Study On Professor Ma Jian’s Medication Rules And Clinical Experience In The Treatment Of Diabetic Kidney Disease With Traditional Chinese Medicine

Obj ective:To collect and organize clinical cases of Professor Ma Jian’s treatment of diabetic kidney disease(DKD),analyze his medication rules for treating DKD with traditional Chinese medicine(TCM)using the TCM Inheritance Calculation Platform(V3.0),and summarize his medication experience and academic thoughts.Methods:The medical records of patients treated by Professor Ma Jian in the Department of Endocrinology,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2019 to May 2022 were selected.According to the inclusion and exclusion criteria,112 cases were selected and analyzed using the TCM Inheritance Calculation Platform(V3.0)for statistical analysis,prescription analysis,symptom analysis,and tongue and pulse analysis.The medication experience and academic thoughts of Professor Ma Jian in treating DKD were summarized.Results:1.In 112 cases of DKD,the ratio of male to female was 1.38:1.The patients aged 60～69 years were the most,with a total of 40 patients,accounting for 35.71%of the total number.2.A total of 54 symptoms were identified in the 112 cases,with the top ten being:frequent urination,thirst,fatigue,dry mouth,foamy urine,lower limb edema,polydipsia,insomnia,blurred vision,and weak waist and knees.3.A total of 18 tongue image types and 20 pulse image types were counted among the 112 medical cases.96 times of red tongue,71 times of white tongue,57 times of tooth mark tongue and 34 times of fat tongue,accounting for a total of 81.39%;There were 49 pulse string slips,17 pulse string slips and 16 pulse sinking slips,accounting for 73.22%.4.In 112 medical cases,120 traditional Chinese medicines were selected,and 40 kinds of medicines were used more than 20 times,accounting for a total of 2,301 times,accounting for 97.30%.5.Summary analysis of the Four Qi,Five flavor and normalization of traditional Chinese medicine:In the four Qi,the leveling,cold and warm drugs accounted for 89.08%;Among the five flavors,sweet,bitter and octorous drugs accounted for 83.1 5%;Drug channeling into kidney,liver,spleen and lung channels accounted for 63.64%.6.Types of efficacy of TCM:the top five in terms of frequency of use were:fill deficiency class,astringent class,heat clearing class,blood circulation and blood stasis class,water infiltration wet class.7.Based on association rules,the core drugs were as follows:membra nous milkvetch root,cheroke rose fruit,coptis,dried ginger,poria,cornus offic inalis,leech,puzzle nut,baikal skullcap root,chinese dodder seed.8.Six core drug combinations were obtained based on k-means algori thm clustering,which were as follows:Core prescription 1:membranous mi lkvetch root,coptis,dried ginger,poria,adhesive rehmannia root tuber,oriental waterplantain tuber,common yam rhizome.Core prescription 2:membranous milkvetch root,cheroke rose fruit,coptis,dried ginger,poria,gordon euryale seed,puzzle nut,baikal skullcap root.Core prescription 3:membranous milkv etch root,cheroke rose fruit,coptis,dried ginger,poria,cornus officinalis,adhe sive rehmannia root tuber,american ginseng.Core prescription 4:membranou s milkvetch root,coptis,poria,cornus officinalis,oriental waterplantain tuber,common yam rhizome,common achyranthes,prepared common monkshood.C ore prescription 5:membranous milkvetch root,cheroke rose fruit,coptis,drie d ginger,chinese dodder seed,glossy privet fruit,mantis egg-case,palmleaf ra spberry fruit.Core prescription 6:membranous milkvetch root,dried ginger,a merican ginseng,adhesive rehmannia root tuber,leech,peach seed,safflower,c hinese angelica.Conclusion:1.Professor Ma Jian often treats DKD with fill deficiency drugs,astringent drugs,heat clearing drugs,blood circulation and blood stasis drugs,water permeability drugs.The core prescription drugs are:Astragalus,golden Yingzi,Coptis,dried ginger,poria,cornus officinalis,leechia,Yizhiren,Huangqin,dodder seed.2.In the treatment of DKD,Professor Ma Jian mainly uses sweet,bitter and occinative drugs,and mainly uses calming,cold and warm drugs,which mainly enter the channels of kidney,liver,spleen and lung.3.In the process of treating diabetic nephropathy,Professor Ma Jian proposed that the basic pathogenesis is based on the virtual standard,and the core is in the kidney,liver and spleen.Heat,poison,phlegm,and stasis are diseases.4.Professor Ma Jian pays attention to the treatment of diabetic nephropathy from the root,taking into account the specimen,combining differentiation and disease differentiation,establishing the law from evidence,and formulating from the law,supplementing the kidney and solid essence,and regulating the liver and spleen as the main treatment principle,with methods such as invigorating qi and nourishing yin,clearing heat and dampness,dissolving phlegm and removing stasis,relieving water and swelling,and regulating qi machine.