| Objective:This paper explores the core of diagnosis and treatment,prescription rules and medication characteristics of modern doctors in the treatment of children’s Henoch Schonlein purpura from multiple perspectives,and explores the molecular mechanism of high-frequency prescription from the theoretical level,so as to confirm and supplement the existing TCM diagnosis and treatment guidelines,provide reference and basis for clinical prescription selection,and enrich the diagnosis and treatment scheme of children’s Henoch Schonlein Pura,More beneficial intervention measures should be added to provide some ideas and directions for basic experimental research.Method:(1)To explore the rule of TCM decoction in the treatment of children Henoch Schonlein purpura based on data mining: Three major databases in China were used as the search source,and the studies publish time is limited from December 31,2010 to December31,2020.Using Microsoft Excel 2016 software to establish the database of "Prescription medicine of TCM in children Henoch Schonlein purpura",and then standardize and normalize the information in the database.Using SPSS statistics 26.0,SPSS modeler 18.0and other relevant software,using descriptive analysis,systematic clustering analysis,association rule analysis,factor analysis /principal component analysis and other data mining methods and statistical analysis algorithm.(2)To explore the mechanism of Xijiao Dihuang Decoction in the treatment of Henoch Schonlein purpura based on network pharmacology: On the basis of data mining research results,Xijiao Dihuang Decoction,a high-frequency-used prescription,was selected as the research object in this part,the main chemical components and effect target of Xijiao Dihuang Decoction were collected from professional TCM databases;the therapeutic targets of Henoch Schonlein purpura were downloaded from human genome database;String database,the Bisogenet 3.0.0 plug-in and Cytonca 2.1.6 plug-in of Cytoscape software,and R language were used to construct the protein-protein interaction networks and extract the core targets;run R language for GO function enrichment analysis,run R language and the Clue GO plug-in and Clue Pedia plug-in of Cytoscape software for KEGG channel enrichment analysis.Results:(1)Prescription rules of TCM decoction for treating children Henoch Schonlein purpura: 1)descriptive analysis: a total of 281 articles were included in this study,including randomized/non randomized controlled trials,retrospective studies,etc.The study area was distributed in 28 provinces and municipalities,and the total sample size was 24734.The distribution of syndrome types was mainly blood heat syndrome,followed by qi deficiency syndrome and wind-heat syndrome.A total of 121 named prescriptions and 422 frequency prescription information were extracted.The top three prescriptions were Xijiao Dihuang Decoction,yinqiao powder and Guipi Decoction.A total of 229 drugs were involved,and the top five were Rehmanniae Radix,Moutan Cortex,Arnebiae Radix,Paeoniae Radix Rubra and Glycyrrhizae Radix Et Rhizoma.There are 17 kinds of first-class efficacy,mainly include heat clearing drugs,deficiency tonifying drugs,hemostatic drugs,exterior resolving drugs and invigorating blood circulation and eliminating stasis drugs;the treatment categories were mainly "heat","blood","deficiency",and also "wind","dampness" and "Qi".The drug properties were mainly include cold,warm and flat,and its taste is mostly sweet and bitter.It mainly enters the liver meridian and heart meridian.2)Systematic cluster analysis and factor analysis/principal component analysis:(1)9 cluster results and 18 common factors were interpreted from the top 50 high-frequency drugs of all prescription information.The basic prescriptions mainly include Guipi Decoction,Taohong Siwu Decoction,yinqiao powder,Xijiao Dihuang Decoction,etc.(2)The top 50high-frequency drugs of blood heat syndrome prescription information were read out 12 cluster results,and the original prescription of Xijiao Dihuang decoction was extracted.3)Association rule analysis: the association rule analysis of 229 drugs in all prescription information obtained multiple frequent itemsets.Under the background of 100%confidence,three Association basic prescriptions were extracted,all of which covered the original prescription of Xijiao Dihuang Decoction.Arnebiae Radix and Rubiae Radix Et Rhizoma were strongly associated with it.(2)The mechanism of Xijiao Dihuang Decoction in the treatment of Henoch Schonlein purpura: 1)the main bioactive ingredients of Xijiao Dihuang decoction are:benzoyl paeoniflorin/total glucosides of paeony,quercetin,kaempferol,etc.;Paeoniae Radix Rubra has the most of targets,followed by Rehmanniae Radix.2)There are 54 overlapping targets between Xijiao Dihuang Decoction and Henoch Schonlein purpura.3)The key therapeutic targets: cytokines(IL 6,IL 10,IL 1 β,TGF-β 1,TNF),adhesion factors(SEL,ICAM1),RAS system related factors(AGTR1,ACE),and other related targets(TLR4,VEGF,NOS2,NOS3).4)Go function enrichment analysis and KEGG pathway enrichment analysis: a total of 43 biological functions and 110 signaling pathways were involved,and the enrichment pathways mainly included: NF-κB signaling pathway,TNF signaling pathway,IL-17 signaling pathway,Th17 cell differentiation,T cell receptor signaling pathway,Toll-like receptor signaling pathway,Chemokine signaling pathway,HIF-1 signaling pathway,PI3K-Akt signaling pathway,Intestinal immune network for Ig A production and Coronavirus disease-COVID-19.Conclusion:(1)According to the results of data mining,the internal cause of IGAV is blood heat rash,followed by Qi dysfunction in blood control,and the external cause is wind-heat injuring collaterals;heat forcing blood circulation or qi deficiency is the two core pathogenesis of IGAV;exogenous wind-heat evil is the key inducement of IGAV;the location of the disease is the combination of internal and external,and the nature of the disease is a mixture of deficiency and excess;the pathological factors are mainly "heat","blood stasis","deficiency","wind" and "dampness";the pathogenesis of IGAV is mainly due to exogenous wind-heat-evil-toxin,which is accumulated in the blood,result in blood heat rash and spilling over the skin;or Qi deficiency that can’t control the blood,which cause the blood to flow outside the pulse.(2)In the treatment of IGAV,modern doctors mainly focus on clearing away heat,cooling blood,stopping bleeding,promoting blood circulation and tonifying deficiency,supplemented by dispelling wind,removing dampness,promoting qi and astringency.At the same time,medication habits include cold and warm,sweet and bitter,attack and tonic.Xijiao Dihuang decoction is the main prescription,heat clearing and blood cooling drugs are commonly used,and the drugs mainly enter the liver,heart,lung and spleen meridians.(3)Xijiao Dihuang decoction is the basic and preferred prescription for the treatment of children’s IGAV by modern doctors,Arnebiae Radix and Rubiae Radix Et Rhizoma were strongly associated with it.(4)Xijiao Dihuang decoction may intervene inflammatory reaction and regulate immune function by influencing many cytokines/inflammatory factors and regulating immune cells,so as to play a comprehensive therapeutic role in IGAV.In addition,the results of network pharmacology showed that Xijiao Dihuang decoction had potential intervention effect on Coronavirus disease-COVID-19. |
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