| [Background]With the development of computer technology,cloud storage,"Internet plus"concept of full integration into social life,open the "transformation of the era of big data,some of the new technology of mass data storage,processing,analysis and forecast,but also affect the development of Chinese medicine has been keeping pace with the times and learn.Liu Baoyan,Professor of Chinese Academy of traditional Chinese medicine(TCM)has established a platform for clinical research information integration,which is suitable for the diagnosis and treatment of traditional Chinese medicine.Chief physician Zhang Ning is director of the Department of Nephropathy of Wangjing Hospital of Academy of Chinese Medical Sciences,the State Administration of Traditional Chinese Medicine nephropathy specialist academic leaders in the clinical aspects of TCM Prevention and treatment of chronic kidney disease has accumulated rich experience.Director Zhang Ning engaged in clinical medicine for nephropathy in recent 30 years,most of the medical data accumulated for scattered paper prescription medical records and electronic medical records,without processing,a systematic summary,concise deep academic thought has a certain degree of difficulty.Facing this huge knowledge treasure house,how to excavate?What kind of medication rule will be excavated?Is it consistent with clinical use?This is a series of problems to be solved urgently.Chronic kidney disease,is characterized by a clinical syndrome with primary or secondary causes of kidney damage,diverse and complex,for the treatment of CKD,which is effective in the treatment of primary disease,to eliminate the cause of reversible factors worsening renal function,no specific medicine for kidney function and structure injury treatment.Traditional Chinese medicine treatment of chronic kidney disease has certain advantages,but the law is not uniform,and the lack of efficacy studies and related mechanisms of action,has not been recognized by the medical profession.With the development of molecular biology,the research focus of abroad has been focused on podocyte,which is regarded as the final target of proteinuria treatment,and has become a new trend in the evaluation of therapeutic effect.There are no reports on the application of podocyte as the target of drug therapy.Traditional Chinese medicine in the treatment of chronic kidney disease can effectively reduce the degree of proteinuria,then,the effect of traditional Chinese medicine on the podocyte structure,the current domestic research is blank.Based on this,this study is divided into two aspects:firstly,using the complex network technique of mining method based on the data of core,prescription and drug compatibility structure summarizes the chief physician Zhang Ning in the treatment of chronic kidney disease,using the topic model method to analyze the correlation between the symptoms and Chinese medicine;Secondly,study on the effect of the YUSHEN decoction on adriamycin-induced in rats,observe the change of podocyte morphology,podocyte molecular biology related regulatory protein expression and association,to explore the influence of the kidney recipe on proteinuria,and renal pathological changes of structure,to provide Chinese medicine for the treatment of proteinuria in the exact and reliable scientific basis.[Partl Clinical Research]1.ObjectsSummarize the core prescription and drug compatibility structure of Zhang Ning's chief physician in the treatment of chronic kidney disease.2.MethodsThe object of study:during the 2014 year taking Chinese herbal medicine in Chinese Academy of traditional Chinese Medicine Department of Endocrinology Wangjing Hospital chief physician Zhang Ning kidney specialist outpatient,(herbal decoction,granule,generation)of patients with chronic kidney disease treatment.Methods:using Liquorice software,the complex network method was used to extract the core prescription of chronic kidney disease and the structure of drug compatibility.The relationship between symptoms and traditional Chinese medicine was analyzed by topic model.3.ResultsThrough the analysis of 862 patients with chronic kidney disease herbal prescription,Zhang Ning director of the treatment of chronic kidney disease in traditional Chinese medicine taste of the 74.The first 10 ingredients:Astragalus,Poria,radix salviae miltiorrhizae,Radix Paeoniae Alba,Radix Bupleuri,rehmannia root,coix seed,angelica,Rhizoma imperatae,rhubarb wine.The top 10 drugs on:Poria,Radix Astragali and Radix Astragali and Radix Salviae Miltiorrhizae,Radix Astragali and angelica,Astragalus and Radix Paeoniae Alba,Radix Astragali and radix rehmanniae,Radix Astragali,Herba Pyrrosiae and coix seed and astragalus,Astragalus and rhubarb,rhubarb and Salvia miltiorrhiza,tuckahoe wine and angelica.4.ConclusionsThrough the analysis of the complex network analysis on 2014 Zhang Ning chief physician outpatient treatment of patients with CKD regimen in the treatment of CKD,summarizes the director Zhang Ning syndrome and treatment ideas:a cure for this,to liver and kidney homologous Fuzheng;liver blood;Shufeng heat,detoxification and disease;for symptomatic treatment.The main treatment methods are:Invigorating the lung,spleen and kidney,filling the essence and strengthening the blood,clearing the dampness and flowing channels,promoting blood circulation and clearing away turbid fluid,expelling wind,dispelling blood poison,and easing the nerves.[Part2 Experimental Research]1.ObjectsTo evaluate the therapeutic effect of Yushen Decoction(YSD)to proteinuria of adriamycin-induced in rats.2.MethodsExperimental subjects:SD rats,male,50.Grouping and administration methods:Sprague-Dawley(SD)male rats of nephropathy model were established by injection of adriamycin through the tail vein of rats twice in 7 days.The rats were divided into 5 groups:group normal(K),group control(M),group prednisone(Y),group high-dosage YSD(D),group low-dosage YSD(X).After treated with the corresponding medicines for 21 days.collect 24 h urine for protein detection.Blood samples and renal tissues were collected.Measure the blood biochemistry parameters by automatic analyzer.The glomerular morphology and podocyte ultrastructure were observed by light microscopy and transmission electron microscopy respectively.Observe the secretion and distribution of endothelin ET-1 in kidney by immunohistochemistry.Observation index:24 hours urine protein,serum creatinine(Cr),urea nitrogen(BUN)changes with light microscope and electron microscope to observe the changes of renal tissue and podocyte pathology,and immunohistochemical method was used to observe the renal endothelin(ET-1)and CD protein(CD2AP)expression.3.ResultsComparing with the group M,24 h urinary protein excretion of group D,E were significantly lower.Light microscopy showed that both the high and low dosage of YSD can protect the kidney tissue from the damage.The quantity of the glomerular increased nearly back to normal group per unit area.The shape of glomerular recovery to full and the vacuolization of visceral epithelial cells disappeared.Tubular edema eased.Ultrastructural studies show fusion of interdigitating foot process and the disappearance of the slit diaphragm structure can significantly repaired in the 2 YSD groups.The ET-1 staining intensity of immunohistochemistry also decreased in those 2 groups treated by YSD.4.ConclusionsYSD can significantly lower the ADR nephropathy model rats' proteinuria by fix the structure of glomerular.The mechanism might be reducing the ET-1 in glomerular.[Innovation]1.Innovative research content:This study uses data mining complex network technology,and analyzed the clinical data of the diagnosis and treatment of the real case of chief physician Zhang Ning,chief physician Zhang Ning summarized the treatment of chronic kidney disease treatment and drug laws,has the innovation in the research design ideas and methods;2.Innovative research methods:Pharmacological study on clinical treatment of proteinuria and effective "Yushen party",confirmed that the compound has the foot to repair cells,slit diaphragm structure,has the innovation in the research target direction,and provides a new way to verify the treatment of traditional Chinese medicine pharmacological experimental research on nephropathy. |
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