| Objective:This study will conduct a retrospective analysis of patients with Ig A nephropathy grade IIIII treated by our center,and analyze the rules of medication through data mining and experience summary to further study the role of traditional Chinese medicine in the treatment of Ig A nephropathy grade II-III effect.Methods:Part 1: Apply retrospective research methods to observe the efficacy and safety of Chinese medicine combined with ARB in the treatment of Ig A nephropathy grades II-III.Collected patients who underwent renal biopsy in the Department of Nephrology,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2014 to December 2018,and were diagnosed with Ig A nephropathy grades II-III after receiving Chinese medicine combined with ARB treatment.Collect and record the patient's general data and urine routine red blood cell count(URBC),24-hour urine protein quantitation(24h UP),blood creatinine(Scr),blood urea(Urea),blood before treatment,3 months treatment,6 months treatment Uric acid(UA),serum Ig A(Ig A),serum complement C3(C3),TCM syndrome scores,etc.,and record the occurrence of adverse reactions,the data obtained was statistically analyzed using SPSS26.0 software to evaluate the combination of Chinese medicine and ARB treatment of Ig A The efficacy and safety of nephropathy grade II-III.Part II: Apply statistics and data mining methods to analyze the rules of the prescription of Ig A nephropathy II-III Chinese medicine prescriptions.Enter the first part of the patient's clinical data and prescriptions of traditional Chinese medicine into an Excel table,and use SPSS 26.0 software,SPSS Modeler 18.0 software and Gephi 0.9.2 software for frequency statistics,association rule analysis and K-core sub-network analysis to get commonly used drugs,The basic prescription,the commonly used drug pair and the addition and subtraction of the certificate,thus summarizing the prescription rules of our center's temporary license.Results:Part I: A total of 73 patients with Ig A nephropathy grade II-III treated with Chinese medicine combined with ARB were included.The results are as follows: compared with before treatment,the 24-hour urine protein content at 6 months of treatment was significantly lower than before treatment(P?0.01);URBC levels decreased significantly at 3 months and 6 months of treatment(P?0.01);Scr levels decreased at 3 months of treatment compared to before treatment(P?0.05);serum Ig A levels at 3 months of treatment were significant Decreased(P?0.01),the level of complement C3 decreased(P?0.05);serum Ig A level and complement C3 level decreased significantly after 6 months of treatment(P?0.01).According to the western medical efficacy evaluation standard,1 case was clinically controlled at 3 months of treatment,19 cases were markedly effective,34 cases were effective,19 cases were ineffective,and the total effective rate was 73.97%;8 cases were clinically controlled at 6 months and 29 cases were markedly effective.21 cases were effective,15 cases were invalid,and the total effective rate was 79.45%.The TCM syndrome scores after 3 months of treatment and 6 months of treatment were significantly lower than before treatment(P?0.01).According to the criteria for determining the effectiveness of traditional Chinese medicine,56 cases were effective at 3 months and 17 cases were ineffective,with a total effective rate of 76.71%;at 6 months,5 cases were markedly effective,59 were effective,9 were ineffective,and the total effective rate was 87.67%.The 73 patients included were generally in good condition during the treatment,and no obvious side effects and adverse reactions occurred.Part II: A total of 73 patients and 687 prescriptions were included in this study.The data mining method yielded the following results:(1)Commonly used drugs: A total of 278 flavors of traditional Chinese medicine were used,with an average of 15.78 flavors per prescription.The top five most frequently used drugs are raw Astragalus,Poria,Scutellaria baicalensis,Bixie,Bupleurum.