The Study Of Professor Nie Lifang’s Treatment Experience Of Primary Nephrotic Syndrome Based On Complex Network And Mutual Information

Primary nephrotic syndrome (PNS) is a kind of common clinical difficult disease. It has a lingering course and some patients develop to renal failure gradually. So it seriously affects the quality of life of patients and has brought great pain and burden to patients and society. Western medicine use corticosteroids and immunosuppressive to treat, but with serious side effects, while some patients presenting for corticosteroids resistance and invalid. However Traditional Chinese Medicine (TCM) has certain advantages and characteristics, some patients only using Chinese herbs can control illness. On one hand, TCM can collaborate to improve efficacy. On the other hand, it can help to withdrawal of corticosteroids and reduce the side effects of corticosteroids. By retrospective analysis of clinical data, this study applies data mining such as mutual information and complex network analysis to conclude my supervisor’s academic idea and clinical experience of treatment of NS. It will provide a reliable basis to further standardize the TCM diagnosis and treatment and improve the clinical efficacy.Modern Medical Research of Nephrotic SyndromeBy overview of Western medicine literature, it elaborates the research progress of the outline, pathogenesis (cellular immunity and humoral immune mechanisms, edema mechanism), treatment (edema, immunosuppressive agents and other treatment) of the nephrotic syndrome.Overview of Professor Nie Lifang’s Experience of Diagnosis and Treatment of TCMThrough the collation and analysis of the literature, the experience of modern TCM masters is summarized and overviewed from such areas as the name of disease, etiology and pathogenesis, diagnosis and syndrome differentiation, treatment and recuperation. NS attributes to "Edema" and other areas in TCM. It is rooted defficiency-symptomed excess and mixed with defficiency and excess. Deficiency of spleen and kidney is the pathogenesis, dampness. Blood stasis is the main evil. Infection is an important factor of deterioration and recurrence. The treatment principle is differential treatment from different points of view.Outline of The Treatment Experience of Professor Nie LifangTreatment ideas and procedures:choosing rather Chinese medicine than western medicine, choosing Chinese medicine first, then western medicine, using Chinese medicine, withdrawaling western medicine; treating edema first, then proteinuria; treatment varies in different stage.Treatment experience:(1) Treatment in different stage:In prominent Edema stage, it should be payed attention to regulating spieen and stomach, strengthening spleen to induce diuresis, coordinating relationship of qi, blood and water and with diet therapy. In continuous proteinuria stage, it is important to invigorate spleen and replenish qi to send up essential substance, enrich qi and nourish Kidney to secure essence. In large steroid using stage and steroid withdrawal phase, differential treatment of TCM should be accompanied.(2) Treatment in different syndrom type: treatment should be given according to qi deficiency and dropsy, yang deficiency and dropsy, yin deficiency and dropsy, qi stagnation and dropsy, retention of damp-heat and blood stasis and dropsy.General Characteristics of CasesThe cases are NS patients diagnosed and treated by my supervisor during January,2007to January2012, a total of161cases,410clinic times. The ratio of male to female is1.875:1. Among them,10cases of minimal change disease,12cases of mesangial proliferation,1case of mesangiocapillary glomerulonephritis,3cases of focal segmental glomerulus sclerosis and22cases of membranous nephropathy,113cases without renal biopsy.Analysis of TCM SyndromeThe symptoms of which the frequency is more than20%in this study are in order: spiritlessness and fatigue, proteinuria, lower extremity edema, pale dark tongue, listless of waist and knees, dizziness, anorexia, constipation, yellow thin fur, reddened tongue, sore throat, cough, ecchymosis on the tongue, sunken and astringent pulse, thin and rapid pulse, palpitations and abdominal distension. TCM syndrome types, dual deficiency of qi and yin is the most common in the main syndrome (57.76%), followed by blood stasis and dropsy (20.73%), dficiency of spleen and stomach (11.95%), qi stagnation and dropsy (8.54%).Mining of The Treatment Experience of Professor Nie LifangThe prescriptions of which the frequency is more than10%in this study are in order:Dangguishaoyao powder (23.41%), Shenqidihuang decoction (18.54%), Xiangshaliujunzi decoction (12.44%), Zhibaidihuang decoction (11.95%), Wupi drink (10.24%). The herb of which the frequency is more than50%is as follows: Poria (Fuling)(89.51%), Euryale Ferox (Qianshi)(82.44%), Radix Astragali Seu Hedysari (Shenghuangqi)(79.76%), Flos Lonicerae (Jinyinhua)(78.05%), Radix Salviae Miltiorrhizae (Danshen)(70%), Radix Pesudostellariae (Taizishen)(66.1%), White Gourd Peel (Dongguapi)(65.37%), Rnizoma Alismatis (Zexie)(57.8%), Atractylodes Macrocephala (51.95%).By mutual information and complex network analysis, I concluded the experience of my supervisor in treating NS as follows:(1) Syndrome differentiation and treatment in different phase, the main treatment in chronic deferral phase (deficiency stage) to strenthen the root vital qi. Strenthening qi and tonifying yin is the most common method.(2) With spleen and kidney as the root, the treatment is overall. To treat kidney, modified Liuwei Dihuang decoction is commonly used. Regulation of spleen and stomach is payed attention to.(3) The method of activating blood and promoting diuresis is payed attention to and Dangguishaoyao powder is often used.(4) Correspondence of syndrome and prescription. Select formula through grasping the main symptoms. One typical symptom is enough for symptom differentiation which can greatly improve the efficiency and accuracy of clinical diagnosis and treatment.(5) Herb modification with symptoms, calm, light and agile, which avoids too hot and fragrant to damage fluid and too bitter and cold to hurt spleen and stomach, all for the clinical effect.(6) Agile method and prescription, exquisite herb compatibility.Relationship between qi, blood, yin and yang is payed attention to. Tonifying is combined with dredging and eliminating the pathogen, with no stagnation.By the use of mutual information and complex network to analyze the law of syndrome differenciation and prescription of my supervisor will help to find the law of clinical treatment and to promote effective herbs. That will help to conclude the experience of old famous TCM doctors further scientificly and systematicly, then to inherit and carry forward.Innovation:1. For the first time by the use of traditional Chinese medicine complex analysis system data mining software, syndrome-prescription, symptoms, symptom-traditional Chinese medicine prescription for mutual information, correlation analysis method, from the massive, fuzzy data mining mentor professor Nie Lifang treatment of nephrotic syndrome in the prescription drug law.2. By the use of traditional Chinese medicine complex analysis system data mining software, for the first time on the main syndromes of traditional Chinese medicine used in complex network analysis, from the massive, fuzzy data summary of tutor Professor Nie Lifang treatment of nephrotic syndrome experience.