| ObjectiveThrough the retrospective collation and analysis of the tutor’s treatment of early renal failure cases of DKD,this topic discusses the etiology and pathogenesis of DKD and the theoretical connotation of Yishen Qingli Tongluo method,analyzes the prescription and medication law of using this method to treat early renal failure of DKD,excavates the core prescription of Yishen Qingli Tongluo method to treat DKD,and carries out network pharmacological research on the core prescription to explore the possible mechanism of this core prescription in the treatment of early renal failure of DKD,So as to reveal the theoretical and practical significance of Yishen Qingli Tongluo method in the treatment of DKD,and provide effective treatment ideas and methods for the clinical treatment ideas for early renal failure of DKD.Methods1.to collect the complete cases of early diabetes failure in the Department of nephropathy of the Second Affiliated Hospital of Heilongjiang University Of Chinese Medicine from September 2016 to December 2021,and screen the cases that met the inclusion criteria.Input its basic information,syndrome and prescription medication into the auxiliary inheritance platform of traditional Chinese medicine(v2.5)for data statistical mining;Analyze the frequency of drug use,obtain the core traditional Chinese medicine of benefiting the kidney,clearing the meridians and dredging the collaterals,and comprehensively analyze the drug nature and taste,meridian tropism,common drug pairs and new prescription combinations,and systematically summarize the medication characteristics and clinical experience of tutor in the diagnosis and treatment of early renal failure of DKD by using the method of benefiting the kidney,clearing the meridians and dredging the collaterals.2.Based on the core drugs of benefiting the kidney,clearing the meridians and dredging the collaterals excavated by the auxiliary inheritance platform of traditional Chinese medicine,carry out network pharmacological analysis;In tcmsp database,the effective components and action targets of core drugs are screened according to ob and DL values,the gene targets of early renal failure of DKD are retrieved in genecards database,the targets of drugs and diseases are unified in Uni Prot database for standardized treatment,then the intersection targets of drugs and diseases are taken,the intersection targets are imported into string database for PPI analysis,and Go and KEGG enrichment analysis is carried out in metascape database,The results were visualized to analyze the main components,targets and pathways of Yishen Qingli Tongluo core drugs in the treatment of early renal failure of DKD.Results1.Basic information: a total of 200 complete cases of early renal failure in DKD were included in this subject,including 132 male patients and 68 female patients;Syndrome statistics showed that there were 134 cases of spleen and kidney deficiency,dampness turbidity and blood stasis type,27 cases of liver and kidney yin deficiency,blood stasis block type,deficiency of yin and Yang,37 cases of dampness and blood stasis block type and 2 other cases.2.Medication: a total of 200 prescriptions were entered,involving 195 traditional Chinese medicines.The top ten traditional Chinese medicines used frequently are: yam 139 times,Astragalus 110 times,Ligustrum lucidum 110 times,Codonopsis pilosula 108 times,Salvia miltiorrhiza 105 times,rhubarb103 times,Hedyotis diffusa 101 times,Mao Xu Cao 99 times,leech 98 times and Jineijin 86 times;The use frequency of four Qi drugs was: 1067 times for flat drugs,1010 times for warm drugs,984 times for cold drugs,136 times for cool drugs and 25 times for hot drugs;The frequency of five flavors: 2037 sweet drugs,1464 bitter drugs,620 pungent drugs,425 sour drugs,192 astringent drugs and 164 salty drugs;The frequency of meridians: 1698 liver meridians,1408 kidney meridians,1387 spleen meridians,1268 lung meridians,916 stomach meridians,884 bladder meridians,335 heart meridians,320 large intestine meridians,197 small intestine meridians,193 gallbladder meridians and 132 pericardial meridians;The commonly used drug combinations are:Codonopsis pilosula and Astragalus membranaceus,Astragalus membranaceus and yam,Codonopsis pilosula and rhubarb,Astragalus membranaceus and Salvia miltiorrhiza,Salvia miltiorrhiza and leech,etc;There are 4 new party combinations.3.Network pharmacology research: there are 113 active components of traditional Chinese medicine,233 active component targets,3396 early renal failure disease targets of DKD,102 drug disease intersection targets and 249 KEGG pathways.The main effective components of Yishen Qingli Tongluo method in the treatment of DKD are kaempferol,quercetin,luteolin β-Sitosterol,the key targets are TP53,ESR1,EGFR,IL10,m TOR,STAT3,MMP9,mapk8,Mapk14 and EGF;The main biological pathways are lipid and atherosclerosis,HIF-1,AGE-RAGE signaling pathway and JAK-STAT signaling pathway.Conclusion1.The core pathogenesis of early renal failure of DKD is deficiency of spleen and kidney,dampness and heat stasis,obstruction of kidney collaterals,which is the syndrome of deficiency of origin and excess,and mixed deficiency and excess.The method of Tonifying the kidney,clearing the meridians and dredging the collaterals is its basic treatment principle.2.the top ten core drugs used by the tutor in clinical practice are:yam,astragalus,Ligustrum lucidum,Codonopsis pilosula,Salvia miltiorrhiza,rhubarb,Hedyotis diffusa,cat’s whisker,leech and chicken inner golden;In addition,they are good at clinical use of drug pair compatibility to enhance mutual synergy or reduce toxicity and increase efficiency.3.the network pharmacological study on the core traditional Chinese medicine of Yishen Qingli Tongluo in the treatment of early renal failure of DKD shows that the traditional Chinese medicine compound is characterized by multi-component,multi-target and multi-channel intervention,which provides a basis for further clinical research. |
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