Clinical Study Of "Tiao Shen Prescription" In The Treatment Of ADHD With Heart And Spleen Deficiency Syndrome And Its Mechanism Of Action Based On Internet Pharmacology

ObjectiveTo evaluate the clinical efficacy of “Tiaoshen Prescription” in treating children with attention deficit hyperactivity disorder(ADHD)syndrome of heart and spleen deficiency through clinical research.To explore the pathway of “Tiaoshen Prescription” in the treatment of ADHD through network pharmacology mechanism.MethodsClinical study: Adopting the method of self-control before and after,enrolling 32 newly diagnosed children with ADHD(heart and spleen deficiency syndrome),treated with “Tiao Shen Prescription”,the course of treatment was 12 weeks.Observe and analyze the results of the prescription’s clinical efficacy,SNAP-IV scale score,and TCM syndrome score.Network pharmacology research: Based on bioinformatics,the active ingredients and targets of“Tiaoshen Prescription” drugs are screened through databases such as TCMSP and Swisstargetprediction;and disease databases such as Drugbank are searched to obtain disease targets,and screen the entire common targets.Use the String platform to build a common target interaction network(PPI)to predict potential targets.Finally,use the R 3.6.3 software to conduct GO biological process analysis and KEGG enrichment pathway analysis on shared targets.ResultsClinical study: Compared to the 0 week(before treating),the SNAP-IV scores were significantly lower in the 4th,8th,and 12 th weeks after treatment(P<0.01),and the score was the lowest at the 12 th week(P<0.01).Among them,attention deficit score and hyperactivity-impulsive score were significantly lower at 4th,8th and 12 th week after treatment than before treatment(0 week)(P<0.05),and the score was the lowest at 12 th week(P<0.05).In terms of TCM syndrome score,the symptoms of spontaneous sweating,loss of appetite,insomnia and stool condition were significantly improved after treatment(P<0.05).Network pharmacology: "Tiao Shen Prescription" screened out 180 kinds of drug active ingredients,1037 targets;151 ADHD disease targets.The important ingredients of "Tiao Shen Prescription " include Palmitic acid,Anwulignan,Tangeretin and Kaempferol.There are a total of66 drug-disease targets.Potential therapeutic targets may include SLC6A4,COMT,DRD2,HTR3 A,SLC6A3,MAOA.KEGG enrichment pathway analysis showed that shared targets are involved in neuroactive ligand-receptor interactions,calcium signaling pathways,serotonergic synapses,c AMP signaling pathways,and dopaminergic synapses.Conclusion(1)"Tiao Shen Prescription" can effectively improve the core symptoms of inattention and hyperactivity in children with ADHD of heart and spleen deficiency,and at the same time effectively improve other secondary symptoms such as spontaneous sweating,loss of appetite,insomnia and stool condition.(2)The palmitic acid,lignans,hesperetin,and kaempferol in "Tiaoshen Prescription " are likely to act on neuroactive ligand-receptor interactions through targets such as SLC6A4,COMT,DRD2,HTR3 A,SLC6A3 and MAOA through calcium signaling pathway,serotonergic synapse,c AMP signaling pathway,dopaminergic synapse and other pathways to exert therapeutic effects.