Study On The Mechanism Of Shenbi Decoction In Treating Lumbar Disc Herniation Based On Collateral Diseases And Network Pharmacology

Objective: Based on the theory of collateral diseases in traditional Chinese medicine,the clinical efficacy of Shenbi Decoction in treating lumbar disc herniation(LDH)was studied by modern clinical randomized controlled experiment.At the same time,combined with the related technologies and methods of network pharmacology,the related molecular mechanism of LDH treatment was analyzed.Methods: The related clinical cases were collected and included in80 LDH patients who met the screening criteria.They were randomly divided into treatment group and control group.The treatment group was treated with Shenbi Decoction,while the control group was treated with etodolac sustained-release tablets and flurbiprofen gel plaster,with two weeks as a course of treatment and two consecutive courses of treatment.At the end of each course of treatment,VAS pain score,VAS numbness score,Oswestry dysfunction index score and lumbar JOA score were used to judge and compare the curative effects between groups.At the same time,based on the guidance of the collateral disease theory of traditional Chinese medicine,and combined with the related technical methods of network pharmacology,we obtained the higher active compounds and corresponding target genes in various traditional Chinese medicines of Shenbi Decoction,mapped them with LDH disease-related target genes,constructed their action network,enriched and annotated the genes,and studied the possible mechanism of intervention treatment of LDH by Shenbi Decoction.Results: After two weeks of treatment,VAS pain score,Oswestry dysfunction index score and lumbar JOA score were significantly different between the two groups(P < 0.05),and the control group was superior to the treatment group.There was no significant difference in VAS numbness score between the two groups(P > 0.05).After 4 weeks of treatment,VAS numbness score and lumbar JOA score were significantly different between the two groups(P < 0.05),and the treatment group was superior to the control group.There was no significant difference in VAS pain score and Oswestry dysfunction index score between the two groups(P > 0.05).According to the network pharmacological analysis,Shenbi Decoction has many effects such as anti-inflammation,anti-oxidation,protection of nucleus pulposus cells,inhibition of angiogenesis,etc.,mainly through TP53,IL6,VEGFA,CYCS,MAPK1 and other specific biological pathways such as TNF pathway,NOD-like receptor pathway,Toll-like receptor pathway and VEGF pathway,which can improve the clinical symptoms of LDH patients.Conclusion: Shenbi Decoction has good clinical efficacy in treating LDH of qi stagnation and blood stasis type,and has more advantages in promoting pain relief and numbness recovery of LDH patients.According to the network pharmacology research,Shenbi Decoction can activate a large number of target genes,interfere with various cellular biological processes and signal pathways in human body,and play a comprehensive role in treating LDH of qi stagnation and blood stasis type through local and overall regulation.