhubarb,peony skin and peach kernel,which is suitable for syndrome of heat and blood stasis,prescription 2 is composed of Xianshao,Achyranthes bidentata and Forsythia forsythia,suitable for syndrome of deficiency of spleen and kidney yang and mutual obstruction of stasis toxin;Prescription 3 is composed of Poria cocos,dandelion and dandelion,which is suitable for syndrome of turbid toxin and stasis,prescription 4 is composed of dry lotus grass,Ligustrum lucidum,wolfberry fruit,cedar and so on,which is suitable for syndrome of deficiency of liver and kidney yin and internal obstruction of damp turbidity.Conclusion:1.In this paper,Yu's and Sun's academic school advocates the combination of macro-differentiation of TCM and microscopic pathology of western medicine to discuss the treatment of chronic renal failure.While tonifying the spleen and kidney,we should pay attention to activating blood circulation to remove blood stasis,relieving turbid and internal heat or fever as well as strengthening the body resistance and eliminating evil.Thecommonly used types of drugs in the treatment of chronic renal failure are tonifying drugs,drugs for invigorating blood circulation and eliminating stasis,heat-clearing drug,and diuretics for eliminating dampness,which are commonly used by the representative characters of Yu's and Sun's academic school.Common core combinations are Astragalus,Angelica,Codonopsis,Poria,yam,Ligusticum Chuanxiong,Citrus tangeralis,Amomum,Coix seed,Cornus officinalis,Dilong,Atractylodes,cooked Rehmannia,safflower,paeonne,rhubarb.2.The academic thoughts of Yu's and Sun's academic school of learning in treating this disease are as follows:Combination of TCM and western medicine,macro and micro;strengthening the base of peiyuan,tonifying the source of spleen and kidney nourishing;taking into account removing evil,promoting blood circulation,removing blood stasis and dispelling turbid poison.3.Using modern data mining methods,and the TCMISS,we can make a comprehensive analysis of the medical records of academic schools,making the results more objective and scientific.The new prescriptions obtained by cluster analysis can provide the basis for clinical use of drugs.