Clinical Experience Of Professor Wu Shen-Tao In The Treatment Of Diabetic Kidney Disease Of Inheritance Of Traditional Chinese Medicine

Purpose Diabetic kidney disease(DKD)refers to the kidney disease complicated by diabetes.It is usually clinically diagnosed based on the increase of UACR or the decrease of EGFR and the exclusion of other chronic kidney diseases(CKD).Studies have shown that 19.5% of patients with DKD develop end-stage renal disease(ESRD),which is nearly 2.5 times the incidence of cardiovascular mortality and 1.5 times the mortality from all causes.This study aims to collect,sort out the endocrine division chief physician professor Wu treatment of diabetic kidney disease related basis material,with the aid of inheritance of traditional Chinese medicine auxiliary platform(TCMISS V2.5 version),the application of modern information technology and the data mining method,to summarize professor Wu treatment of diabetic kidney disease medication rule and experience,to inherit promote name old doctor of traditional Chinese medicine academic ideas,to provide new ideas for traditional Chinese medicine treatment of diabetic kidney disease,for young and middle-aged doctors learning experience in old Chinese medicine to provide new methods.Methods Included in this study between January 2016 and July 2019 between deep into exclusion standard by Wu,a professor at the clinic diagnosis and treatment and prescription of the 125 patients,a total of 301 cases of time basis information collected,and the basis of data(four diagnostic information,name of traditional Chinese medicine,related tests,etc),standardizing application of statistical reporting system on the basis of basic information,drug frequency,four gas mixed,return,belongs to categories of statistics,the application of association rules analysis,complex system entropy clustering analysis,no monitoring system entropy clustering analysis,digging out the wu division basis of common diabetes kidney disease symptoms,tongue and pulse condition frequency,Commonly used Chinese medicine and dose,commonly used drug combination,the law of each syndrome type and the analysis of new prescription,etc.Results1.A total of 125 patients were included in this study,including 79 males and 46 females.The age distribution was mainly in the range of 50-69 years,among which 39 were 50-59 years old,accounting for 31.2%,and 34 were 60-69 years old,accounting for 27.2%.2.Through the analysis of 301 cases of the basis,the symptoms of kidney disease can be concluded that diabetes is systemic sex more,including dry mouth(258),thirst(196),frequency of urine(89),more drinks(65)as the common symptoms of diabetes,lack of power(177),bosom frowsty,breath(153)(167),mei Clinton(121),lower extremity edema(84),urine bubble(92)as the symptoms of kidney disease.The tongue coating types were mainly tongue red(120),tongue dark red(70),tongue light red(45),tongue coating types were mainly tongue white greasy(77),tongue coating yellow greasy(65),tongue coating white(57).The pulse condition was mainly pulse chord(55),pulse chord slip(52),pulse sink fine(38),pulse chord fine(31).The24-hour urine protein quantification was roughly equal to the early and clinical phases,among which the early(53)and the clinical phases(55).Urinary albumin/creatinine ratio(A2)and(A3)accounted for the main part,accounting for 95.6% in total,among which,A2(56),A3(53)and A1(5).3.A total of 301 prescriptions were recorded in this study,and 255 drugs were used to treat diabetes and kidney diseases.The first 25 drugs were:Liquorice(189),poria cocos(186),radix bupleuri(185),radix scutellariae(153),astragalus membranaceus(151),radix pseudostellariae(146),cooked rhubarb(122),stone lotus seed(102),Fried hovenia dulcis(101),rhizoma coptidis(98),dwarf lilyturf(97),angelica(96),raw radix rehmanniae(88),Fried atractylodes(87),radix paeoniae alba(81),rhizoma anemarrhenae(84),semen plantaginis(78),cinnamon(70),puerarin(69),bone(68),alisma(68),achyranthes bidentatasalvia(67),miltiorrhiza(67),perrin(64),radix paeoniae rubra(62).4.Statistics of wu shi's drugs for treating diabetic kidney diseases: cold drugs(46.30%),warm drugs(24.07%),flat drugs(22.73%),hot drugs(3.61%),cool drugs (3.30%).Five tastes: sweet(33.36%),bitter(32.12%),and spicy(19.63%).Statistics:spleen meridian(16.94%),lung meridian(16.32%),liver meridian(16.27%),stomach meridian(12.76%),kidney meridian(11.35%).5.In this study,according to the number of drug flavors,there were 43 antipyretic drugs,41 antiasthenic drugs,22 antihydrophilic drugs,19 antiseptic drugs,17 antiseptic drugs and 17 antiseptic drugs.Frequency statistics of the categories of drugs:tonic drugs(24.15%),heat-clearing drugs(20.13%),hydrolytic drugs(9.98%),antiseptic drugs(9.04%),blood-activating drugs(7.35%),astringent drugs(4.97%).6.Statistics division for the treatment of diabetic kidney disease Wu 301 prescription drug combinations using frequency,the use frequency of 60 or more combinations,a total of 316 sets,association rules analysis(as shown in table 17),set up the support of 40%,sets of rules as shown in figure 4,include dandelion,peach kernel,kudzuvine root,rhubarb,Chinese angelica,radix paeoniae rubra,radix paeoniae alba,rhizoma coptidis,Fried hovenia dulcis,radix rehmanniae,radix glycyrrhizae,radix bupleuri,perrin,batryticated silkworm,bone,skin,radix astragali,radix scutellariae,radix