The Study Of Professor Zhang Zongli's Syndrome And Medication Rules On The Treatment Of CKD Stage 2 To 4

Objective:To analyze the syndrome patterns of CKD 2 to 4,summarize the theoretical basis for Professor Zhang Zongli's treatment of CKD 2 to 4,and find out the rules of Professor Zhang Zongli's medication for CKD 2 to 4.Besides,this paper aims to deeply analyze Professor Zhang Zongli's clinical experience in treating CKD 2 to 4,which can help us more effectively inherit and carry forward the valuable experience of well-known Chinese medicine,and provide excellent clinical experience and new ideas for treatmentMethods:Collect and sift 60 medical records of CKD 2 to 4 patients with primary chronic glomerulonephritis who visited the outpatient clinic of Professor Zhang Zongli from February 2018 to June 2019.The number of effective TCM prescriptions was 214.By using the Excel software,we established a database to enter the gender,age,stage,symptom data and law of treatment.We input the prescription data to form a database.The frequency of herb use,four properties and five tastes,meridian attribution,efficacy,number of flavors,etc.We conduct unified and standardized processing of the corresponding fields.Then we analyzed the number,proportion to summarize the syndrome characteristics of CKD 2 to 4.The high frequency herbs in the prescription were introduced into SPSS 24.0 software for cluster analysis,and new drug combinations were obtained.Professor Zhang Zongli's experience and ideas in the treatment of CKD2 to 4 and the medication rules were summarized for clinical applicationResults:1.A total of 60 patients were enrolled in this study,including 36 males and 24 females,with a male-to-female ratio of 1.5:1;the youngest age was 29 years,the oldest age was 74 years,and the average age was 51.85+10.85 years;the proportion of patients with stage 3 was the highest,with 38 cases.The most frequent frequency is fatigue,weakness of waist and knee,foam urine,chills,cold limbs,short breath,lazy words,etc.In terms of syndrome types,the syndrome of spleen and kidney qi deficiency(75.0%)was commonly seen in asthenic syndromes.The syndromes of blood stasis(51.7%),damp turbidity syndrome(51.7%)and damp-heat(31.7%)were commonly seen in sthenic syndromes.The most frequent treatments are invigorating the kidney and activating blood circulation(48.3%),invigorating the kidney and invigorating the spleen(33.3%),clearing away heat and dampness(26.7%),invigorating the spleen and dispelling dampness(18.3%),etc2.According to the statistics of 214 effective prescriptions,16 kinds of high frequency herbs such as Astragalus membranaceus,rhubarb charcoal,rhubarb,Atractylodes macrocephala,skin of abdomen,Ligusticum chuanxiong and Angelica were obtained.From the perspective of four properties and five tastes of drugs,cold properties of traditional Chinese medicine are the most frequently used,followed by warm properties of traditional Chinese medicine,neutra properties of traditional Chinese medicine,cool properties of traditional Chinese medicine and hot properties of traditional Chinese medicine;from the perspective of five taste of drugs,bitter drugs are the most frequently used,followed by sweet drugs,pungent drugs,light drugs,sour drugs,salty drugs and astringent drugs;from the perspective of drug meridian,the frequency of drugs in spleen meridian,liver meridian,stomach meridian,lung meridian and large intestine meridian.According to the specific efficacy classification,tonic drugs are the most frequently used,represented by qi-supplementing drugs,with the cumulative use frequency accounting for 14.6%of all drugs,followed by damp-clearing drugs,promoting blood circulation and removing blood stasis drugs,heat-clearing drugs,Qi-regulating drugs,etc The average number of Chinese medicines used is 11.5.Finally,eight groups of new drug combinations were obtained by cluster analysis:Astragalus,rhubarb,rhubarb charcoal;wulingzhi,puhuangtan;Perilla leaf,dried ginger;cassia twig,Poria cocos,mulberry bark;Smilax glabra,Patrinia villosa;Yinchen,Jinqiancao;Atractylodes macrocephala,Poria cocos;Angelica,Ligusticum chuanxiong,big belly barkConclusion:1.According to the study of syndrome regularity,Zhang Zongli believed that CKD2-4 was located in the kidney,and its onset was closely related to the spleen,involving the lung and large intestine.The main pathogenic factors were deficiency,stasis,dampness,heat and wind The syndrome of deficiency was mainly blood stasis,dampness,dampness and heat,while the syndrome of deficiency was mainly spleen and kidney qi deficiency.The basic pathogenesis was deficiency of both spleen and kidney,stasis of blood,dampness and heat obstruction,and the treatment was to invigorate the kidney and activate blood circulation.Tonifying kidney and invigorating spleen,clearing away heat and dampness,invigorating spleen and dispelling dampness are the main methods2.The conclusion of the study of medication laws is that from the frequency of medication,four properties and five tastes,meridian,and efficacy classification.Teacher Zhang Zongli used cold,warm and neutra properties medicines mostly,with bitter,sweet and pungent medicines as the main medicinal properties.The medicines were mainly classified as spleen meridian,liver meridian and stomach meridian.The efficacy categories of the medicines were mainly water-diffusing and dampness-invigorating drugs,Qi-invigorating drugs,blood-activating and stasis-removing drugs,and heat-clearing drugs.By comparing the medication differences in different stages of CKD2-4,it can be seen that Teacher Zhang Zongli always used the method of invigorating kidney and activating blood circulation.In CKD2,he paid attention to lung and liver,and used the products of nourishing yin and clearing heat,nourishing blood and softening liver.In CKD3,he paid more attention to spleen,invigorating spleen and replenishing qi,clearing heat and promoting dampness.In CKD4,both kidney and large intestine were taken into account,and the products of Warming Yang and diuresis,excreting toxicity and turbidi.It embodies the treatment method of Professor Zhang Zongli for CKD2-4 stage of diuresis,invigorating spleen and kidney,dissipating blood stasis and heatThe eight groups of characteristic drug combination(Astragalus membranaceus,Rhubarb,Rhubarb charcoal;Wulingzhi,Puhuang charcoal;Perilla leaves,dried ginger;Cassia twig,Morus alba,Plantago;Pori a cocos,Patrinia patrina;Yinchen,Qiancao;Atractylodes macrocephala,Poria cocos;Angelica sinensis,Ligusticum chuanxiong,Dabelly bark)obtained by cluster analysis were the core drug combinationsIn summary,Professor Zhang Zongli's academic thoughts and experience in the treatment of ckd2-4 are consistent with the clinical practice,and the effect is quite good,which is worthy of clinical promotion.