Summary Of Professor Li Jianmin's Medication Rules In The Treatment Of Chronic Kidney Disease With Hyperuricemia

Background:The prevalence of chronic kidney disease(CKD)is increasing year by year,and the threat to human health is increasing.The treatment of CKD is mainly to control risk factors to reduce the rate of decline in renal function.The prevalence of hyperuricemia(HUA)is also increasing.As the prevalence of the two diseases increases year by year,more and more studies in recent years have led people to realize that HUA is involved in the development of CKD and is an independent risk factor for CKD.Monitoring and intervening blood uric acid levels in patients with CKD is important for delaying the progression of CKD.A large number of clinical cases have confirmed that Chinese medicine can exert certain advantages in the treatment of CKD and HUA,which can delay the time of entering end-stage renal disease and reduce blood uric acid level.Professor Li Jianmin has been engaged in the clinical treatment of CKD for more than 30 years.He has accumulated rich experience in the treatment of CKD diseases with traditional Chinese medicine and achieved good clinical effect.After learning in the instructor's outpatient department,more patients with CKD combined with HUA were found.Therefore,summarizing Professor Li's clinical experience in treating CKD with HUA can provide a reference for the treatment of CKD with HUA.Objective:Applying modern information technology and data mining methods on CKD with HUA cases,this study aim to summarize and analyze the drug using patterns and experience of Professor Li in the treatment of CKD with HUA.Methods:This study included 91 CKD with HUA patients who were diagnosed and treated by Professor Li from the Department of Nephrology and Endocrinology of Beijing Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to December 2018.The patient's data were standardized.Frequency statistics method was Applied to count general data,relevant laboratory indicators,TCM symptom diagnosis and drug of four gas,five flavors,channel tropisms,function classifications and doses,using the association principle algorithm in SPSS Modeler 18.0 and the cluster analysis algorithm in IBM SPSS Statistics 20.0 for data mining Machine and analysis.Result:A total of 91 patients with CKD and HUA were included in the study,64(70.33%)were male and 27(29.64%)were female.The youngest is 19 years old,the largest is 91 years old,and the average age is 58.8±17.7 years old.Syndrome distribution deficiency syndrome is mainly spleen and kidney Qi deficiency,Qi and Yin deficiency,and the excess syndrome is mainly blood stasis,Turbid Toxin and damp-heat.Through the frequency statistics of 91 prescriptions of CKD combined with HUA patients,a total of 125 kinds of traditional Chinese medicine were obtained,and the cumulative frequency of use was 1226 times.The most frequently used 10 herbs were Shenghuangqi,Baimaogen,Sanqi,Shuizhi,Danshen,Tufuling,Shengbaizhu,Jiangcan,Guizhi,Cheqianzi.The analysis of high frequency drugs showed that most of the selected drugs were tonic drugs,blood-activating and stasis-removing drugs and heat-clearing drugs;the drugs' "four natures drugs" are mostly cold,warm and flat;the drugs' "the five flavors" are mostly sweet and bitter.The drug "meridian tropism" is mainly liver,lung,stomach,spleen and kidney.The average number of flavors in Chinese herbal prescriptions is 13.5,and the dosage is relatively concentrated,but the overall dosage is larger.The association rules were applied to analyze the Chinese medicines,and the core drug combinations were obtained:Shenghuangqi,Sanqi,Baimaogen,shuizhi,Danshen.Based on the results of Apriori association rules and cluster analysis algorithms,8 pairs of related drug combinations were selected:Pugongying and Baihuasheshecao,Tufuling and Bixie,Nvzhenzi and Hanliancao,Sangbaipi and Tinglizi,Tinglizi and Zhifuzi,Qingfengteng and Jingjie,Danggui and Baishao,Guizhi and Rougui?Conclusion:This study explored the medical treatment of CKD with HUA by Professor Li,and obtained some of his treatment experience:Professor Li believed that HUA could aggravate the deficiency and excess of pathogenesis of CKD,aggravate deficiency of Qi and yin,aggravate damp-heat and blood stasis,and make chronic kidney disease more entangled and difficult to heal.Professor Li Jianmin thinks that treatment should be focused on the pathogenesis,chooses the prescription medication,pays attention to tonifying spleen and kidney,promoting blood circulation and removing blood stasis,clearing away heat and dampness.The core combination of common drugs is Shenghuangqi;Sanqi,Baimaogen,shuizhi,Danshen.Aiming at the pathogenesis of HUA with CKD,which is aggravated by deficiency of Yin and Qi in deficiency syndrome,dampness-heat and blood stasis in excess syndrome,the compatibility of tonifying Yin and Qi,clearing dampness-heat and activating blood circulation and removing blood stasis is commonly used.The prescription is concise,the medicine is few and refined.