ophiopogonis,Fried atractylodes,stone lotus seed,poria cocos,plantain seed,cassia twig,pseudostellaria root,cinnamon,twotooth achyranthes root,rhizoma alismatis,rhizoma anemarrhenae,a total of 28 drugs.From the overall point of view,the commonly used drugs used in this statistics are mainly used for the compatibility of heart and kidney,invigorating qi and nourishing Yin,purifying turbidity and detoxification,nourishing liver and kidney,and clearing away deficiency heat,which conforms to the academic thought of Wu in the treatment of diabetes and kidney diseases.7.Wu is to first prescription for the treatment of diabetic kidney disease 301 syndromes are classified into seven card type,and statistical analysis,sorted by frequency and percentage from high to low:(1)heart kidney syndrome(20.27%),(2)qi and Yin deficiency syndrome(18.94%),(3)turbidity toxin intrinsic syndrome(17.94%),(4)two deficiency of Yin and Yang,turbidity toxin intrinsic syndrome(17.28%),(5)the spleen kidney Yang deficiency syndrome(10.96%),6 liver and kidney Yin deficiency syndrome(10.30%),7 stomach heat injury kidney syndrome (4.32%).The core drugs of different syndrome types are: heart and kidney not to hand in syndrome: licorice root,scutellaria,radix pseudostellariae,radix ophiopogonis,radix astragali,ground bone skin,plantain seed,poria cocos,stone lotus seed,radix bupleuri;Qi Yin two deficiency syndrome: cassia twig,licorice root,poria cocos,radix ginseng,white peony root,astragali,radix pseudostellariae,radix scutellariae,Fried atractylodes,radix ophiopogonis,radix rehmannii,radix bupleuri;Turmeric,rhizoma coptidis,cooked rhubarb,stiffening silkworm,scutellaria baicalensis,radix bupleuri,peilan root,radix paeoniae alba,liquorice root;(4)the deficiency of Yin and Yang,turbidity toxin syndrome: angelica sinensis,bupleurum chinensis,calcina molasses,forsythia,dandelion,licorice root,centella asiatifolia,peach kernel,pueraria root,safflower,raw rehmannia root,Fried fructus aurantii,red peony root,cooked rhubarb;(5)spleen and kidney Yang deficiency syndrome: cassia twig,alisma,motherwort,achyranthes,papaya,poria cocos,Fried atractylodes,cuscuta,wolfberry,codonopsis,roasted licorice root,raspberry,cinnamon,cooked rehmannia,angelica,dogwood,astragalus,yams;6.Syndrome of liver and kidney Yin deficiency:astragalus membranaceus,cortex phellodendri,bark of peony,cooked rehmannia glutinosa,cornus officinalis,rhizoma alisma,Chinese yam,cinnamon,angelica sinensis,anemarrhena,poria cocos,radix pseudostellariae pseudostellariae,radix rehmanniae;All landowners stomach heat injury kidney syndrome: caulis dendrobii,continous Bi Xie,rhizoma coptidis,radix rehmanniae,radix trichosanthis,poria cocos,calcined magnets,cicada,common cnidium fruit,radix scrophulariae,chicken's gizzard-membrane,pseudostellaria root,raspberries.8.Based on entropy clustering of complex systems and unsupervised entropy hierarchy clustering,the correlation coefficient between 255 traditional Chinese medicines commonly used in wu shi's treatment of diabetic kidney disease was analyzed,and 36 core combinations and 18 new prescriptions of Wu treatment of diabetic kidney disease were obtained.This result basically accords with professor Wu medication rule of treating diabetic kidney disease.Conclusion1.The "TCM inheritance assistant platform" realizes the input,management and analysis of medical case data,as well as the statistical analysis of prescription prescription rules,which is conducive to the study of prescription prescription rules and the excavation of new prescriptions.Combination of drugs based on association rules analysis and unsupervised data mining analysis of Wu,a professor at the drug for the treatment of diabetic kidney disease regularity,for clinical teaching and provides a clear clue,indicate the direction of the research,but has to be combined with the specific situation of the patients,the clinical syndrome differentiation and treatment,the lines,can be applied to clinical,achieve the desired effect.2.Currently,it is generally believed that the deficiency of qi and Yin is the dominant factor in the early stage of diabetic kidney disease,and both deficiency of qi and blood and Yin and Yang are observed in the late stage.Its disease place is with kidney as the center,often involve liver,spleen various dirty,late still can affect heart and lung,bring about five viscera all disease.Professor Wu treatment of this disease emphasizes that the disease is a mixture of deficiency and substance,or deficiency caused by deficiency,or deficiency caused by deficiency,deficiency caused by qi and Yin,or deficiency caused by spleen and kidney Yang,deficiency caused by qi and Yin,deficiency caused by qi and Yin,deficiency caused by Yin and Yang,deficiency caused by qi and Yin,deficiency caused by Yin and Yang,deficiency caused by Yin and Yang,deficiency caused by Yin and Yang,deficiency caused by Yin and Yang,deficiency caused by Yin and Yang.On the treatment of heart and kidney,tonifying qi Yin,turbid detoxification,spleen warming kidney and other methods.3.Wu treatment of this disease main ideas: one is to pay attention to the mediation of coke,clear and turbid,the second is to pay attention to the syndrome differentiation of qi and blood,the initial disease in qi,long in the blood in the collateral,so turbid and remove blood stasis should be throughout the treatment of this disease.