Research On Diagnosis And Treatment Of Diabetic Kidney Disease Under The Combination Of Disease And Syndrome Based On The Diabetes Structured TCM Hospital Records

Diabetic kidney disease (DKD) is one of the most common chronic complications of diabetes, and is the leading cause of end-stage renal disease,it has seriously affected the life-quality of the patients.Treating the DKD with Integrative Medicine has become a trend,the combination of disease and syndrome is main clinical treatment of Integrative Medicine Clinical.Objectives:To discuss the treatment law of the combination of disease and syndrome of DKD based on clinical data of the diabetes structured TCM hospital records acquisition system.Methods:1.Gather clinical data of DKD based on the system. Establish data warehouse through storing and processing data,Summarize the medical records which met the inclusion criteria through writing SQL statements,and divide them into13main data sheets,including basic information, chief complaint, the carved disease, past history, personal history, tongue and pulse diagnosis, physical examination, diagnosis, prescription, medicine, medical orders, physical and chemical indicators and all of the information. Overall verification of the total number of sample cases, the entire data table on the missing data, according to the paper-based medical records fill the record into random samples for verification.2.Pre-process the data through the combination of Man-Machine,the principle is:symptoms are in accordance with the National standards,Adopt specialist’s consensus or suggestions in special occasions.Data processing includes the process of the text and the number.The process of the text includes symptoms, diagnosis, medicine, prescription, doctor drugs, basic information, tongue and pulse diagnosis, personal history, past history, etc.The process of the numerical data includes all kinds of physical and chemical indicators.3.(1)Using SPSS19.0statistical analysis software for General descriptive statistics.Describe the mean, standard deviation, of the qualitative data quantitative data which are corresponded with normal distribution.Using frequency, composition ratio to describe the Qualitative data.use multi-frequency number of cross-table method in Multiple Indicator Combined Statistical classification.(2)Determine the evidence of the DKD through Discriminant analysis by computer.(3)Count the frequency of the common-use medicine in each stage.Research on common single herbs and the compatibility of two herbs, three herbs, four herbs which are commonly used compound in clinical Research the drug-using law in Chinese medicine using association rules in Clementine data mining platform.(4)Count the frequency of the symptoms of each stage,and combine them with the common used prescription and the indicators.Research the relationship among them through Bayesian network analysis in Clementine data mining platform.(5)Build up visible Scale-free network diagram of the symptoms,indicators and the use of drug of all cases.Using Medico/3S system to research the law of the Symptomatic medication and the Medication for indicators.Results:Valid cases432,363cases (age>50), accounting for the proportion of84.0%; BMI overweight (male BMI>25,female>24):298cases, accounting for69.0%of the proportion; duration of diabetes>10years,280cases, accounting for64.8%of the proportion; smokers are mainly men, and there are158cases of men with a history of smoking, accounting for73.5%of the proportion; suffering from hypertension:334cases, accounting for77.3%, after admission dyslipidemia in373cases, accounting for86.3%, glycosylated hemoglobin abnormalities:333cases, accounting for77.1%. Ages, BMI, duration of diabetes, smoking history, hyperlipidemia, hypertension, and poorly control of blood glucose are all related factors that affect DKD. Through Data Mining and man-machine combination, the following results were obtained:1.Clinical law of Combination of disease and syndrome:Early stage of DKD has three syndromes; those in common are dry mouth, fatigue, shortness of breath, frequent urination and blurred vision. Master symptom is Deficiency of both qi and yin accounting for45.39%; prescriptions are Shengmaisan, Shenqidihuang Tang, Liuweidihuang Tang. Secondly, Yin Deficiency and Heat card accounted for10.46%,prescriptions are Zhibaidihuang Tang, Qijudihuang Tang, TianmagoutengYin. The blood stasis accounted for18.95%; representative prescriptions are Salvia drink, Taohongsiwu Tang.The interim stage of DKD has three syndromes,its common performances are dry mouth, polydipsia, fatigue, insomnia, limb edema, nocturnal, numbness. Main syndrome is Deficiency of both qi and yin,accounted for31.93%, prescriptions are ShengmaiSan, Shenqidihuang Tang, Liuweidihuang Tang.23.53%followed blood stasis due to qi deficiency. Representative prescriptions are Bu yanghuanwu Tang, Salvia drink, Taohongsiwu Tang. Phlegm stasis syndrome accounted for15.13%, prescriptions Wuling San, Shenlingbaizhu San, Wendan Tang.Late stage of DKD has three syndromes,the common manifestations are dry mouth, fatigue, chills, chest tightness, shortness of breath, palpitations, swollen limbs and limb pain. Deficiency of both yin and yang and Yang deficiency and blood stasis accounted for26.89%each. Representative prescriptions of the former are Shenqiwan, shenqimaiweiDihuang Tang. Representative prescriptions of the latter are Shenqiwan Dangguishaoyao San. Accumulation of fluid caused by insufficiency of Yang accounts for10.08%, prescriptions are Zhenwu Tang, Lingguizhugan Tang.2.Disease and syndrome drug card relationship:association rules and scale-free networks analysis showed that reflect the basic theory of traditional Chinese medicine for the symptoms of drug use, such as Achyranthes-low back pain, and more food-berberine dysuria-dangshen, and Zeeland, rhubarb, and for the physical and chemical the indicators medication reflects the modern treatment of the theory and pharmacological research, such as lowering urine protein:Astragalus root, Salvia.Conclusion:According to the principle of combining disease and syndrome, DKD clinical can be divided into three phases,every phase has three syndromes. Treat DKD according to the phase and symptoms are corresponding with the clinical.The law of the use of Drug includes the treatment of symptomatic treatment and for the physical and chemical indicators, reflecting the basic theory and modern treatment of TCM theory, the results of pharmacological studies. Appropriate statistical data mining method is an effective mean in the research of the DKD disease and syndrome clinic law.