(2)Basic prescription: Module 1(raw Astragalus,Angelica,Radix Radix,Radix Scutellariae,Bombyx mori,Bombyx mori,cicada slough,Ophiopogon japonicus,Atractylodes macrocephalae,Radix Atractylodis,Radix Chrysanthemum,Rehmannia glutinosa,Codonopsis,Eucommia,Coix seed),Module 2(Bupleurum,Poria,Ramie Root,Amomum,Glycyrrhiza glabra,Albizia chinensis,Nepeta),Module 3(Honeysuckle,Raw Licorice,Shiwei,Phellodendron chinense,Rhizoma Adenophora),Module 4(Erythraea,Dandelion,White Flower Snake)Tongue grass,Phellodendron chinensis,Deer grass,Poria cocos),Module 5(Rehmannia glutinosa,thistle,madder,lotus root charcoal).(3)Commonly used compatibility and addition and subtraction according to the certificate: Commonly used medicines include cicada slough,silkworm;golden cherry seed,gynostemma chinensis,Dijin grass,shepherd's purse flower;dandelion,white flower Hedyotis diffusa;raw astragalus,Pseudostellaria heterophylla;honeysuckle,forsythia;Mother,Cork;Windproof,Atractylodes macrocephala.Commonly used combination of drugs plus or minus the syndrome are five upset fever/night sweats/dizziness tinnitus-rehmannia glutinosa,white peony root,peony bark,angelica,poria cocos;fever/cough-honeysuckle,forsythia,forsythia root;sore throat-honeysuckle,forsythia Cicada slough;limb numbness-raw astragalus,radix rehmanniae,Angelica,Atractylodes,cicada slough;loose stools-white lentils;puffiness-Fangji.Conclusion:In this study,patients with Ig A nephropathy grade II-III were taken as the research object.By analyzing the clinical data of 73 patients with Ig A nephropathy grade II-III treated by Chinese medicine combined with ARB,the following conclusions were obtained:(1)Chinese medicine combined with ARB treatment of Ig A nephropathy II Level ?III can reduce the 24-hour urine protein quantification and urine red blood cell count of patients,and have a certain protective effect on renal function.The mechanism may be related to the modulation of the patient's immune function by the treatment plan,which is reflected in the decrease in the serum Ig A and C3 levels of the patients before treatment.(2)The disease is more common with deficiency and reality,and the deficiency is more common with qi and yin syndromes;the standard evidence is mainly damp heat syndrome,and water dampness syndrome and blood stasis syndrome are also not uncommon.(3)The treatment of this disease in our center is based on the principle of replenishing deficiency,clearing away heat and dampness,detoxifying,treating blood and treating wind.The medicine is mild in nature and rarely biased.The prescriptions of the clinical prescriptions can be roughly divided into the following 6 categories:(1)acute stage of exogenous sensation: Yu module 3,medicinal honeysuckle,raw licorice,shiwei,Pakchoi root,Radix Adenophora,throat swelling and pain plus forsythia,cicada slough;(2)Exogenous wind evil unsolved,damp heat content: Yu module 2,medicinal Bupleurum,Poria,ramie root,Amomum,licorice root,albizia peel,nepeta;(3)spleen and kidney Qi and Yin deficiency,damp heat content: Yu module 1 side,medicinal raw astragalus,angelica,radix ginseng,scutellaria baicalensis,Ophiopogon japonicus,raw Atractylodes macrocephala,Radix Rehmanniae,Codonopsis,Eucommia ulmoides,coix seed,white lentils for loose stools,anti-self for puffy ones,and jade screen powder for those with colds;(4)Dampness,heat and turbidity poison content: Pre-Module 4,Medicinal Diabetes,Dandelion,Hedyotis diffusa,Phellodendron chinensis,Deer Grass,Poria cocos;(5)Bloody fever,hematuria: Pre-Module 5,medicinal raw Rehmannia glutinosa,Small thistle,madder,lotus root charcoal,combined medicine to heat and cool blood to stop bleeding in Dijin grass and shepherd's purse flower;(6)Others: liver and kidney yin deficiency,nourish the liver and kidney with Zishui Qinggan drink;cicada slough with wind and kidney 3.The stupid silkworm searches for the wind and removes the collaterals;those with urine turbidity are given Jinyingzi and Zhishi;those with kidneyyang deficiency are given Yougui pills. |
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