Study On Traditional Chinese Medicine Regularity For The Treatment Of Primary Retintis Pigmentosa

Objective.To summarize the medication pattern of primary retinitis pigmentosa(RP)treated by our supervisor,Dr.Chao Guojun,through data mining,to explore potential drug combinations and combinations,to summarize RP treatment ideas,to pass on RP treatment experience,and to provide reference for clinical prescriptions and medications.Methods.Medical records of RP inpatients treated by mentors from 2016.01 to 2020.12 were selected.Eligible medical records were screened to establish a database of RP medical records information.After organizing the data,we used "symptom statistics","four QI statistics" and "five WEI statistics" in the"statistical analysis"module of the TCM inheritance computing platform(V3.0)."Five WEI statistics","meridian tropism statistics","efficacy statistics" and "prescription analysis".The"association rule" and "cluster analysis" functions in the "prescription analysis"module were used to mine the medical records in the RP information database.Results.General:A total of 440 cases of primary retinitis pigmentosa were collected.The youngest of them was 8 years old and the oldest was 85 years old,with an average age of 46.99±13.76 years.Gender:215 cases(48.86%)were male and 225 cases(51.14%)were female.Symptoms:According to the results of evidence statistics,among 440 RP patients,there were 335 cases(76.14%)with evidence of spleen-kidney yang deficiency,80 cases(18.18%)with evidence of liver-kidney yin deficiency,and 25 cases(5.68%)with evidence of qi deficiency and blood stasis.Medication use:The medical records of 440 RP cases involved a total of 156 types of drugs,with a cumulative medication frequency of 8347 times.The frequency of use exceeded 100 for 26 species,and their cumulative frequency of use accounted for 83.77%of the total frequency of use,mainly for deficiency medicines.The frequency of drug use was different for each type of evidence.① Spleen and kidney Yang deficiency type:Poria cocos(96.12%),Glycyrrhiza uralensis(94.33%),Angelica sinensis(94.33%),Radix astragali(91.04%),Codonopsis pilosula(91.04%),Ligusticum chuanxiong Hort(90.15%)as high frequency drugs.(2)Yin deficiency of liver and kidney:Angelica sinensis(91.25%),fructus lycii(90.00%),Radix Rehmanniae(70.00%),semen cuscutae(68.75%),Ligusticum chuanxiong Hort(68.75%)),Poria cocos(62.50%),Radix Puerariae(60.00%),etc.as high frequency drugs.③Qi deficiency and blood stasis type:Angelica sinensis(88.00%),Poria cocos(76,00%),radix paeoniae alba(76.00%),Radix astragali(76.00%),Ligusticum chuanxiong Hort(72.00%),Atractylodes macrocephala(64.00%),Codonopsis pilosula(60.00%),fructus lycii(60.00%)as HF drugs.Association rules:21 groups of drug combinations with a simultaneous frequency of>300 and a probability of simultaneous occurrence of≥95%were obtained.Cluster analysis:Cluster analysis was performed on the medical records of different evidence types according to the identification typology,and six groups of clustered prescriptions were obtained for each evidence type,and for the spleen-kidney-yang deficiency type.①Poria cocos,Codonopsis pilosula,Glycyrrhiza uralensis,Atractylodes macrocephala,Angelica sinensis,Ligusticum chuanxiong Hort,Fructus Psoraleae,Radix astragali.②Glycyrrhiza uralensis,Angelica sinensis,Atractylodes macrocephala,Fructus Psoraleae,Poria cocos,Ligusticum chuanxiong Hort,radix paeoniae alba,Atractylodes lancea.③Codonopsis pilosula,Angelica sinensis,Ligusticum chuanxiong Hort,Atractylodes macrocephala,Poria cocos,Glycyrrhiza uralensis,Ramulus Cinnamomi,Radix astragali.④Poria cocos,Codonopsis pilosula,Glycyrrhiza uralensis,Radix astragali,Angelica sinensis,Ligusticum chuanxiong Hort,Fructus Psoraleae,Radix Puerariae.Radix Puerariae.⑤Codonopsis pilosula,Poria cocos,Fructus Psoraleae,Glycyrrhiza uralensis,Angelica sinensis,Radix astragali,Atractylodes macrocephala,Ligusticum chuanxiong Hort.Ligusticum chuanxiong Hort.⑥Angelica sinensis,Poria cocos,Codonopsis pilosula,Glycyrrhiza uralensis,Atractylodes macrocephala,Radix astragali,Saussurea involucrata,Radix paeoniae alba.Liver and kidney yin deficiency type:① fructus lycii,Angelica sinensis,Fructus Broussonetiae,semen cuscutae,Radix Rehmanniae,radix paeoniae alba,Saussurea involucrata,Prunella Vulgaris L.Prunella Vulgaris L.②Angelica sinensis,fructus lycii,Radix Rehmanniae,Poria cocos,Ligusticum chuanxiong Hort,semen cuscutae,radix paeoniae alba,Fructus Broussonetiae.③ fructus lycii,Radix Puerariae,Angelica sinensis,Poria cocos,Ligusticum chuanxiong Hort,Atractylodes macrocephala,radix paeoniae alba,semen cuscutae.