Research On Zhao Jinxi's Experience In Treating Diabetic Nephropathy And His Experience In Treating Diabetic Nephropathy Based On Data Mining

Background: Diabetic kidney disease(DKD)is chronic kidney disease caused by diabetes,which is one of the most common microvascular complications of diabetes.Renal disease caused by diabetes is the most common cause of chronic renal failure worldwide,and the main single cause of end-stage renal disease(ESRD).Professor Zhao Jinxi has been engaged in the treatment of diabetes and its complications for a long time and has accumulated rich clinical experience.Objective: To analyze and make statistics on professor Zhao Jinxi experience in treating DKD by data mining,and analyze the data of ‘treating DKD by wind' method,so as to comprehensively learn professor Zhao Jinxi experience in treating DKD,and inherit and spread the academic thoughts of experts.Methods: We collected the medical cases treated by professor Zhao Jinxi in Dong Zhi Men hospital from January 1,2016 to December 31,2018.The four diagnostic information,symptoms and names of the herb drugs are standardized.MATLAB 2016 b was used to conduct statistics on the basic information of medical cases,the four diagnostic information,and the four qi,five flavors,converge to the meridian,classification of efficacy and dose of drugs.Apriori association rule was used for analysis,and SPSS was used for cluster analysis of prescriptions,so as to analyze the core syndromes,the core combination and use rules of drugs.The Traditional Chinese Drugs Inheritance Support System(V2.5)was used to conduct entropy clustering method for drug discovery and analysis the potential new prescriptions.Results: Among the cases included in this study,92 patients are finally included,with a total of 104 cases and 104 prescriptions.Among them,there are 25 cases in the early stage of DKD,accounting for 24.0%.15 cases(14.4%)of DKD are in the middle stage.There are 64 patients with advanced DKD,accounting for 61.5%.According to the CGA staging standard,41 cases are in G1 or G2 stage,accounting for 39.4%.There are 29 cases in G3 stage,accounting for 27.9%.There are 24 cases in G4 stage,accounting for 23.1%.There are 10 cases in G5 phase,accounting for 9.6%.There are 3 cases in A1 stage,accounting for 2.9%.There are 31 cases in A2 stage,accounting for 29.8%.There are 70 cases in A3 stage,accounting for 67.3%.There are 1 case in the low-risk group,25 cases in the medium-risk group,18 cases in the high-risk group and 60 cases in the extremely high-risk group.The correlation between the stages of traditional Chinese and western drugs shows that there is a high degree of confidence between the group with moderate risk of DKD and the group with early stage of DKD diagnosed by traditional Chinese drugs,the group with high risk of DKD and the group with middle stage of DKD diagnosed by traditional Chinese drugs,and the group with high risk of DKD and the group with late stage of DKD diagnosed by traditional Chinese drugs.Symptoms from more to less followed by weak,foam urine,dry mouth,edema,blurred vision,numbness and so on.The results showed that the main syndromes of DKD are qi and Yin deficiency and blood stasis,which accounted for 79.8% of all cases.The most common syndromes are turbidity,followed by Yin deficiency,damp-heat,and phlegm.In the early and middle stages,the main syndromes of DKD are qi and Yin deficiency and blood stasis,accounting for 60% of the total cases in the early and middle stages,among which Yin deficiency syndrome and blood stasis syndrome are the most.The syndromes with multiple syndromes are dampness-heat,hyperactivity of liveryang,phlegm and heat with Qi depression.The main advanced DKD syndromes was qi-Yin deficiency and blood-stasis syndrome,accounting for 92.2% of the total cases.In addition,there are many other syndromes,including dampness,fluid,damp-heat,phlegm and Gastrointestinal heat.Professor Zhao Jinxi's most commonly used drugs in treating DKD are Huang Qi,Dan Shen,Tu Fu ling,Bi Xie,Dang Gui,etc.In the aspect of medicinal property and taste,more cold,warm and flat drugs are selected,the dosage of cold drugs was slightly more than warm drugs,and the application of cool and hot drugs was less.The main drugs flavors are pungent,bitter and sweet.In terms of