Prof. Cui Hongsheng's Preliminary Study On The Regularity Of Traditional Chinese Medicine For Treating Asthma And The Formulation Of Traditional Chinese Medicine Diagnosis And Treatment Scale

ObjectiveAsthma is a respiratory disease characterized by sudden onset,difficulty in breathing,pale complexion,and wheezing in the throat.In modern medicine,bronchial asthma,chronic bronchitis and wheezing type,and chronic obstructive pulmonary emphysema can all be Refer to its syndrome differentiation and treatment.Some of these bronchial asthma are extremely stubborn,with repeated attacks,prolonged and difficult to heal,about 5%will develop into refractory asthma,especially steroid dependent asthma(steroid dependent asthma,SDA),which requires long-term application of systemic glucocorticoid therapy to control it.Modern medicine has limited treatment measures for SDA,which cannot fundamentally solve the contradiction between withdrawal and treatment,and clinical interventions are mostly used in traditional Chinese medicine.However,the classification,diagnosis,and choice of treatment methods for Chinese medical syndromes have never been unified,and there is no standardized treatment guide or consensus that combines syndromes and therapeutics,which seriously plagues many clinicians and patients.The purpose of this study is to conduct data mining on Professor Cui Hongsheng’s medication rules in the treatment of asthma using traditional Chinese medicine,analyze his prescriptions and medication rules,and provide medication experience for clinical treatment.And focus on the analysis of the effective active ingredients of its empirical formula-Jiajian Wumei Pills and its molecular mechanism for the treatment of SDA.Finally,the questionnaire of Delphi method was conducted on the questionnaire of the Delphi method that has not yet reached a consensus in the application of SDA in TCM and TCM,and the expert interviews were conducted in detail,and the amount of diagnosis and treatment of SDA in TCM was drawn up.Table for the development of the follow-up guide and put forward the research direction and scientific basis.Method1 Using the traditional Chinese medicine inheritance auxiliary platform software(V2.5)as the calculation carrier,through the data mining method,the use of Professor Cui Hongsheng’s medication rules for the treatment of asthma was analyzed and summarized,and the medical records of Professor Cui Hongsheng’ s diagnosis and treatment of asthma from April 2011 to December 2020 were counted.After screening the inclusion criteria and exclusion criteria,the medical records are included.The audit data is entered through the Chinese Academy of Sciences’ development of the Chinese Medicine Inheritance Auxiliary Platform Software(V2.5).Finally,the platform software and Microsoft EXCEL software are used for data mining and statistical analysis to summarize Professor Cui Hongsheng’s treatament of asthma Medication experience.2 To study the molecular mechanism of Professor Cui Hongsheng’s Experience Formula-Jiajian Wumei Pills in the treatment of SDA,and search for the effective active ingredients of Jiajian Wumei Pills and their target proteins in the treatment of SDA through the TCMSP database and Genecards database.Targets,construct a network diagram of effective active ingredients-disease targets;the protein interaction network is constructed through the String database,and GO and KEGG enrichment analysis are performed through the Metascape database;finally,the effective active ingredients and targets are verified using molecular docking technology.3 Construct the first draft of the hormone-dependent asthma treatment scale based on the literature research method and the expert interview method,combined with the actual clinical situation,and determine the indicators of the treatment scale at all levels through expert consultation with the Delphi method,for the subsequent drafting of the guideline to propose research directions and science basis.Results1 The study included 2011 medical records with a total of 1040 valid prescriptions.The male to female ratio in the included patients was 1:2.05,and the age range was 8 to 99 years.The prescription drugs in the medical records involve 273 flavors.The four qi of the drugs are mainly cold and cold(50.52%in total),of which cold drugs are used the most(45.92%),followed by warm drugs and flat drugs;the five flavors of the drugs are mainly cold and cold(accounting for 45.92%).It is mainly sweet,bitter,and pungent(87.69%in total);the meridian of the medicine is mainly in the lung,stomach and spleen(57.86%in total).Medical records involving high-frequency medications were used most frequently(accounting for 22.86%of total medications),followed by anti-cough and antiasthmatic medications(accounting for 16.37%of total medications).According to the statistical results and the prescription rules,the common drug combinations are obtained through frequency and confidence statistics:Ophiopogon-reed root,reed root-scutellaria,roasted licorice-loquat leaves,Ophiopogon-scutellaria,ebony-white peony.Through network-based correlation analysis,it is concluded that the core prescriptions used in SDA medical records are:ebony,white peony,scutellaria,perilla,honeysuckle,Ophiopogon japonicus,reed root,coix seed,almond,raw gypsum,peach kernel,loquat leaf,Mulberry bark,platycodon,roasted licorice,chrysanthemum,parsnip,mulberry leaf,pinellia,cicada slough,Zhejiang fritillary.A number of results show that the treatment is closely related to our teacher’s empirical prescription-Jiajian Wumei Wan Recipe.2 After screening,the addition and subtraction of quercetin,β-sitosterol,kaempferol,stigmasterol and other key active ingredients in Wumei Pills may act on the transcription factor AP-1(Transcription factor AP-1,JUN).),tumor necrosis factor(Tumor necrosis factor,TNF),mitogen-activated protein kinase 1(Mitogen-activated protein kinase 1,MAPK1),RAC-alpha serine/threonine-protein kinase(RAC-alpha serine/threonine-protein Kinase,AKT1),cellular tumor antigen p53(Cellular tumor antigen p53,TP53)and other core genes are involved in the treatment of modified Wumei Wan prescription.The pathways involved in KEGG enrichment analysis include Pathways in cancer,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and NF-kappa B signaling pathway(NF-kappa B signaling pathway),cAMP signaling pathway(cAMP signaling pathway),Jak-STAT signaling pathway(Jak-STAT signaling pathway),etc.3 The first draft of the Hormone Dependent Asthma Treatment Scale was established with 2 first-level indicators,11 second-level indicators and 234 third-level indicators.Conclusions1 Professor Cui Hongsheng’s treatment of asthma is mainly through the treatment of eliminating evils and strengthening the body,regulating and replenishing yin and yang,and proposes the treatment from the liver.His empirical formula-Modified Wumei Pill Recipe is frequently used,providing clinical treatment experience.2 Modified Wumei Pills can play an anti-inflammatory effect through a complex mechanism of multi-component,multi-target,and multi-pathway,and then have a therapeutic effect on stimulating SDA.3 Through the Delphi expert interview method,the first draft of the treatment scale suitable for SDA was analyzed and integrated,which provided the research direction and scientific basis for the drafting of future guidelines.