Study On Mechanism Of TCM Syndrome Differentiation And Medication Rule Of Gouty Nephropathy Based On Cloud Platform Of Ancient And Modern Medical Records

Objective:Through data mining on the medical cases of gouty nephropathy in the platform of Ancient and Modern Medical Case Cloud,to summarize the TCM(Traditional Chinese Medicine)syndrome differentiation and medication rules of gouty nephropathy,and to provide ideas for clinical treatment.Methods:In this study,relevant medical cases of gouty nephropathy were collected and combined with diagnostic criteria to establish the original database of gouty nephropathy.After being reviewed and verified by two researchers,the data were standardized and added to the analysis pool.Data mining technology was used to analyze the data,in order to explore the characteristics of the incidence of gouty nephropathy and its medication rules.Results:(1)A total of 123 literatures were included in this study,involving 204 prescriptions and a total of 328 Chinese herbs.The total frequency of Chinese herbs was 3,239.(2)Gouty nephropathy is more common in men than in women.Its symptoms mainly include lower back pain,fatigue,waist pain,nocturia,and joint inflammation.The tongue body is often red,pale red,dark red,and with tooth marks.The tongue coating is mainly yellow greasy,white,thin yellow,and thin greasy.The pulse is often thin,deep,slippery and wiry.The pathogenesis is related to pathological factors such as dampness,heat,deficiency,and stasis.The affected organs are related to the kidney,spleen,and liver.Common TCM syndrome patterns include damp-heat syndrome(including damp-heat internal disturbance syndrome and damp-heat obstruction syndrome),damp turbidity internal disturbance syndrome,spleen-kidney deficiency syndrome,and blood stasis obstructing collaterals syndrome.(3)There are a total of 15 Chinese herbs with a frequency of≥50 in the prescriptions,namely,Smilax glabra,Astragalus membranaceus,Coix seed,Atractylodes macrocephala,Achyranthes bidentata,Polygonum bistorta,Poria cocos,Atractylodes rhizome,Phellodendron chinense,Alisma orientale,Licorice root,Rheum palmatum,Salvia miltiorrhiza,Angelica sinensis,and Clematis chinensis.(4)The four Qi(properties)are mainly composed of mild and warm herbs,followed by cold herbs.The five flavors are mainly composed of sweet herbs,followed by bitter,pungent,and bland herbs.In terms of meridian tropism,the herbs that enter the liver,spleen,and kidney meridians are the most commonly used,followed by those that enter the lung,stomach,and heart meridians.The main functions are clearing heat and detoxification,strengthening tendons and bones,nourishing liver and kidneys,diuresis and relieving urinary dysfunction,detoxification,and dispelling wind and dampness.(5)Cluster analysis of Chinese herbal medicines resulted in 4 categories,with their main effects being tonifying qi and invigorating the spleen,promoting diuresis and removing turbidity,clearing dampness and heat,and activating blood circulation and resolving stasis;association analysis of Chinese herbal medicines identified high co-occurrence of Huangqi-Tufu Ling,Bixie-Tufu Ling,and Yiyiren-Tufu Ling,with high confidence in Huangbo-Cangzhu,Danshen-Tufu Ling,and Dahuang-Tufu Ling.Complex network analysis identified 22 core Chinese herbal medicines,with Huangqi,Tufu Ling,Yiyiren,Bixie,Cangzhu,Huangbo,and Niuxi having the highest weights.Conclusion:Middle-aged and elderly men are more likely to suffer from gouty nephropathy.The onset of the disease is related to pathological factors such as dampness,heat,stasis,and deficiency.Clinically,it is mainly manifested as damp-heat syndrome(including damp-heat endogenous syndrome and damp-heat impediment syndrome),damp turbidity endogenous syndrome,deficiency of spleen and kidney syndrome,and blood stasis obstructing collaterals syndrome.It is mostly due to congenital insufficiency and acquired spleen and stomach deficiency,which leads to the formation of phlegm and dampness.Over time,it transforms into heat and blood stasis,eventually damaging the kidney collaterals and leading to the development of the disease.In treatment,the main methods are clearing heat and dampness,promoting water and dampness,tonifying qi and strengthening the spleen,promoting blood circulation and removing blood stasis.This study used statistical methods from the Gujin Yimiao Yunping platform to analyze and summarize the characteristics of gouty nephropathy and the medication rules in treatment,providing new ideas and methods for future clinical treatment.