Exploring the Staged Treatment Patterns of Diabetic Kidney Disease Through Single Herbs,Herb Combinations,and Herb Community Network

DU Yizhe; HE Mengnan; YUAN Tingting; FU Yu; LI Xingrui; PAN Yuying; CUI Weifeng

doi:10.3969/j.issn.1006-3250.2026.02.033

Abstract：Objective To explore the characteristics of disease nature and location syndrome elements in diabetic kidney disease(DKD)and the medication and treatment patterns at different stages,providing evidence for the prevention and treatment of DKD with traditional Chinese medicine(TCM).Methods Clinical cases meeting the diagnostic criteria for DKD from 2016 to 2023 at Henan Integrative Medicine Hospital were collected.Frequency statistics,association rule analysis,and complex network community detection algorithms were used to analyze the medication characteristics,herb combinations,and changes in core herb communities across different stages of DKD.Results A total of 1 164 DKD patients were included,comprising 248 cases in stage I,150 in stage Ⅱ,382 in stage Ⅲ,263 in stage Ⅳ,and 121 in stage V.The study involved 1 164 prescriptions and 368 herbs.The top 10 high-frequency herbs were Fuling(Poria),Huangqi(Astragali Radix),Chenpi(Citri Reticulatae Pericarpium),Danggui(Angelicae Sinensis Radix),Baizhu(Atractylodis Macrocephalae Rhizoma),Chuanxiong(Chuanxiong Rhizoma),Huanglian(Coptidis Rhizoma),Niuxi(Achyranthis Bidentatae Radix),Banxia(Pinelliae Rhizoma),and Danshen(Salviae Miltiorrhizae Radix Et Rhizoma).The most frequent herb properties,flavors,meridian tropisms,and efficacies were warm,sweet,spleen meridian,and deficiency-tonifying herbs,respectively.Association rule analysis identified herb combination pairs such as Taizishen(Pseudostellariae Radix)-Wuweizi(Schisandrae Chinensis Fructus)-Maidong(Ophiopogonis Radix),Zhuru(Bambusae Caulis in Taeniam)-Chenpi,Fuling-Zhuru-Chenpi,Chuanxiong-Dilong(Pheretima)-Huangqi,and Danggui-Honghua(Carthami Flos)-Chuanxiong.Complex network community analysis across stages revealed the following:In stage I,Community A showed Huangqi as the largest node,with the closest connection between Huangqi and Baizhu;Community B featured larger nodes for Maidong and Fuling.In stage Ⅱ,Community A had Danshen as the largest node,with the closest connection between Shanzhuyu(Corni Fructus)and Shengdihuang(Rehmanniae Radix);Community B featured a larger node for Fuling;Community C featured a larger node for Shanyao(Dioscoreae Rhizoma).In stage Ⅲ,Community A included larger nodes for Niuxi,Chishao(Paeoniae Radix Rubra),Huangqi,Danggui,and Dilong;Community B featured larger nodes for Chenpi,Banxia,Fuling,Baizhu,Huanglian,and Zhuru.In stage Ⅳ,Community A had Niuxi as the largest node,with the closest connection among Niuxi,Shengdihuang,and Shanyao;Community B featured larger nodes for Huangqi,Fuling,Baizhu,Danggui,and Danshen.In stage V,Community A had Fuling as the largest node,with the closest connection between Fuling and Dangshen(Codonopsis Radix);Community B featured a larger node for Huangqi,with the closest connection between Guizhi(Cinnamomi Ramulus)and Huangqi;Community C featured a larger node for Houpo(Magnoliae Officinalis Cortex),containing only Zhishi(Aurantii Fructus Immaturus)and Houpo.Conclusion The primary disease nature syndrome element is deficiency of both Qi and Yin,often accompanied by phlegm-dampness and blood stasis.The primary disease location syndrome element is the spleen.The fundamental pathogenesis of DKD is summarized as deficiency in origin and excess in manifestation.The main treatment principles for DKD include supplementing Qi and nourishing Yin,combined with unblocking blood vessels and resolving phlegm-turbidity.Specifically,the early stages focus on supplementing Qi and nourishing Yin,transforming Qi to promote diuresis,and activating blood to unblock vessels;the middle stages emphasize activating blood to resolve masses and promoting diuresis to reduce swelling;and the late stages focus on supplementing Qi and nourishing blood,clearing turbid toxins,and activating blood to resolve stasis.These findings provide a scientific basis for TCM-guided treatment of diabetic kidney disease.