Study On Medication Rules For Diabetic Kidney Disease And Application Of Medicines To Replenish Deficiency Based On Data Mining

Objective: Based on the collected effective TCM prescriptions(2016-2020)of diabetic kidney disease(DKD),this paper uses data mining technology and related TCM theories,and mainly analyzes the compatibility applications of the tonic drugs.It aims to summarize the characteristics and prescription rules of the current Chinese medicine treatment of DKD,and analyze the medication regularity and dose of tonic medicines for this disease.It is expected to contribute to the clinical rational use of drugs in the treatment of DKD.Methods:1.Set related inclusion criteria.Based on the criteria,search for related documents that have been published in CNKI,Wanfang,and VIP in the past five years.Then,establish the original database and the database of tonic drugs after collation.2.Based on the original database,use TCMISS(V2.5)to conduct a frequency analysis to obtain the high-frequency drugs,their properties,flavors,and meridians.The distribution of tonic drugs are also analyzed.3.Record the ingredient dosages of high-frequency tonic drugs and use SPSS 21.0 to analyze the recorded data.4.Based on the original database and tonic drug database,conduct the association rule analysis and cluster analysis to obtain the commonly-used medicine pairs and combinations,and new prescriptions.Results:1.724 papers and 749 prescriptions were included in the original database,involving 283 Chinese medicines. In terms of frequency,the top 10 medicines were astragalus,salvia,yam,poria,dogwood,dried rehamnnia root,rhizoma alismatis,angelica,atractylodes,and rhubarb,accounting for 39.16% of the total frequencies. In terms of medicine category,tonic medicines were mostly applied,followed by medicines for invigorating blood circulation and eliminating stasis. As for the four properties,the included medicines were mainly warm,cold,or mild.And for the five tastes,they were mainly sweet,bitter,or pungent. In terms of meridian tropisms,they mainly belonged to the liver,spleen,and kidney meridians,followed by the heart,lung,and stomach meridians. 39 medicine pairs or combinations and 42 association rules were found through the association rule analysis,involving 13 Chinese medicines. 38 potential core prescriptions and new prescriptions were obtained through the entropy clustering analysis.2.79 Chinese medicines were included into the tonic medicine database.They were classified into the following categories based on the function:Qi-tonifying,hematinic,Yin-tonifying,Yang-tonifying,and other medicines(dampness-reducing tonic medicine,heat-clearing tonic medicine,warm-inside and warm-middle tonic medicine,astringency-induction and essence-securing tonic medicine,Qi-regulating and digestant tonic medicine,blood-activating tonic medicine,and heart-nourishing and tranquilizing tonic medicine).The total usage frequency of tonic drugs accounted for 59.57% in the original database.The dosage of the top 5frequently-used medicines were as follows: Astragalus: The therapeutic window was 5-93 g,19 dose points were involved,and the mean dose was 30.08±11.60 g.P10-P90 were15-50 g.The most commonly used dose was 30 g,accounting for56.53%. Yam: The therapeutic window was 6-30 g,10 dose points were involved,and the mean dose was 17.92±6.31 g.P10-P90 were 10-30 g.The most commonly used dose was 15 g,accounting for 37.89%. Poria: The therapeutic window was 5-30 g,13 dose points were involved,and the mean dose was 15.95±5.55 g.P10-P90 were10-24.6g.The most commonly used dose was 15 g,accounting for43.19%. Dogwood: The therapeutic window was 3-30 g,10 dose points were involved,and the mean dose was 13.71±4.58 g.P10-P90 were 10-20 g.The most commonly used dose was 15 g,accounting for 34.59%. Dried rehamnnia root: The therapeutic window was 5-60 g,11 dose points were involved,and the mean dose was 16.46±6.24 g.P10-P90 were 10-25 g.The most commonly used dose was 15 g,accounting for44.02%.Through the association rule analysis,we found 20 tonic medicine pairs or combinations with high frequency,36 association rules,and 9 involved core medicines.Based on the entropy clustering analysis,we obtained 18 potential core prescriptions and 9 new prescriptions.Conclusion:1.DKD is of asthenia in origin and enrichment in symptom.The asthenia in origin for DKD is mostly qi deficiency and yin deficiency.The enrichment in symptom is mostly represented with blood stasis,dampness,and damp-heat.The disease is located in the kidney and is closely related to the spleen and liver.2.The treatment method is mainly based on tonifying qi and nourishing yin,promoting blood circulation and removing blood stasis,as well as dispelling dampness and turbidity,clearing heat,and solidification.It embodies the treatment principle of invigorating deficiency and reducing excessiveness.3.Tonic medicines,and medicines promoting blood circulation and removing blood stasis are commonly used in the treatment of DKD.In terms of medicine combination,tonic medicines are often adopted together with blood-activating medicines,heat-clearing medicines,damp-clearing and diuresis-promoting medicines,and astringent drugs.4.For tonic medicines,the followings are commonly used: Qi-tonifying medicine,astringency-induction and essence-securing tonic medicine,dampness-reducing tonic medicine,hematinic,and Yin-tonifying medicine.5.Tonic medicines with high frequency have a flexible dose treatment window.Large doses are normally adopted,instead of small doses,and over-dose is very common.6.The new prescriptions obtained from the two databases are of certain guiding significance for the clinical treatment of DKD.Their efficacy needs to be further verified by a large number of clinical trials.