Research On The Prescription Pattern Of Professor Fu Bin In Treatment For Chronic Kidney Disease By Harmonization Method Based On Date Mining

Background: Chronic kidney disease(CKD)refers to the abnormal structure or function of the kidney,and its pathogenesis is complex and diverse.The disease and its end-stage renal disease(ESRD)have a serious impact on people’s life,health,safety and quality of life.The prevalence of this disease is increasing year by year,with high cost and poor prognosis.At present,modern medicine has achieved remarkable results in the treatment of CKD,mainly for the treatment of primary diseases,prevention and treatment of serious complications.Modern pharmacological research and a large number of clinical and animal experimental studies have found that traditional Chinese medicine has its unique advantages in the prevention and treatment of CKD,so it is of great significance to study the treatment of CKD with traditional Chinese medicine.Professor Fu Bin has been a doctor for more than 30 years.He has devoted himself to the treatment and research of traditional Chinese medicine for CKD.He has accumulated rich experience in the treatment of CKD.He advocates the method of harmony in the treatment of CKD and has achieved good results.The author had the honor to study with Professor Fu Bin for three years,and deeply felt the remarkable effect of the method of harmony in the treatment of CKD.Objective: To summarize Professor Fu Bin’s prescription and medication rule in the treatment of CKD,to explore his medication experience and academic thinking,and to provide objective basis for clinical practice.Methods: According to the inclusion and exclusion criteria,82 cases of CKD treated by Professor Fu Bin were selected.And the patient’s name,gender,age,diagnosis,prescription and other information were input into the Software v1.1 of "TCM inheritance auxiliary system",and the statistical analysis was carried out after verification.The statistical contents include general statistics(gender and age distribution of patients),case inclusion Statistics(primary disease distribution,CKD staging distribution),frequency statistics(including medication frequency,four Qi,five flavors,meridian tropism frequency,etc.),association rules and cluster analysis(and new formula analysis based on clustering).Results:1 General situation: In the 82 medical records included,there are 38 male patients and 44 female patients.The ratio of men and women is about 1: 1.16.In terms of age,there were 1under 20 years old,3 between 20 and 29 years old,7 between 30 and 39 years old,12 between 40 and 49 years old,24 between 50 and 59 years old,28 between 60 and 69 years old,6 between 70 and 79 years old,and 1 over 80 years old.2 Inclusion of cases: Among the 82 patients included,the primary diseases were counted.The most common primary disease was chronic nephritis,followed by diabetic nephropathy,nephrotic syndrome and so on.Among the 82 patients included in this study,GFR was estimated according to serum creatinine,and the number of patients with CKD1-5stage was 21,20,29,7 and 5,respectively.3 Frequency of medication: 194 herbs were obtained by analyzing 408 prescriptions and6670 times were used.Among them,53 herbs were used with frequencies more than 40 times.The top ten Chinese herbs with frequencies were: licorice,scutellaria,Poria cocos,Salvia miltiorrhiza,cucurbita,Achyranthes bidentata,astragalus,shiwei,tuckahoe,fried Radix rapae.4 The frequency of medicinal property,flavor and meridian: In the analysis of four-qi,cold drugs were the most,followed by gentle and warm drugs,and cool and heat drugs were less used.In the analysis of five flavors,sweet,bitter and spicy drugs were most used,while acid,salty and astringent drugs were less used.In the meridian analysis,the drugs that return to the liver,lung,and spleen are the most.5 Classification of commonly used Chinese medicines: Common Chinese medicines are divided into 15 categories,which are distributed according to frequency as follows: tonifying deficiency drugs,heat-clearing drugs,diuresis and dampness drugs,blood-activating and stasis-removing drugs,reconciling drugs,exterior-relieving drugs,Qi-Regulating drugs,Liver-Calming and Wind-Extinguishing drugs,food-killing drugs,rheumatism-dispelling drugs,astringent drugs,hemostatic drugs,purgative drugs,phlegm-resolving cough-relieving and humidifying drugs.6 Rule analysis of the formula: Through the association rule analysis of all prescription drugs,the commonly used drug pairs are screened out: Polygonum cuspidatum and fenugreek,Hedyotis diffusa and Poria cocos;the most core of prescription is: Astragalus,fenugreek,Scutellaria baicalensis,Poria cocos,Poria,Shiwei,Salvia,Achyranthes,Licorice;the core ofprescription is: Astragalus,fenugreek,baicalin,soil Poria,cicada slough,Poria,Shiwei,Polygonum cuspidatum,silkworm sand,salvia,Achyranthes,fried laver,Licorice.Based on complex entropy clustering analysis,16 core combinations of 3-4 kinds of drugs were extracted,and on the basis of the above core groups,through unsupervised entropy hierarchical clustering algorithm,eight new combinations were obtained.7 According to the analysis of CKD stages,the core drugs in CKD1 stage are: Scutellaria baicalensis,Poria cocos,Hedyotis diffusa,Poria cocos,Shiwei,Achyranthes bidentata,Scutellaria chinensis,fried radish,orange peel and licorice;the core drugs in CKD2 stage are:Scutellaria baicalensis,cicada molt,Poria cocos,Poria cocos,Shiwei,Silkworm sand,Radix Salviae miltiorrhizae,Achyranthes bidentata,Lycium barbarum,Huangjing,orange peel and licorice;the core drugs in CKD3 stage are: Cucur Ba,Astragalus membranaceus,Scutellaria baicalensis,Centella asiatica,Poria cocos,Shiwei,Polygonum cuspidatum,Silkworm sand,Yinchen,Salvia miltiorrhiza,Achyranthes bidentata,raw rhubarb,Licorice;CKD4-5 core drugs are: Cucurbita,Astragalus membranaceus,Huangqin,Centella asiatica,Silkworm sand,Polygonum cuspidatum,Yinchen,Salvia miltiorrhiza,Radix Rhubarb,Rhubarb,Orange shell,Perilla leaf,Calcined oyster,Licorice.The distribution rules of four qi,five flavors and meridian attribution of drugs in each stage of CKD were basically consistent with the overall distribution.Conclusion:1 In the treatment of CKD,we can discover that the drugs used by Professor Fu Bin are mainly tonic,heat-clearing,dampness promoting and blood activating drugs in various stages.It is a combination of attack and ivertonic,cold and warm,bitter opening and descending.Specifically,CKD1 phase focuses on spleen and kidney,exterior and interior,and Qi and blood;CKD2 phase uses bitter opening and descending;CKD3 phase uses cold and warm;CKD4-5 phase uses attack and supplement simultaneously,tonic and diarrhea in the same way.2 In the treatment of CKD,Professor Fu Bin combines the treatment of bitter opening and descending,cold and warm,attack and supplement,and tonic and purgative,which embodies the essence of "harmony method".At the same time it reflects that harmony method is the treatment of CKD for Professor Fu Bin.