Research On The Medication Rule And Academic Experience Of Ruan Shiwei In The Treatment Of Chronic Kidney Disease With Spleen And Kidney Deficiency Syndrome Based On Data Mining

Objective:The main research objectives of this study were to analyze the medication rules of professor Ruan Shiwei on chronic kidney disease with spleen and kidney deficiency,summarize professor Ruan Shiwei’s academic experience in treating chronic kidney disease with spleen and kidney deficiency,and provide guidance for the treatment of this disease in traditional Chinese medicine.Methods:This study collects the cases of patients who were diagnosed chronic kidney disease with spleen and kidney deficiency in the People’s Hospital of Fujian University of Traditional Chinese Medicine from January 2017 to December 2021,and was treated by professor Ruan Shiwei,and come to the hospital 3 times or more in half a year.That established a medical case database for professor Ruan Shiwei’s treatment of chronic kidney disease with spleen and kidney deficiency,and used the "Chinese Medicine Inheritance Assistance Platform(V2.5)" to conduct frequency statistics on the four diagnostic information,syndromes,medications,primary disease,etc.The traditional medicine were clustered and visualized,so as to analyze and discuss the medication rules and academic experience of professor Ruan Shiwei.Results:1.A total of 235 patients with chronic kidney disease with spleen and kidney deficiency were included in this study,with 776 prescriptions.Among them,there were 128 males and107 females,and the age of the patients is concentrated in the 38-66 years of age.From the perspective of renal disease staging,there were 25 cases in stage 1,61 cases in stage 2,93 cases in stage 3,45 cases in stage 4,and 11 cases in stage 5.Previously confirmed pathological diagnosis is mainly diagnosis,if no pathological examination is performed,clinical diagnosis is the mainstay,such as cases with clear pathological diagnosis of Ig A nephropathy are not included in cases of chronic glomerulonephritis.The primary disease of the included cases was 72 cases of chronic glomerulonephritis,51 cases of Ig A nephropathy,24 cases of diabetic nephropathy,22 cases of membranous nephropathy,17 cases of nephrotic syndrome,16 cases of mesangial proliferative nephritis,10 cases of hypertensive nephropathy,8 cases of gouty nephropathy,and 15 other diagnosed patients such as purpura nephritis,HBV-associated nephritis,lupus nephritis,membranoproliferative glomerulonephritis,and renal impairment of Sjogren syndrome.According to statistics,the patients took dry,urine foam,fatigue,waist and knee soreness,nocturia,loose stool,sleep disturbance,poor appetite,edema,dizziness,flatulence,bitter taste,chilly sensation and the cold limbs,etc.as the main clinical symptoms;the common tongue images were in order of pale tongue with tooth marks,pale red tongue,dark red tongue;tongue moss was thin yellow,thin white,yellow greasy,white greasy,less moss;pulse image was thin pulse,pulse sinking,pulse string,pulse sinking and thin,weak pulse.The distribution of syndromes is in order of spleen and kidney qi and yin deficiency,spleen and kidney qi deficiency,spleen and kidney yang deficiency.2.Statistics on the frequency of medication,professor Ruan Shiwei’s top 20 commonly used traditional medicine for the treatment of chronic kidney disease with spleen and kidney deficiency are dioscorea rhizoma,astragali radix,rehmanniae radix,poria,glycyrrhizae radix et rhizoma,pseudostellariae radix,plantaginis semen,corni fructus,ophiopogonis radix,moutan cortex,nelumbo nucifera gaerth,serissa foetida,achyranthis bidentatae radix,rubi fructus,phellodendri chinensis cortex,anemarrhenae rhizoma,lycii cortex,codonopsis radix,plantaginis herba,bupleuri radix.The medicinal properties are mainly cold,flat and warm.The medicinal taste is mainly sweet,bitter and spicy,and the meridian tropism is mainly distributed in the kidneys,spleen,liver,lungs,heart and stomach meridians.3.According to the analysis of the formula rules,83 groups of medicine patterns were obtained,the repetitive parts were removed,and the commonly used medicine pairs were finally determined as follows:(1)Pseudostellariae radix and astragali radix;(2)Plantaginis semen and rehmanniae radix;(3)Astragali radix and nelumbo nucifera gaerth.Commonly used Triangle medicines and medicinal strings are as follows:(1)Corni fructus,astragali radix,dioscorea rhizoma;(2)Pseudostellariae radix,astragali radix,poria;(3)Corni fructus,plantaginis semen,rehmanniae radix,dioscorea rhizoma.Through the analysis of association rules,48 medicine combinations were obtained,and the repetitive parts were removed,and the commonly used combinations were obtained as follows:(1)Corni fructus,plantaginis semen,rehmanniae radix,dioscorea rhizoma;(2)Lycii cortex,nelumbo nucifera gaerth,astragali radix;(3)Rehmanniae radix,moutan cortex,dioscorea rhizoma,poria,corni fructus;(4)corni fructus,rehmanniae radix,astragali radix,dioscorea rhizoma;(5)plantaginis semen,rehmanniae radix,moutan cortex,dioscorea rhizoma,corni fructus;(6)ophiopogonis radix,nelumbo nucifera gaerth,astragali radix.4.Based on the mutual information method of new prescriptions analysis,22 new medicine combinations were obtained,arranged as follows:(1)Codonopsis