| Purpose:This study summarized the randomized controlled trials of Chinese herbal decoction combined with chemotherapy in the treatment of gastric cancer published in the public database in recent five years.To provide reference for the clinical treatment of tumor with integrated traditional Chinese and western medicine,the prescription of traditional Chinese medicine(TCM)decoction was used to conduct data mining to discuss the frequency of TCM combined with chemotherapy,medicinal flavor,distribution of channels and collaterals,and prescription formation rule.At the same time,the core prescriptions extracted from data mining were studied on network pharmacology to explore the mechanism of TCM treatment of gastric cancer.MethodsRandomized controlled trials on Chinese herbal decoction combined with chemotherapy in the treatment of gastric cancer published on CNKI,Chinese scientific and technology journal database,Wanfang database,Chinese biomedical literature service system and Pub Med database on January 1,2015 and November 15,2020 were retrieved,and relevant literature reviews and systematic reviews were used to supplement.Literature was managed through Note Express,and strict screening was conducted in accordance with inclusion and exclusion criteria to obtain the final literature and input it into Excel 2019.At the same time,the names of Chinese medicines were standardized with reference to the 2015 edition of Chinese Pharmacopoeia and the 12 th Five-year Plan of Chinese materia medica.The frequency analysis,cluster analysis,association analysis,relapse network and other methods in "ancient and modern medical case cloud platform" software were used to study the rule of medication and prescription.The effective components and targets of core prescriptions obtained from the complex network were screened,and the effective targets of gastric cancer were screened.After the intersection targets were obtained,gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were conducted to study the mechanism of action.Results1.A total of 228 randomized controlled trials of TCM combined with chemotherapy in the treatment of gastric cancer were included,of which 173 flavours were used,a total of2563 times.According to the distribution range of frequency of use,drugs were divided into:high-frequency drugs(40%<N ≤100%),medium frequency drug(10%<N ≤40),lowfrequency drug(0≤N ≤10%),among which there were 8 high-frequency drugs: Atractylodes,Licorice,Poria Cocos,Codonopsis Radix,Astragalus membranaceus,Tangerine Peel,Pinellia ternata and Coix seed,respectively;there were 14 middle-frequency drugs and 151low-frequency drugs.2.The prescription of traditional Chinese medicine: the medicinal properties are mainly flat and warm,the taste is mainly sweet,bitter and plenum are the second;the distribution of channeling meridians is mainly the spleen meridian,lung and stomach meridian is the second.3.Cluster analysis showed that 10 drug combinations were obtained: C1: Pinellia pinellia and Rhizoma tangerine peel,C2: Dangshen and Astragalus membranaceus,C3 Atractylodonis Atractylodonis,Poria coing and Glycyrrhizae;C4: Coix seed,Chinese yam,C5: Rhizoma Curcuma,Hedyotis officinalis,Scylla officinalis,C6: Radix Paeonia alba,Angelica sinensis,C7: Ginseng,C8: Root of chicken,Malt,C9: Amomum seed,Amyrrhiza sinensis,C10: Dendrobium officinalis,Radix ophiopogonis,Salviae miltiorrhiza.4.There were 23 association rules among traditional Chinese medicines,the co-occurrence degree was > 60,the promotion degree was > 1,the association rules were all based on Atractylodes as the core,combined with other high frequency and medium frequency drugs composed of drug group.5.The core prescriptions(Jian-pi-qu-shi-san-jie Formula,JPQSSJF)obtained by the complex network were: Atractylodes,Licorice Radix,Poria Cocos,Dangshen,Astragalus membranaceus,Tangerine Peel,Pinellia ternata,Coix Seed,and Hedyotis diffusa.6.Rules of Chinese Medicine Prescription and Chemotherapy Combination Treatment of Gastric Cancer: chemotherapeutics acting on the organism,cause human body deficiency of vital qi,spleen qi activity lifting disorders,combined TCM at this time,need to consider the common adverse reaction of chemotherapy drugs and prevention before disease.You also need to consider the nature of the patients with cancer of the stomach and spleen deficiency,spleen and stomach qi is sufficient,but the side reaction of chemotherapy cocoa.7.The effective compound of JPQSSJF:radix scutellariae element,element of pomelo peel,mignonette element,quercetin,rhizoma kaempferiae phenol most target involved in regulation of gastric cancer,and potential targets of TP53,AKT1,CASP3,MYC,JUN,CCND1,PTGS2,EGFR,MAPK1,VEGFA,and so on targets with good synergistic anticancer.Among the potential pathways,PI3K-Akt,Pathway in cancer,TNF and other signaling pathways play an important role in the proliferation of gastric cancer cells and the regulation of vascular invasion and cell cycle by inflammatory factors.ConclusionThe randomized controlled trials of traditional Chinese medicine combined with chemotherapy in the treatment of gastric cancer published in public databases in the past five years mostly believe that gastric cancer is a syndrome of deficiency in origin and enrichment in symptom.The treatment is mainly based on strengthening the body resistance to eliminate pathogenic factors.and the method of strengthening the body is mostly through strengthening the spleen and stomach.But during peri-chemotherapy,the spleen and stomach are more damaged by Chemotherapy drugs.The prescription is mostly based on strengthening the body,with a little supplement of traditional Chinese medicine.JPQSSJF achieves the effect of treating gastric cancer through the coordination of multiple components,interaction of multiple targets and cooperation of multiple pathways,which provides a scientific basis for the treatment of gastric cancer by JPQSSJ formula,and also provides a reliable research idea for the further discussion of the treatment of gastric cancer. |
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