Analysis On Medication Rule In Prescriptions For Idiopathic Membranous Nephropathy Of Chief Physician Ma Hongjie Based On Data Mining

Objective:This study aims to provide a reference for the treatment of idiopathic membranous nephropathy(IMN)by collating the medical records of Chief physician Ma Hongjie's outpatient treatment of IMN,using data mining technology to analyze medication rules in the prescription,and exploring the clinical experience and academic thought of Chief physician Ma Hongjie.Methods:From January 2014 to August 2019,the medical records of patients with IMN who were treated with traditional Chinese medicine(TCM)in the outpatient department of Chief physician Ma Hongjie in the First Teaching Hospital of Tianjin University of TCM were used as the data source for this study.According to the inclusion and exclusion criteria,360 prescriptions were finally collected.Those prescriptions were analyzed by the method of unsupervised data mining and frequency statistics,such as association rules and clustering algorithms,using Excel and TCMISSV2.5.After statistics on the medical records and data mining,results were obtained to explore the medication rule in prescriptions for IMN of Chief physician Ma Hongjie.Results:1.This study collected 97 patients with a total of 360 prescriptions.The male to female ratio was 1.55: 1,with the youngest aged 19 and the oldest 77.The average onset age was 50.99±14.86,and the age of "50 ? 59" was the highest incidence age group.2.Chief physician Ma Hongjie's prescription for IMN has significant curative effects.The overall medicinal properties are moderate and peaceful.The five flavors are mainly sweet and bitter.Hepatic and renal medicinal drugs are mostly used,mainly tonic medicine,diuresis,Dampness dispelling drugs,promoting-circulation drugs and so on.Among them,Astragalus and Atractylodes are used most frequently.Other high-frequency drugs include Dioscorea Spongiosa,Radix Rehmanniae,Herba Polygoni Avicularis,Cornus,Chinese yam,Leech,Viscum,Stephania tetrandra S.Moore,Eucommia ulmoides Oliv,Grass leaved Sweetflag,tuckahoe,Herba Dianthi,etc.3.Analyzing by the method of association rules,Herb combinations for IMN which Chief physician Ma Hongjie use frequently are Astragalus-Atractylodes,Dioscorea spongiosa-Herba Polygoni Avicularis,Cornus-Radix Rehmanniae.4.The 5 groups of new prescriptions generated by cluster analysis are as follows.New prescription 1 including Lophatheri Herba,Spine Date Seed,Leech,Achyranthes root.New prescription 2 including scutellaria,taraxacum,Atractylodes,Xanthium.New prescription 3 including Imperatae Rhizoma,Herba Polygoni Avicularis,Charcoal of Honeysuckle,Dioscorea Spongiosa,Madder.New prescription 4 including scutellaria,Bupleurum,Radix Rehmanniae,Cornus,Chinese yam,Cortex Moutan,Tuckahoe.New prescription 5 including Stephania tetrandra S.Moore,Herba Dianthi,Polyporus,Cortex Mori,Cherokee rose,Euryale Ferox,Nelumbinis Stamen.5.Chief physician Ma Hongjie's treatment of IMN is mild,with incidental and fundamental in combination,mainly based on TCM dialectical treatment.In deficiency syndrome,the spleen-kidney Qi deficiency syndrome is the most common and liver-kidney Yin deficiency syndrome is the least.In excess syndrome,the blood stasis syndrome is most common,and the least damp pathogen syndrome.As the course of disease increases,the distribution of TCM syndromes in each stage varies.6.The most common complications involved in this study are acute upper respiratory infections,urinary tract infections,thrombotic diseases,and hematuria.For patients with acute upper respiratory tract infection,in addition to basic treatment,chief physician Ma Hongjie use mentha,periostracum cicadae,radix saposhnikoviae and so on.Honeysuckle,forsythia,taraxacum are commonly used for detoxification.Patient with urinary system infection often use polyporus,white gourd peel,cortex mori,Herba Polygoni Avicularis,coicis semen,dioscorea spongiosa,Stephania tetrandra S.Moore,Imperatae Rhizoma,Lophatheri Herba,Grass leaved Sweetflag.When combined with thrombotic diseases,chief physician Ma Hongjie uses leeches,lycopi herba,etc.For those with hematuria,use platyclade cacumen,Charcoal of Honeysuckle,nelumbinis rhizomatis nodus,cirsii herba,agrimoniae herba,Imperatae Rhizoma,etc.Conclusions:1.Chief physician Ma Hongjie's prescription for IMN has significant curative effects.The overall medicinal properties are moderate and peaceful.The five flavors are mainly sweet and bitter.Hepatic and renal medicinal drugs are mostly used,mainly tonic medicine,diuresis,Dampness dispelling drugs,promoting-circulation drugs and so on.Herb combinations for IMN which Chief physician Ma Hongjie use frequently are Astragalus-Atractylodes,Dioscorea spongiosa-Herba Polygoni Avicularis,Cornus-Radix Rehmanniae.The 5 groups of new prescriptions generated by cluster analysis still need to be evaluated by clinical experts and tested by practice.2.Chief physician Ma Hongjie believes that root deficiency and branch excess is the mechanism of IMN in theory of TCM.The deficiency syndrome is related to spleen,lung,kidney,liver and other organs.The excess syndrome is related to damp-heat,turbid phlegm,blood stasis,etc.Therefore,the treatment is mild,with incidental and fundamental in combination.,mainly based on TCM dialectical treatment.In deficiency syndrome,the spleenkidney Qi deficiency syndrome is most common and liver-kidney Yin deficiency syndrome is least.In excess syndrome,the blood stasis syndrome is most common,and least damp pathogen syndrome.In the later period,the wet,turbid,and stasis intersect,and there is a case of yin deficiency.The common complications involved in this study are acute upper respiratory infections,urinary tract infections,thrombotic diseases,and hematuria.Chief physician Ma Hongjie change and reorganize the basic prescription,and takes those comorbidities into account,using TCM dialectical treatment.