radix,astragali radix,and pseudostellariae radix;(2)Poria with hostwood,chuanxiong rhizoma,and mume fructus;(3)Portulacae herba,eupatorii herba,and albiziae cortex;(4)Taxilli herba,gentianae macrophyllae radix,and siegesbeckiae herba;(5)Rubiae radix et rhizoma,capsella bursa-pastoris,centellae herba;(6)Mori folium,trichosanthis radix,glehniae radix;(7)Corni fructus,poria,moutan cortex;(8)Foeniculif fructus,lablab semen album,coicis semen,hordei fructus germinatus;(9)Angelicae pubescentis radix,saposhnikoviae radix,siegesbeckiae herba,asari radix et rhizoma;(10)Gentianae macrophyllae radix,saposhnikoviae radix,siegesbeckiae herba,erythrinae bark cortex;(11)Ophiopogonis radix,rehmanniae radix,glycyrrhizae radix et rhizoma,corni fructus,moutan cortex;(12)Astragali radix,pseudostellariae radix,stellariae radix;(13)Poria with hostwood,chuanxiong rhizoma,sophorae flos;(14)Scrophulariae radix,bombyx batryticatus,cistanches herba;(15)Gentianae macrophyllae radix,siegesbeckiae herba,curcumae longae rhizome;(16)Rubiae radix et rhizoma,capsella bursa-pastoris,cirsii japonici herba;(17)Bombyx batryticatus,lycii fructus,trichosanthis radix;(18)Paeoniae radix alba,euryales semen,paeoniae radix rubra,poria;(19)Lablab semen album,amomi fructus,coicis semen,psoraleae fructus;(20)Gentianae macrophyllae radix,saposhnikoviae radix,siegesbeckiae herba,stephaniae tetrandrae radix;(21)Gentianae macrophyllae radix,saposhnikoviae radix,siegesbeckiae herba,asari radix et rhizoma;(22)Ophiopogonis radix,rehmanniae radix,corni fructus,moutan cortex,dioscorea rhizoma.5.Calculated by entropy clustering method,11 potential new square combinations are obtained,arranged as follows:(1)Codonopsis radix,astragali radix,pseudostellariae radix,and stellariae radix;(2)Poria with hostwood,chuanxiong rhizoma,mume fructus,and sophorae flos;(3)Portulacae herba,eupatorii herba,albiziae cortex,scrophulariae radix,bombyx batryticatus,cistanches herba;(4)Taxilli herba,gentianae macrophyllae radix,siegesbeckiae herba,and curcumae longae rhizome;(5)Rubiae radix et rhizoma,capsella bursa-pastoris,centellae herba,and cirsii japonici herba;(6)Mori folium,trichosanthis radix,glehniae radix,bombyx batryticatus,and lycii fructus;(7)Corni fructus,poria,moutan cortex,paeoniae radix alba,euryales semen,paeoniae radix rubra;(8)Foeniculif fructus,lablab semen album,coicis semen,hordei fructus germinates,amomi fructus,psoraleae fructus;(9)Angelicae pubescentis radix,saposhnikoviae radix,siegesbeckiae herba,asari radix et rhizome,gentianae macrophyllae radix,stephaniae tetrandrae radix;(10)Gentianae macrophyllae radix,saposhnikoviae radix,siegesbeckiae herba,erythrinae bark cortex,asari radix et rhizome;(11)Ophiopogonis radix,rehmanniae radix,glycyrrhizae radix et rhizoma,corni fructus,moutan cortex,dioscorea rhizoma.Conclusion:1.The high-frequency traditional medicine used by professor Ruan Shiwei in the treatment of chronic kidney disease with spleen and kidney deficiency include: dioscorea rhizoma,astragali radix,rehmanniae radix,poria,glycyrrhizae radix et rhizoma,pseudostellariae radix,plantaginis semen,corni fructus,ophiopogonis radix,moutan cortex,nelumbo nucifera gaerth,serissa foetida,etc.The selection of medicine mostly starts from reinforcing qi,nourishing yin,clearing heat,removing water,activating blood,warming yang,and astringent.2.The common distribution of syndromes is mostly spleen and kidney qi and yin deficiency,followed by spleen and kidney qi deficiency,and spleen and kidney yang deficiency.The diseased organs are mainly the kidneys,and closely related to the spleen,liver,lungs,heart and stomach.3.The causative factors of chronic kidney disease are relatively complex,the disease course is long,and there are more diseased organs involved.So that professor Ruan Shiwei combined his own clinical diagnosis and treatment experience,proposed to take pathology as the basis,take the syndromes as the precursor,according to the changes of five elements and six climatic,the difference between regions,the variation of seasons,the distinction in physique,the comprehensive syndrome differentiation and treatment framework of the combination of syndrome differentiation and disease differentiation,traditional Chinese medicine and Western medicine,including:(1)Six-look diagnosis and treatment mode:Emphasizing the importance of the concept of organic wholeness of "harmony between man and nature",not only to grasp macroscopic speculation,but also to pay attention to microscopic perspectives;(2)The Zheng and Xie syndrome differentiation system: Pointing out that the zhengqi and the xieqi are a pair of basic contradictions in the emergence,development and evolution of the disease,the struggle between the zheng qi and the xieqi is the basic rules of the occurrence of the disease,and strengthening zhengqi to eliminate xieqi is the fundamental principle of treating the disease.4.Professor Ruan Shiwei’s experience prescriptions Baoshen Fang,Yishen Jiangzhuo Tang,which has been developed into a traditional Chinese medicine preparation,suitable for nephritis and kidney failure,belonging to the spleen and kidney deficiency,clinical application for decades,achieved good feedback on efficacy.This is worthy of reference for modern clinical diagnosis and treatment of chronic kidney disease.