| Objective:1 Systematically evaluate the clinical efficacy and adverse reactions of Buzhong Yiqi Decoction combined with Shashen Maidong Decoction in the treatment of advanced NSCLC,and to provide evidence-based medical evidence for the clinical application of Buzhong Yiqi Decoction and Shashen Maidong Decoction in the treatment of NSCLC.2 The mechanism of action of licorice in Buzhong Yiqi Decoction on non-small cell lung cancer(NSCLC)was studied by network pharmacology method.Methods:1 Meta-analysisComputer retrieval CNKI,Wan Fang Data,VIP database,CBM,Pub Med,The Cochrane Library,Embase of The Buzhoongyiqi decoction and Shashen Maidong decoction combined platinum chemotherapy(experimental group)compared to pure platinum chemotherapy(control group)randomized controlled study for The treatment of advanced NSCLC.The retrieval time limit is from the establishment to November 30,2020.Through screening,outcome index data were extracted and the quality of the included studies was evaluated according to the Cochrane manual.Meta-analysis was performed using Stata 14 software,and risk ratio(RR)and 95% confidence interval(CI)were calculated.2 Network pharmacologicalTaking licorice in Buzhong Yiqi Decoction as the research object,the active ingredients and the corresponding potential drug targets in licorice were obtained from the Chinese Medicine Pharmacology System Analysis Platform(TCMSP)database,and the lung cancer-related genes were collected from Gene Cards database and OMim database.Then,Venny 2.1.0 was used to obtain the target protein of the two intersecting,and the Venn plot was made.Drug-compound-disease-target network diagram was constructed by using Cytoscape3.7.2 software,and PPI protein interaction network was made by using String database.Gene ontology(GO)functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed using R software package.Finally,PYMOL software was used for molecular docking.Results:1 Meta-analysisTotals of 16 RCTs were included in this study,involving a total of 1337 patients with advanced NSCLC.Meta-analysis results showed that: in terms of efficacy,the trial group could increase the objective response rate(ORR)(RR=1.22,95%CI:1.12,1.33,P =0.000);Improved TCM syndrome score(SMD=-4.68,95%CI:-6.70,-2.67,P =0.000);Improved quality of life(RR=1.53,95%CI:1.27,1.84,P =0.000),and the differences were statistically significant.In terms of clinical symptoms,the incidence of nausea and vomiting(RR=0.53,95%CI:0.44,0.64,P=0.000),dizziness(RR=0.37,95%CI:0.21,0.65,P=0.001),gastrointestinal discomfort(RR=0.59,95%CI:0.45,0.77,P=0.000)and cough(RR=0.34,95%CI:0.12,0.98,P=0.045)were reduced.Hematological examination showed statistically significant differences in alleviating leukopenia(RR=0.63,95%CI:0.54,0.74,P=0.000),liver function injury(RR=0.28,95%CI:0.16,0.52,P=0.000),renal function injury(RR=0.53,95%CI:0.29,0.97,P=0.039)and other toxic and side effects..2 Network pharmacologicalIn this study,92 active components of traditional Chinese medicine were obtained from TCMSP database,and 1255 meaningful targets were obtained from Uniprot database.Through 23107 disease target protein Gene Cards database,will get the intersection compounds and target protein of disease mapping target 197,import Cytoscape3.7.2 software,the result to build "drug-compounds-target protein-disease" network,intersection targets into the STRING database,construction of protein interaction network,the higher degree,in the core position of targets are AKT1,IL6,MAPK3,VEGFA,JUN,CASP3 and so on,then GO function enrichment analysis was carried out on the key targets for 197,The 20 enrichment processes most associated with disease were screened out.126 channels were obtained from KEGG pathway analysis.Molecular docking results showed that EGFR and MAPK3 showed good binding energy with Kaempferol.Conclusion(s):1 Meta-analysisThe combination of Buzhong Yiqi Decoction and Shashen Maidong Decoction with Platinum chemotherapy can improve the clinical efficacy,life quality and clinical symptoms of patients.Reduce the incidence of nausea,vomiting,dizziness,gastrointestinal discomfort,cough and other clinical symptoms;The toxicity and side effects of leukopenia,liver function injury,renal function injury and other hematological reactions were alleviated with statistically significant differences,and the heterogeneity among various studies was low.Although the included in the study of 16,into the researchers reach more than 1300,but due to the low part into the study quality evaluation,quality is not high,cause the overall literature and are included in the study of Chinese,so,the study result is late need to high quality,multicenter,large sample randomized clinical research further validation.2 Network pharmacologicalThe network pharmacology research results showed that the radix glycyrrhizae ACTS on the element of non-small cell lung cancer involving licorice phenol,beta sitosterol,galangal,pomelo and so on,by tumor necrosis factor signaling pathways,hypoxia inducing factor signaling pathways,IL-17 signaling pathways and various signaling pathways mediating the happening of non-small cell lung cancer development,molecular docking results showed that EGFR,MAPK protein is the main protein of licorice role in lung cancer.To provide theoretical basis for pharmacological experimental study of licorice on non-small cell lung cancer. |
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