| Prof.Nie Lifang is the subject leader of our Nephrology department.She learned from Wang Mianzhi,and Fang Yaozhong Chinese medicine practitioners that she had benefited greatly and had laid a solid foundation for the development of Chinese medicine in the future.Later,she was sent by the government to the Department of Medicine of Hiroshima University in Japan to study kidney disease,accumulated a solid modern medical technology.In the course of practice in the past half century,Prof.Nie has accumulated rich experience in the treatment and research in kidney disease of TCM,and formed her unique and valuable academic ideology.I have been with the Prof.Nie for several years,in addition to clinical attendance,in close to contact with her life in general,I understood the characteristics of her work as a person,and found that she is rigorous and serious in her work.Based on her own strict requirements,after work,she consulted ancient Chinese medicine to understand the characteristics of traditional Chinese medicine in the treatment of the characteristics,and applied to the clinical,and summarized.So she found that the characteristics of various chronic kidney disease,,At the same time,careful study of the progress of chronic kidney disease in Western medicine.Research and inheritance of Professor Nie Lifang's clinical experience and academic thinking,and develop in succession,to guide clinical practice,for the successors of the generations and the learners of traditional Chinese Medicine,is a very practical work.Professor Nie Lifang believes that Chinese medicine has great advantages in the treatment of kidney disease,not only can delayed the impairment of renal function,but mproved the quality of life of patients with chronic kidney disease.Gradually,in the work of clinical diagnosis and treatment,she found that a growing number of patients with chronic kidney disease,and the age of onset has a downward trend.By observating and researching several years,Professor Nie has summarized a set of prescriptions for the treatment of chronic renal disease.For the patients of the most common clinical manifestations are chronic kidney disease are deficiency of both qi and Yin,she originat a variety of prescriptions for nourishing qi and nourishing yin,for example Nie's Shenqi Dihuang Decoction?Yiqi nourishing kidney Decoction?Curing Purpura kidney Decoction and astragalus carp Decoction and so on.However,she most commonly used prescription in clinic is Nie's Shenqi Dihuang Decoction.It's different from the ancient Shenqi Dihuang Decoction,the ginseng is not easy to use,and radix Ginseng replaces ginseng;Rehmannia glutinosa replaces Radix rehmanniae Rehmanniae,because the people with Yin deficiency is prone to internal heat,Rehmannia Rehmannia can repair deficiency and clear fire,is better to Radix rehmanniae Rehmanniae.At the same time,Alisma orientalis is added to the decoction,she thought that the role of Alisma orientalis in the Liuwei Dihuang Decoction is not to drain the kidney,it's the eviling of the kidney,and it is indeed the evil of diarrhea kidney.The Rehmannia glutinosa replenishes kidney yin to encapsulate the essence of the kidney,and the slightest suggestion of Alisma orientalis is to drive away the evil in the kidney and keep the kidney clear.Therefore,the side of diarrhea in the match,complement each other.Our nephrology department had a long history of treating chronic renal failure with Shenqi Dihuang Decoction.In addition,more clinical observations were conducted and certain data were obtained,which laid a certain foundation for clinical research.However,the molecular studies of Shenqi Dihuang Decoction have not been conducted in depth and it is impossible to understand the mechanisms that affect the human body.With the rise of network pharmacology,the study of the mechanism of action of traditional Chinese medicine compound and molecular research brought a dawn.Based on the review of a large number of online pharmacology articles,this article summarized the development of online pharmacology,and the Chinese herbal compound has a more in-depth study,especially for the mechanism of action and new drug development,providing a good basis for clinical research.Based on the network pharmacology,in-depth study of Professor Nie's experience of Shen Di Huang Decocotion in the treatment of chronic renal failure,and laid the foundation for further clinical work.Through the analysis of network pharmacological active ingredients of chronic kidney failure treated by Shenqi Dihuang Decoction,it was found that quercetin,kaempferol,luteolin,baicalin isoflavanosin,formononetin,isorhamnetin,?-Gushenol,stigmasterol,tetrahydroaldoine,ketolactone,and hedgehog are the most active components.The most representative of the network is quercetin.Analysis of their compatibility mechanisms:The 15small-molecule compounds that playing an important role in the network,which 9 are provided by Huangqi and 3 are provided by Radix Ginseng and Yam.Therefore,that can be basically deduced that the king drug in Shenqi Dihuang Decoction is Astragalus membranaceus.Minister of Medicine is Radix Ginseng and Yam,the rest of them are adjuvant medicine.Analysis of the mechanism of action of chronic renal failure:Nuclear receptor coactivator protein 2 is a key target of Shenqidihuang Decoction in treating renal failure.GO enrichment analysis and in-depth analysis of the KEGG pathway show that:It is presumed that this party can regulate renal fibrosis and electrolyte imbalance as a whole,and it has a direct preventive and therapeutic effect on the cardiovascular system diseases caused by renal failure.,the three signaling pathways act on two key genes,ADRA1B and ADRB2,it's suggested that Shenqi Dihuang Decoction may treat Kidney failure by regulating adrenergic receptors.After that,207 cases of chronic renal failure treated with Shenqi Dihuang Decoction on the outpatient visit of Professor Nie Lifang were collected and used according to the symptoms.Four months after taking the prescription,blood creatinine,blood urea,and serum uric acid were administered.And before and after analysis of 24-hour urinary protein quantification,The instructor's experience of Shenqi Dihuang Decoction has a good therapeutic effect on 24-hour urinary protein excretion in patients with various types of chronic renal failure,and the indicators after treatment can reduce the mean value of the indicators.From the results of the treatment of chronic renal failure caused by the four primary diseases,we can see that this side has a good effect on the treatment of renal failure caused by chronic nephritis,by primary hypertension,by primary disease IgA nephropathy,the blood creatinine,the blood urea nitrogen,the blood uric acid,and the 24-hour urine protein quantification have a good result,P value<0.05,there is a statistical difference.But for the patients with chronic renal failure who had primary disease of diabetic nephropathy,in addition to the 24-hour urinary protein quantification,the p-value was<0.05,since both serum creatinine,blood urea nitrogen,and serum uric acid increased after treatment,and the P value>0.05.No statistical significance.In the end,we make renal replacement therapy as an end point,and carried out survival analysis,conclude that Shenqi Dihuang decoction was used to treat chronic renal failure with syndrome differentiation of Qi and yin deficiency,not all chronic renal failure patients have good curative effects,it's necessary to analyze the patient's primary disease and visiting time. |
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