Using the theory of Chinese medicine, the treatment of kidney disease with Chinese medicine is based on evidence-based treatment and is effective. However, due to the limitation of the concept of human anatomy and cell biology in the development of TCM, the kidney is included in the concept of nephropathy, and the kidney diseases are often confused with systemic diseases. The overly comprehensive approach cannot fully elucidate and clarify the exact site and mechanism of action of treatment. In order to take advantage of the advantages of Chinese medicine in kidney disease, scientific research on kidney disease is very important. Scientific research should really create practical results and make efforts to solve some clinical problems of kidney disease
Applying the theory of Chinese medicine, with evidence-based treatment as the core, Chinese medicine has been used to treat kidney disease with definite effect. However, due to the limitation of the concept of human anatomy and cell biology in the development of Chinese medicine, the kidney is included in the concept of nephropathy, and the kidney diseases are often confused with systemic diseases. The overly comprehensive approach cannot fully elucidate and clarify the exact site and mechanism of action of treatment. In order to take advantage of the advantages of Chinese medicine in kidney disease, scientific research on kidney disease is very important. Scientific research should really create practical results and work hard to solve some clinical problems in nephrology.
The ideas and methods of TCM research related to nephropathy have been discussed many times [1-2], but there are not many guiding ideas and methods that really work in the research work. In the process of studying with my supervisor, Professor Sun Wei, I was fortunate to learn more about the current status and content of TCM research on kidney diseases. Combined with the current research topics related to kidney disease in Chinese medicine and the author’s experience to discuss the views on this issue. The author believes that in order to have the correct scientific research ideas and methods, the following aspects and methods must be identified as the guiding principles and core of research.
1, pay attention to the study and application of classical Chinese medical literature
Chinese medical theory is gradually formed and developed during thousands of years of human struggle with diseases, during which a large number of learning experiences and clinical insights have been recorded in the course of study and clinical process by successive generations of doctors. It reflects the theories, experiences, prescriptions and formulas of Chinese medicine for thousands of years. These ancient documents are a valuable spiritual treasure that we are proud of, and the prescriptions and formulas or summaries of medical experience contained in them have a high clinical application and research reference value. Some of the theories and methods still play an important role to this day. For example, when the clinical manifestation of edema appears in kidney disease or other internal diseases, whether it is the treatment principle of “opening the ghost door, cleansing the house, and removing the Huan Chen’s” in the Yellow Emperor’s Classic of Internal Medicine or the correct application of the “Eight Methods of Treating Water” in the Treatise on Typhoid
The treatment of kidney disease can be achieved with obvious results. Therefore, in the process of scientific research on kidney disease, we must first study the classical Chinese medical literature and works carefully,
In the process of scientific research on kidney disease, we must first study the classical Chinese medical literature and works, and find research ideas and research topics in conjunction with modern clinical needs. From the scientific research work not only can further understand and learn the treatment ideas and experience of the sages, but also can be combined with the specific conditions of disease onset and lesions in today’s society, so that the theory of Chinese medicine can be further developed and improved.
2.Giving full play to the characteristics and advantages of Chinese medicine itself
The main research method of TCM is the holistic method, which has the following main characteristics:
For example, one of the core of research in TCM is the symptoms, and the symptoms themselves are the overall state of the body, rather than the concept of specific organs and systems. For example, kidney yin deficiency refers to the external manifestation of a series of symptoms such as fever, soreness and weakness of the waist and knees, seminal emission and night sweating, dry mouth, red tongue with little coating and fine pulse, rather than the structural damage or abnormal function of the kidneys in Western medicine. Therefore, the corresponding treatment is also carried out from the whole body.
②We emphasize the comprehensive analysis of multiple factors, rather than the simple “monism” of cause and effect. For example, the appearance of a certain symptom often involves multiple causes, such as age, gender, occupation, environment, season and climate, living habits, physical constitution, culture and cultivation, disease, medication, etc.
(3) Emphasize the correspondence of state changes. TCM theory attaches great importance to the relationship and mutual influence between human and environment. The same cause does not necessarily lead to the same symptoms, such as the same climate change environment, some people will be safe and sound, some will become wind-cold cold, some will become wind-heat cold, some people will also have edema and other symptoms. This is related to the individual, environment, climate, age, gender and many other factors.
④We emphasize the principle of individualization of treatment, i.e. the principle of differentiation and treatment. The so-called “diagnosis and treatment” means that each patient’s treatment method is formulated according to his or her symptoms. Because the manifestations are random and changing, there is no one-size-fits-all treatment method or panacea for all diseases. This is fundamentally different from Western medicine’s allopathic treatment of diseases and causes. From the Qin and Han dynasties to the Ming and Qing dynasties, Chinese medicine has selected its own specific object of study – the human being in a holistic state under natural conditions – and applied its own specific research method – the holistic method – to achieve The development of Chinese medicine was marked by the Yellow Emperor’s Classic of Internal Medicine, the Treatise on Typhoid and Miscellaneous Diseases, the Four Great Masters of Jin Yuan and the Doctrine of Warm Diseases. In today’s world where the Western scientific system, including Western medicine, is dominant, the scientific research of Chinese medicine
In order to achieve the purpose of inheritance and development, it is necessary to follow its own specific research methods. If the emphasis is on learning and imitating the scientific research methods and ideas of Western medicine, there may be no significant innovation and development in the scientific research results of TCM itself. For kidney diseases, we should see the role of modern medical technology in the diagnosis and treatment of clinical diagnosis, but the characteristics and advantages of Chinese medicine should not be ignored. For example, in chronic nephritis patients, hormones are the first choice of treatment, but there are many side effects that need to be solved. At this time, the analysis of the causes and mechanisms of these side effects from Chinese medicine theory, the targeted application of Chinese medicine formulas can not only reduce the side effects but also improve the efficacy of the hormone itself is unanimously recognized by Chinese and Western medicine colleagues. The mechanism of action
3.Computer-based mathematical methods, especially statistical knowledge
Learning and application of statistical knowledge
The effectiveness of Chinese medicine in treating kidney disease is a topic that needs no further explanation. But the fact is that there are always doubts about this issue. The use of large samples
The effectiveness of TCM in the treatment of kidney disease is a necessary issue, which must be studied with the help of statistical methods. Epidemiological survey of kidney disease [3] is an important research method for the study of related diseases. Statistical analysis of data is used to recognize or confirm a phenomenon and its patterns, thus laying the foundation for scientific research. The main design idea of the survey method in the study of TCM evidence related to kidney disease is to take the theoretical approach of TCM evidence as the core.