converge to the meridian,the highest frequency of drugs is meridian of liver,followed by meridian of lung,spleen,stomach,heart and kidney.In the early and middle stage,the most commonly used drugs are Gan Cao,Guang Qin,Bai Shao,Chai Hu,etc.The drug with the most commonly used in the late stage are Huang Qi,Tu Fu Ling,Dan Shen,Bi Xie,Dang Gui,etc.The most commonly used drugs in the dampness syndrome are Huang Qi,Bi Xie,Dang Gui,Shi Wei,etc.The most commonly used drugs in the fluid syndrome are Huang Qi,Tu Fu Ling,Bi Xie,Dang Gui,Shi Wei,etc.The most commonly used drugs in the damp-heat syndrome are Tu Fu Ling,Huang Qi,Bi Xie,Shi Wei,Dan Shen,etc.The most commonly used drugs for phlegm syndrome include Dan Shen,Huang Qi,Fa Ban Xia,Chen Pi,Dang Gui,etc.Professor Zhao Jinxi's most commonly used drugs for DKD are tonifying deficiency drugs,heat-clearing drugs,blood-activating drugs,water-promoting drugs and exterior-relieving drugs.Professor Zhao Jinxi's core drug combination for the treatment of DKD involved 12 core drugs,Huang Qi,Dang Gui,Dan Shen,Chuan Xiong,Tu Fu Ling,Bi Xie,Shi Wei,Chuan Shan Long,Jiang Can,Chan Tui,Jiang Huang,cooked Da Huang.At the center of the core of drugs are Huang Qi,Dang Gui,Dan Shen,Chuan Xiong,Tu Fu Ling,Bi Xie.Professor Zhao Jinxi's most commonly used drug pairs are Chan Tui and Jiang Can,Tu Fu Ling and Bi Xie,Jiang Can and Jiang Huang,Shi Wei and Huang qi,which on behalf of the Tonify Qi,dispel the wind and resolving turbidity therapies.Professor Zhao Jinxi's most commonly used drug combinations bunches are Jiang Huang,cooked Da Huang,Chan Tui,Jiangcan,and Sang Ji Sheng,Gou Ji,Xu Duan,and Ju Hua,Xia Ku Cao,Sang Ye,and so on.Through unsupervised entropy hierarchical clustering analysis,the most valuable new prescriptions as follows: 1.Huang Qin,Chai Hu,Bei Sha Shen,Zhi Mu,Jie Geng 2.Huang Qi,Chuan Xiong,Jiang Can,Jiang Huang,Chan Tui,Shu Da Huang,Xia Ku Cao.According to the research on "treating from the wind",professor Zhao Jinxi always use wind drugs in treating DKD.The commonly used wind drugs consists of three categories: wind-damp-dispelling drugs,drugs for extinguishing wind to arrest con,as well as drugs for relieving exterior disorder.The most commonly used wind drugs includes Chan Tui,Jiang Can,Sang Ye,Ju Hua.In the early stage of DKD,drugs for relieving exterior disorder are mostly used,while in the middle stage,wind-damp-dispelling drugs are mostly used.The drugs for extinguishing wind to arrest con are majority used in the late stage of DKD.Conclusion: The most common main syndromes of DKD are qi and Yin deficiency and blood stasis syndromes,while the most common combination syndromes are dampness,damp-heat,phlegm and gastrointestinal heat.In the early stage of DKD,damp-heat and heat,phlegm and dampness,hyperactivity of liver-yang and other syndromes are more common,while in the late stage,dampness,fluid,and damp-heat are more common.The correlation between Chinese medicine staging and CGA staging is strong,indicating that Chinese staging of DKD has certain value in predicting the prognostic risk.According to the statistics of efficacy,the most commonly used drugs for the treatment of DKD are tonifying deficiency drugs,heat-clearing drugs,drugs for activating blood circulation,drugs for promoting water infiltration,and drugs for dispelling wind and pathogenic factors.The results showed that professor Zhao Jinxi paid attention to the strengthening body resistance as well as eliminating evil in treating DKD.The core of Professor Zhao Jinxi's drug combination are Huang Qi,Dang Gui,Dan Shen,Tu Fu Ling,Bi Xie,which can strengthen body resistance and activating blood circulation.The commonly used drug pairs and bunches are Sang Ji Sheng,Xu Duan,Tu Fu Ling,Bi Xie,Shi Wei,Sang Ye,Ju Hua,Jiang Can,Chan Tui,Jiang Huang,cooked Da Huang and so on.Professor Zhao Jinxi usually use wind medicine in treating DKD.The commonly used wind medicine includes drugs for relieving exterior disorder,wind-damp-dispelling drugs,and drugs for extinguishing wind to arrest con.The commonly used wind medicine includes Chan Tui,Jiang Can,Niu Bang Zi,Sheng Ma,Sang Ye,etc.Wind drugs not only plays the role of winddamp-dispelling,but also has the effect of raising Yang qi,promoting qi and blood,promoting heat,gasifying dampness and so on.