Professor Wang Baokui's Medication Rules And Experience In The Treatment Of Idiopathic Membranous Nephropathy

BACKGROUND:Idiopathic membranous nephropathy(IMN)is one of the most common pathological types of adult nephrotic syndrome and one of the major glomerular diseases leading to end-stage renal disease in adults.Its pathological feature is the deposition of a large number of immune complexes on the glomerular capillary epithelial side,resulting in thickening of the glomerular basement membrane,impaired podocyte function,destruction of the glomerular filtration barrier integrity,and the emergence of large amounts of proteinuria.A large amount of proteinuria and its duration are important factors influencing the prognosis of patients with IMN.At present,Western medicine treatment is treated with glucocorticoids and cytotoxic or immunosuppressive agents.These kind of mediicines have many adverse reactions,while the current clinical efficacy is not satisfactory.In traditional Chinese medicine treatments,most doctors include IMN in the categories of“kidney wind”,“urinary turbidity”,"edema",and“virtual labor" currently.Based on years of clinical experience and research,My tutor,Professor Wang believes that the pathogenesis of IMN is Deficiency-excess mixing,spleen and kidney deficiency,wind and heat into the kidney,he prove the method of“fuzhengqufeng”to treat IMN.Pre-clinical experiments have confirmed that this method can effectively reduce proteinuria in patients with IMN,relieve its clinical symptoms and delay disease progression.At present,there are still some shortcomings in the systematic research on Professor Wang Bakui's treatment of IMN.OBJECTIVE:This study uses real-world research methods to explore the treatment of IMN by Professor Wang Baokui through frequency analysis,cluster analysis,association rules and other data mining methods,and summarizes clinical experience to provide reference for clinical treatment of IMN.METHODS:The basic information and medical data of 72 patients with IMN who were treated by Professor Wang Baokui during the period from December 2015 to June 2018 at Dongfang Hospital of Beijing University of Traditional Chinese Medicine were collected.By use of IBM SPSS Statistics 20.0 and IBM SPSS Modeler 16.0 software,data mining was performed on prescription drugs using methods such as frequency analysis,cluster analysis,and correlation rules.RESULTS:A total of 188 prescriptions for 62 patients with IMN were collected in this study,involving a total of 136 flavors of traditional Chinese medicine.First,select the frequency analysis of high frequency drugs with frequency>15,from high to low:heat-clearing medicine,rheumatism medicine,tonic medicine,blood-activating medicine,astringent medicine,qi-regulating medicine,nourishing medicine,digestion medicine,chemical Wet medicine,water-disinhibiting medicine.Second,through cluster analysis,5 cluster groups were obtained to participate in the effects of spleen and kidney,phlegm and blood stasis,nourishing yin and tonifying blood,clearing away heat and detoxifying,promoting blood circulation and removing blood stasis.Third,through the analysis of drug association rules,the most relevant drugs were obtained to help the body tonic,nourishing yin and clearing away heat,removing wind and collaterals,promoting blood circulation and removing blood stasis.The drugs with the highest degree of support is Astragalus membranaceus-Anemarrhena,,and the most reliable drugs is Caulis spatholobi,Herba swallows-Rhizoma dioscoreae nipponicae.CONCLUTION:Professor Wang combined with years of experience in clinical diagnosis and treatment,that the basic pathogenesis of IMN is spleen and kidney deficiency,and wind and heat into the kidney.At the time of treatment,it is the basic method of tonifying kidney and hurricane,and taking the Astragalus membranaceus,Anemarrhena,Caulis spatholobi,Herba swallows,Rhizoma dioscoreae nipponicae etc as the basic foundation,giving patient guidance to the patient's diet while treating.This article summarizes the experience and insights during the study with the teacher,and data mining for Professor Wang Bakui's treatment of IMN's repatriation medication.It is of great significance to implement the modern data collation method to realize the entry,management and analysis of the old Chinese medicine prescriptions,to study the prescriptions of the treatment of idiopathic membranous nephropathy and to discover new prescriptions.