④Angelica sinensis,Radix Rehmanniae,semen cuscutae,Poria cocos,Scutellaria baicalensis Georgi,fructus lycii,Fructus Broussonetiae,Panax notoginseng powde.⑤ Angelica sinensis,Ligusticum chuanxiong Hort,fructus lycii,Radix Rehmanniae Preparata,Dendrobium,semen cuscutae,Fructus aurantii,Semen Cassiae.⑥ Angelica sinensis,Fructus Corni,fructus lycii,Radix Rehmanniae Preparata,semen cuscutae,Ligusticum chuanxiong Hort,Dendrobium,Chinese yam.Qi deficiency and blood stasis type.①Poria cocos,Atractylodes macrocephala,Salvia miltiorrhiza,Codonopsis pilosula,Radix Puerariae,Radix astragali,Hawthorn,Glycyrrhiza uralensis.②Angelica sinensis,Poria cocos,fructus viticis,Cimicifuga foetida,Qianglong,Codonopsis pilosula,Glycyrrhiza uralensis,Radix Bupleuri.③ Radix paeoniae alba Safflower,Panax notoginseng powde,mulberry,Prunella Vulgaris L,Angelica sinensis,Gentiana Dahurica Fisch,Ligusticum chuanxiong Hort.④Poria cocos,Angelica sinensis,Ligusticum chuanxiong Hort,Atractylodes macrocephala,radix paeoniae alba,Glycyrrhiza uralensis,Panax notoginseng powde,Fructus Tritici Ievis.⑤Angelica sinensis,Radix astragali,Safflower,Ligusticum chuanxiong Hort,fructus lycii,Rubus chingii,Saussurea involucrata,semen persicae.⑥Saussurea involucrata,Angelica sinensis,Poria cocos,Ligusticum chuanxiong Hort,Salvia miltiorrhiza,radix paeoniae alba,Rubus chingii,Atractylodes lancea.Atractylodes lancea.Conclusion.1.Onset of disease:comprehensive general data and statistics showed that no significant differences were seen in the onset of primary retinitis pigmentosa(RP)in terms of gender,and the onset was mainly concentrated in young adults.2.Classification of medicines used by tutors for RP treatment.①strengthening the spleen and benefiting the qi:Radix astragali,Codonopsis pilosula,Atractylodes macrocephala,Atractylodes lancea,Poria cocos,Glycyrrhiza uralensis and so on.② Mourishing the kidney and filling the essence:Radix Rehmanniae Preparata,Fructus Psoraleae,fructus lycii,semen cuscutae,Herba epimedii,Fructus Corni,etc.③ Blood nourishing and liver softening:Radix Rehmanniae,Radix Rehmanniae Preparata,radix paeoniae alba,Angelica sinensis,mulberry,etc.④blood circulation class:Ligusticum chuanxiong Hort,Radix Puerariae,Ramulus Cinnamomi,Panax notoginsen,etc.⑤Brightening the eyes.Prunella Vulgaris L,Semen Plantaginis,Atractylodes lancea,Rubus chingii,Fructus Ligustri Lucidi,etc..⑥ Empirical medicine category:Hawthorn,Gentiana Dahurica Fisch,Radix Puerariae,Ramulus Cinnamomi,etc.3.According to the association rules and clustering results,combined with clinical experience,the common drug pairs for the treatment of RP were Radix astragali and Angelica sinensis,Fructus Ligustri Lucidi and Eclipta prostrata L,and Dendrobium,Atractylodes lancea and Herba epimedii.Selection of representative core class formulas.①Spleen and kidney Yang deficiency type:Radix astragali,Codonopsis pilosula,Poria cocos,Atractylodes macrocephala,Glycyrrhiza uralensis,Radix Rehmanniae,radix paeoniae alba,Angelica sinensis,Ligusticum chuanxiong Hort,Fructus Psoraleae,Fructus Corni,semen cuscutae,Raw Hawthorn,Radix Puerariae,Ramulus Cinnamomi.Cinnamomi.② Liver and kidney yin deficiency type.fructus lycii,semen cuscutae,Rubus chingii,Fructus Broussonetiae,Radix Rehmanniae Preparata,Chinese yam,Angelica sinensis,Ligusticum chuanxiong Hort,radix paeoniae alba,Radix Rehmanniae,Radix Puerariae,Dendrobium.③Qi deficiency and blood stasis type.semen persicae,Safflower,radix paeoniae alba,Poria cocos,Atractylodes macrocephala,Codonopsis pilosula,Salvia miltiorrhiza,Glycyrrhiza uralensis,Radix astragali,Angelica sinensis,Ligusticum chuanxiong Hort,Gentiana Dahurica Fisch.4.Etiology and pathogenesis:The treatment of RP is mostly based on the theory of spleen and kidney yang deficiency,which is considered to be a disease of "yang not being able to overcome yin",but there are also cases of congenital deficiency of yin essence.Therefore,the treatment is to benefit the essence and nourish the deficiency first,adjust the medicine according to the strength and weakness of yin and yang,and use cold and heat together with qi and blood,so that the qi and blood can be harmonized and the eyes can be moistened,and the light will be bright and clear.At the same time,he combines modern pathology and pharmacology research,and based on clinical experience,he has developed his own experience in the use of drugs,such as Hawthorn and Gentiana Dahurica Fisch.5.Treatment features.①tonifying the spleen and kidney and harmonizing yin and yang.② Regulate the qi and blood,move stagnation and open the ligaments.③Integration of Chinese and Western medicine to improve the therapeutic effect.