Study On The Law Of Traditional Chinese Medicine Syndrome And Treatment Of Idiopathic Membranous Nephropathy Based On Data Mining

Objectives:In this study,clinical research information sharing system was used as the carrier to collect the clinical informations of patients with idiopathic membranous nephropathy(IMN)in the real world and establish a database.Based on the data mining technology,this paper analyzed the clinical sympt oms,syndrome distributions and medication regularities of IMN,and analyzed the evolution laws and drug use laws of the urine protein level of IMN from light to heavy,so as to explore the rule of TCM treatment of IMN and provide cl inical reference for the TCM treatment of IMN.Methods:Taking the information sharing system of clinical sci entific research of traditional Chinese medicine,collecting the relevant informations of patients with IMN in the Department of Nephrology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2014 to June 2019.After data preprocessing,establishing the population database of IMN.Based on frequency analysis,layered network analysis of complex network and relative risk,exploring the laws of tradi tional Chinese medicine treatment of IMN from symptoms,syndromes and medicinesResults:1.In this study,the data mining analysis results of 436 IMN patients’ clinical symptoms,tongue pictures,pulse conditions and syndrome distributions were as follows:the core symptoms of IMN were foam urine,lower extremities edema,fatigue,and waist acid,night urination,low back pain,easy fatigability,dry mouth,poor sleep,red or dull-red tongue,yellow and greasy tongue fur,deep pulse,thready pulse,deep and thin pulse,string pulse,or slippery pulse.The deficiency syndromes were mainly spleen and kidney qi deficiency syndrome,qi and yin deficiency syndrome,and the syndromes of damp-heat and blood stasis were the main accompany syndromes.2.The 436 prescriptions in this study involved 219 kinds of traditional Chinese medicines.The main traditional Chinese medicines involved five categories:tonic,diuretic and osmotic,heat-clearing,blood activating and astringent medicines.The core traditional Chinese medicines(prescription)of IMN were poria,astragalus,yam,raw rehmannia,gorgon fruit,cornus officinalis,codonopsis pilosula,plantain seed,fructus rosae laevigatae,angelica,ligusticum,cortex moutan,and pyrrosia lingua,among which poria,astragalus and yam were the core node herbs3.The core traditional Chinese medicines(prescription)and specific Chinese medicines of the main deficiency syndromes were as follows:the core herbs(prescription)of spleen and kidney qi deficiency syndrome were poria cocos,astragalus,yam,gorgon fruit,angelica,cornus officinalis,raw rehmannia,plantain seed,ligusticum,rosa laevigata michx,codonopsis pilosula,cortex moutan,and the specific drugs were the shell of areca nut,pheretima,dried tangerine peel.The core herbs(prescription)of Qi Yin deficiency syndrome were poria cocos,yam,raw rehmannia,cornus officinalis,cortex moutan,astragalus,plantain seed,codonopsis pilosula and pseudostellaria.Schisandra chinensis and ophiopogon japonicus were the specific drugs of this syndrome.The core drugs(prescription)of liver and kidney yin deficiency syndrome were astragalus,poria,ligusticum,yam,raw rehmannia,angelica,plantain seed,wolfberry,gorgon fruit,codonopsis pilosula,achyranthes bidentata The specific Chinese medicine were eclipta and ligustrum lucidum.There was a close relationship between the accompany syndrome of water dampness,heat dampness and blood stasis,and they were often intertwined to cause disease.Therefore,the medicines for diuresis and detumescence,clearing heat dampness,promoting blood circulation and removing blood stasis were often used in combination.The commonly used medicines of the three syndromes were poria cocos,polyporus,plantain seed,angelica,raw rehmannia,leech,pyrrosia lingua,achyranthes bidentata,cortex moutan and salvia miltiorrhiza.4.The core node symptoms,tongues,pulses and core Chinese medicines of different urinary protein stratifications were as follows:at the stage of mild proteinuria,the symptoms of the core nodes were foam urine and fatigue,the main manifestations of tongues and pulses were dark red or red tongue,yellow and greasy fur,deep pulse,smooth or thin pulse.During the stage of moderate proteinuria,the symptoms of the core node changed to foam urine and lower extremities edema,compared with mild proteinuria,the nodal degree of edema of both lower limbs and waist acid were higher at this stage and increased the symptoms of dry mouth and easy fatigability.The symptoms,tongues and pulses of patients with severe proteinuria were more diversified.The network relationships between symptoms,tongues and pulses were mixed,and the symptoms of the core node changed into edema of the lower extremities,foam urine and fatigue.From mild to severe proteinuria,the symptoms of lower extremity edema and waist acid were more prominent.In the treatment of mild proteinuria,the core Chinese medicine were poria cocos,astragalus,yam,angelica,cornus officinalis,codonopsis pilosula,ligusticum,pyrrosia lingua,atractylodes macrocephala,plantain seed,raw rehmannia;the core medicines for moderate proteinuria were poria cocos,astragalus,raw rehmannia,cornus officinalis,yam,angelica,ligusticum,gorgon fruit,rosa laevigata michx,cortex moutan,plantain seed,codonopsis pilosula;poria cocos,astragalus,yam,plantain seed,gorgon fruit,rosa laevigata michx,angelica,ligusticum,raw rehmannia,cornus officinalis,codonopsis pilosula and cortex moutan were the core medicines for patients with severe proteinuria.With the development of proteinuria,the compatibility of raw rehmannia,plantain seed,gorgon fruit and rosa laevigata michx were strengthened.Conclusions:1.This study showed that the deficiency syndromes of IMN were mainly spleen and kidney qi deficiency syndrome,qi and yin deficiency syndrome,and the syndromes of damp-heat and blood stasis were the main accompany syndromes.The main therapeutic methods were invigorating the spleen and benefiting the kidney,clearing away dampness and heat,activating blood and removing stasis,and the drugs of invigorating deficiency,clearing heat and removing dampness,activating blood and removing stasis and astringency were the main ones2.On the basis of IMN core traditional Chinese medicines(prescription),spleen and kidney qi deficiency syndrome attached importance to the application of drugs for regulating qi and unblocking collaterals such as shell of areca nut,dried tangerine peel and pheretima.Qi and yin deficiency syndrome commonly used pseudostellaria,schisandra chinensis and ophiopogon japonicus,emphasizing both qi and yin supplement and Qing supplement.On the basis of the core traditional Chinese medicines(prescription),liver and kidney yin deficiency syndrome had increased the medicines of tonifying liver and kidney,such as wolfberry,achyranthes bidentata,eclipta and ligustrum lucidum3.The core herbs of different urinary protein stratifications of IMN were mainly the medicines of invigorating the spleen and kidney,cl earing heat and promoting dampness,activating blood and removing stasis.With the progress of proteinuria,the signs of kidney essence deficiency and damp-heat become more obvious.Therefore,in the stage of moderate and severe proteinuria,more attention should be paid to invigorating kidney and astringent essence,clearing away dampness and heat.