通讯作者: 陈钦, chenqin2858@163.com

DOI：10.12201/bmr.202507.00050

Analysis of the medication rules of famous traditional Chinese medicine practitioners for the treatment of Idiopathic Membranous Nephropathy based on data mining

• 摘要：摘要 目的 基于数据挖掘探析全国名老中医治疗特发性膜性肾病（Idiopathic Membranous Nephropathy，IMN）相关难点的用药规律。方法 收集符合纳排标准的医案，针对病程≥1年、肾功能损害、低蛋白血症及高甘油三酯血症等难点，进行证型统计、药物频次、关联规则及聚类分析。结果 纳入医案128例，发现脾肾亏虚证为最常见的证型；结合中药频次及关联规则，发现黄芪、白术、茯苓、当归、丹参在处方中使用的频率最高；聚类分析获得以真武汤、参苓白术散、水陆二仙丹等为主的核心聚类方。结论 在IMN相关治疗难点的医案中，证属本虚标实，核心治法均为健脾益肾，针对病程≥1年的患者加虫类药以搜剔通络，松动病根；伴肾功能损害者注重温阳祛风；伴低蛋白血症者重视滋阴固本、清热解毒，伴高甘油三酯血症者辅以清热化湿。

  关键词： 特发性膜性肾病; 治疗难点; 名老中医; 用药规律; 数据挖掘

   

  Abstract: Abstract Objective To explore the medication patterns of nationally renowned veteran Traditional Chinese Medicine (TCM) practitioners in treating challenging aspects of Idiopathic Membranous Nephropathy (IMN) based on data mining. Methods Medical records meeting the inclusion and exclusion criteria were collected. Statistical analysis of syndrome patterns, herb frequency, association rules, and cluster analysis were conducted for key challenges, including disease duration ≥1 year, renal impairment, hypoalbuminemia, and hypertriglyceridemia. Results A total of 128 medical cases were included. Spleen-kidney deficiency syndrome was identified as the most common pattern. Based on herb frequency and association rule analysis, Radix Astragali, Atractylodes macrocephala, Wolfiporia extensa, angelica sinensis and salvia miltiorrhiza were the most frequently used in prescription. Cluster analysis revealed core herbal groupings primarily based on classical formulas such as Zhenwu Decoction,Shenling Baizhu Powder, and Shuilu Erxian Dan. Conclusion In the medical cases addressing treatment challenges, the syndrome is characterized by root deficiency and branch excess, with the core therapeutic principle focusing on fortifying the spleen and tonifying the kidney. For patients with a disease duration ≥1 year, insect-derived herbs were added to dredge collaterals and dislodge the disease root. Cases with renal impairment emphasized warming yang and dispelling wind; those with hypoalbuminemia prioritized nourishing yin, consolidating the root, and clearing heat-toxins; and patients with hypertriglyceridemia were additionally treated with heat-clearing and dampness-resolving methods.

  Key words: idiopathic membranous nephropathy; difficulty in treatment; famous old Chinese medicine practitioners; medication rules; data mining

  提交时间：2025-07-16

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• 序号	提交日期	编号	操作
  1	2025-05-08	bmr.202507.00050V1	下载

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