A cross-sectional or longitudinal study of specific populations, such as chronic glomerulonephritis and chronic renal failure, was conducted. The descriptive data of TCM symptoms and their pulse evidence of the studied diseases were collected in a specific time period. Modern statistical or mathematical methods combined with medical theory are used to analyze the data and provide a basis for etiology, diagnostic criteria, and quantitative study of the disease. In short, the epidemiological investigation method of kidney disease is the basic method to start the research for the specific “problem”, the investigation data of large samples of related diseases is the basis, and the establishment of various mathematical models and exploratory analysis can make the research more objective and reasonable and reflect the scientific value.
4. Evaluation of clinical efficacy and scientificity by laboratory-related testing techniques
It is emphasized that TCM research should adhere to its own main research methods, but it is not necessary or possible to completely reject all modern scientific research methods, including Western medical research methods. On the contrary, we should take a more positive attitude to absorb, introduce and utilize all the research methods that are helpful for the development of TCM academics. For example, in nephrology, we often encounter patients with edema, which can be caused by kidney pathology or other pathologies such as heart or liver, and sometimes must be combined with modern scientific tests to make a comprehensive judgment. In the case of chronic nephritis, the edema may be obvious at the beginning but not after treatment, but in the case of proteinuria, it may be detrimental to the treatment of the disease if we rely only on the symptoms. At the same time, laboratory tests can objectively prove the efficacy of TCM treatment, which is easily accepted by most people. The use of these techniques and methods is to maintain the characteristics and ideas of TCM, neither to reject them nor to deny their own theories. With the help of the objectivity of experimental testing technology, scientific methods and advanced equipment for Chinese medicine research services.
5, new technology, especially the application of molecular biology technology
Excellent research ideas and highly sophisticated research techniques are the two most important parts of research methods. Due to the long-term traditional way of thinking in Chinese medicine
Due to the limitation of traditional way of thinking in Chinese medicine, empirical and vague theories and understanding make us practice and perceive many specific problems, but lack of analysis, and do not rise to the level of modern science that can be widely recognized by scientific researchers.
The modern scientific expression of meaning is not recognized by the majority of scientific researchers. Today, not only is the modern scientific way of thinking about research more advanced and rational, but also the technical
The technical means have also reached an unprecedented high level. Nowadays, trace detection technology is very advanced and developed, but the meaning of this microscopic information to us, who are used to macroscopic evidence, needs to be further explored. Although there have been some corresponding studies, the understanding is very inadequate and deserves our attention in the future research work. In recent years, with the completion of the Human Genome Project, the maturation of protein microarray technology and the further clarification of the three-dimensional spatial structure and composition of amino acids, it is very obvious that the basic research work has been helped. It is very important to apply these technologies to the field of nephrology, which is related to TCM research. The author hopes that through these advanced technologies in the field of TCM, these technologies can further elucidate the action sites and mechanisms of TCM, as well as the theoretical basis of TCM for the treatment of kidney diseases at the molecular or genetic level, which is a significant contribution not only to the field of TCM kidney diseases, but also to the development and innovation of the whole TCM theory.
6.The ultimate purpose of scientific research is to select research for human health services.
The focus should not be on scientific research for the sake of scientific research, whether it is Chinese medicine or Western medicine to engage in scientific research, the starting point is to treat human diseases, the ultimate goal is to prevent and treat diseases for the health of the world’s people. Scientific research is rigorous and difficult, and it requires a spirit of struggle and a sense of collaboration. Much scientific work requires long and painstaking clinical observation and experimental research to complete. Without Darwin’s long and painstaking research and data collection, the famous “Origin of Man” would not have been published. Some of the work is multidisciplinary and requires mutual learning and communication with researchers from other fields. In the selection of scientific research topics, the core of the research is to study the most common diseases that seriously endanger people’s health.
Systematic research, long-term observation, identification of a target, long-term systematic research, is the key to success. To abandon the utilitarian thinking and the attitude of seeking for success, so as to make greater achievements in Chinese medicine research work. For example, IgA nephropathy, the most common chronic nephritis, accounts for about 30%-40% of chronic nephritis diagnosed by kidney puncture biopsy. This disease has a wide incidence in China, Japan, and Southeast Asia, especially in adolescents and a significant proportion of adults. Through the observation in recent years, the poor prognosis has been gradually recognized. In western medicine, hormones, immunosuppressants, and plasma exchange have been used, but they are not effective in proteinuria in some patients, but have not fundamentally improved hematuria and long-term prognosis, and sometimes lead to deterioration of renal function. Therefore, the search for effective TCM prescriptions for IgA nephropathy is not only a contribution of TCM to nephrology, but also a contribution to the world health.