| Objective1.Based on network pharmacology,predict the potential target of Shengmai injection in the treatment of gastric cancer-related cancer-related fatigue,and preliminarily explore its possible mechanism of action.2.By observing the clinical efficacy of Shengmai injection in intervening patients with gastric cancer fatigue due to deficiency of both qi and yin,it provides a basis for the clinical application of Chinese patent medicine injection.Methods1.with the help of TCMSP platform,chemical database,Drug Bank database,BATMAN-TCM database and published literature,the active ingredients and protein targets in shengmai injection were screened,the protein targets were standardized by Uniprot database,and the network diagram of "drugs-active ingredients-targets" of shengmai injection was constructed by using Cytoscape3.8.2 software.Gen Cards database,OMIM database,TTD database,Disgenet database were used to mine related targets of gastric cancer fatigue,and Venny2.1online software was used to obtain the common targets of both.Then,the online software Venny2.1 was used to obtain the intersection target of Shengmai injection and disease,and the Venn diagram was made.The intersection target was imported into String11.0 to obtain the protein interaction map.Cytoscape3.8.2 software was used to calculate the topology parameters of the protein interaction map,and the core target was screened out.With the help of Metascape platform,GO bioenrichment and KEGG pathway analysis were performed on the intersection targets,and a network diagram of active component,target and pathway of Shengmai injection was constructed to analyze and discuss the mechanism of Shengmai injection in the treatment of cancer-induced fatigue.2.According to the criteria for inclusion and exclusion,collected 60 hospitalized cases from March 2020 to January 2021 in the Oncology Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine who met the research requirements,and randomly divided them into a control group and a treatment group.The control group provided basic support For treatment,the treatment group was treated with Shengmai injection on the basis of the control group.To observe and evaluate the improvement of Piper fatigue scale,tumor patients’ quality of life rating scale,Chinese medicine symptom score scale,the Karfel Score,lymphocyte subgroup analysis,depression or anxiety state and the occurrence of adverse reactions.Results1.The effective active ingredients of Shengmai injection and their targets: After database screening and literature supplementation,64 effective active ingredients of Shengmai injection were finally obtained,including 14 kinds of red ginseng,40 kinds of schisandra and10 kinds of Ophiopogon japonicus.The active ingredient targets 59 red ginseng,57 schisandra,36 ophiopogon japonicus,and a total of 116 targets were obtained after combined deduplication.2.Screening of gastric cancer-cancer-related fatigue intersection targets,drug-disease intersection targets and core targets: use Venny2.1 online software to obtain 956 gastric cancer-cancer-related fatigue intersection targets,Shengmai Injection-44 Disease Intersection Targets,and 6 core targets were screened out by topological parameter calculation: JUN,TNF,IL1 B,CASP3,NOS3,PTGS2.3.Shengmai injection GO bio-enrichment and KEGG pathway analysis: GO function enrichment analysis was carried out through the Metascape data platform,and the results showed that Shengmai injection participated in the apoptosis pathway,regulating cell proliferation,regulating hormone levels,cell differentiation,and drugs 20 biological functions such as reaction,gene expression,and protein kinase signaling;related gene targets are enriched in 6 cell components including outer cell membrane,membrane raft,postsynaptic membrane,and cytoplasm;affect cytokine receptor binding and protease 15 molecular functions such as binding,heme binding,kinase binding,and nuclear receptor activity.KEGG pathway analysis revealed a total of 19 significant pathways,including tumor-related pathways,inflammatory cytokine signaling pathways,estrogen signaling pathways,and PI3K-Akt signaling pathways.Shengmai injection may inhibit tumor cell proliferation,induce tumor cell apoptosis,and regulate the level of inflammatory cytokines to play an anti-tumor and improve cancer-induced fatigue.4.A total of 60 qualified patients with fatigue due to gastric cancer with deficiency of both Qi and Yin were collected.According to the principle of 1:1 random allocation,30 cases were in the control group and 30 cases in the treatment group.After baseline analysis,the differences in gender,age,physical exercise status,clinical stage,treatment history,and pre-treatment scale scores and laboratory indicators between the two groups were not statistically significant(P>0.05).The two groups can be compared.After 14 days of treatment,the intervention group was significantly better than the control group in terms of Piper fatigue scale score,tumor patient quality of life score,TCM syndrome score,Karnofsky score,and lymphocyte subpopulation analysis(P<0.05).During the treatment of the two groups,some patients had slight increases in blood routine and liver and kidney function indexes,but they were still within the normal range.There were no adverse reactions and side effects related to this study,and the overall safety was good.Conclusions1.Shengmai injection has the characteristics of multi-component,multi-target,multi-channel synergy.The three traditional Chinese medicines contain a total of 64 effective ingredients and116 active ingredients targets.They are involved in different processes such as inducing tumor cell apoptosis,inhibiting tumor cell proliferation,and regulating inflammatory cytokines.2.There are 11,842 gastric cancer-related targets,1484 cancer-related fatigue targets,and a total of 956 gastric cancer-carcinogenic fatigue targets.There are 44 targets of Shengmai injection-diseases intersection,including 6 core targets,namely: JUN,TNF,IL1 B,CASP3,NOS3,and PTGS2,which are the possible potential of Shengmai injection to treat cancer-related fatigue Target.3.Shengmai injection acts on 20 biological functions such as apoptosis pathway,regulation of cell proliferation,regulation of hormone levels,cell differentiation,drug response,gene expression,and protein kinase signal transduction.It is significantly enriched in 6 cell components including outer cell membrane,membrane raft,postsynaptic membrane,and cytoplasm.It affects 15 molecular functions including cytokine receptor binding,protease binding,heme binding,kinase binding and nuclear receptor activity.Significantly affect 19 signal pathways including tumor-related pathways,inflammatory cytokine signaling pathways,estrogen signaling pathways,tumor-related pathways,inflammatory cytokine signaling pathways,estrogen signaling pathways,and PI3K-Akt signaling pathways.4.Shengmai injection may play an anti-tumor effect by inhibiting tumor cell proliferation and inducing tumor cell apoptosis,and by inhibiting the production of inflammatory cytokines,regulating the level of related hormones,regulating the hypothalamic-pituitary-adrenal axis and other mechanisms to improve fatigue,Negative emotions and so on.5.Shengmai injection combined with basic therapy is better than basic therapy for cancer-related fatigue,significantly reducing patients’ PFS score,TCM syndrome score,depression score,and improving patients’ quality of life score and KPS score,which can be better improved The patient’s fatigue symptoms improve the patient’s quality of life.6.Shengmai injection combined treatment can up-regulate the ratio of CD3+,CD3+/CD4+,CD3+/CD8+ cells in the analysis of lymphocyte subsets,and improve the patient’s immune function.7.The combined treatment of Shengmai injection can significantly increase the patient’s WBC level,play a role in reducing bone marrow suppression,and there is no liver and kidney toxicity and adverse reactions and side effects related to this study. |
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