| Objective:Using the method of literature research and expert consensus to compile the expert consensus on the clinical application of Jianganle granule,so as to provide reasonable guidance for the clinical rational use of Jianganle granule in the treatment of abnormal liver function.At the same time,combined with network pharmacology and molecular docking technology,this paper discusses the potential mechanism of Jianganle granule in the treatment of abnormal liver function,so as to provide basis for further research on the drug.Methods:（1）Firstly,"Shaoyao Gancao Decoction" and its alias are used to search the Chinese medical code,the full-text database of traditional Chinese medicine ancient books（national medical collection）and the database of Digital Library of traditional Chinese medicine ancient books,sort out the ancient literature of Shaoyao Gancao Decoction,and make textual research from the aspects of alias evolution,main symptoms,drug composition,dosage,processing and decoction.Then,"jian’ganle granules" and "jian’ganle granules" were searched in China biomedical literature（CBM）,China Knowledge Network（CNKI）,Wanfang Data knowledge service platform,VIP,sinomed,Pub Med and webofscience,and with the help of revman5 2 and gradeprofile software,grade classification method was used to evaluate the evidence quality of the literature.（2）Use the expert consensus method including questionnaire survey method,nominal group method and consensus meeting method to form recommendation opinions and consensus suggestions.Firstly,through two rounds of questionnaire survey on 140 clinicians and statistical analysis of the questionnaire survey results,the original list of clinical problems is obtained.Combined with the evidence obtained from literature research,29 experts are convened to hold two consensus seminars by using the nominal group method and consensus meeting method.After reaching a consensus,the optimal clinical problems,final recommendations and consensus suggestions are determined,Form the expert consensus on the clinical application of Jianganle granule in the treatment of abnormal liver function.（3）Obtain the effective chemical components and potential targets of Jianganle granule related traditional Chinese medicine through tcmsp;The disease targets with abnormal liver function were obtained from TTD,OMIM and other data databases,and the intersection genes with the target genes of traditional Chinese medicine were screened and drawn by Wayne diagram;Using string database to construct protein-protein interaction network;Use Cytoscape 3 8.0 draw the network diagram of active ingredient target and disease traditional Chinese medicine compound intersection target with software;The Bioconductor installation package of R language was used to analyze the enrichment of go and KEGG pathways;Molecular docking of the screened components was carried out with Vina software.Result:（1）Ancient books and documents: a total of 242 ancient books were obtained,with 452 articles effectively recorded.Among them,Zhang Zhongjing’s treatise on febrile diseases was the earliest work to record Shaoyao Gancao Decoction,and the largest number of articles and books were in the Ming and Qing Dynasties.The categories of books include annotation and discussion of the Golden Chamber of febrile diseases,comprehensive works,various clinical disciplines and Pediatrics;In the medical records of past dynasties,Shaoyao Gancao Decoction has five aliases: Quzhang decoction,liuban decoction,Zhongyue decoction,Wuji Decoction and Jiaji Huatu decoction.Its main symptoms mainly include foot contracture,abdominal pain and small intestinal cough;The prescription is mainly composed of white peony and roasted licorice,but there is no special method in preparation and decoction.Modern literature:14 modern literatures of Jianganle granule meeting the requirements were obtained,and the comprehensive forest map and evidence summary table of relevant evidence evaluation were obtained.（2）Through two rounds of questionnaire survey and result analysis,the list of 25 original clinical problems was obtained.Through two rounds of expert consensus discussion,15 preferred clinical problems and items of recommendation / consensus suggestions for these 15 problems were determined,including 5 recommendations and 10 consensus suggestions,Finally,the first draft of expert consensus on the clinical application of Jianganle granule in the treatment of abnormal liver function was formed.（3）245 effective drug targets of Jianganle granule,8950 targets of abnormal liver function diseases and 202 drug disease intersection genes were screened by network pharmacology;Through the analysis of network interaction network and topology,16 core targets and 155 interaction relationships were obtained;Quercetin,kaempferol and naringenin are the main active components of Jianganle granules,and mapk3,mapk1,Jun and TP53 are the main targets.Go enrichment analysis showed that the cell groups where the target was located were mainly membrane raft,membrane microdomain and membrane region;Biological processes are mainly concentrated in the response to metal ions and lipopolysaccharide;The main molecular functions are nuclear receptor activity and transcription factor activity.The enrichment of KEGG found that the main pathways were interleukin-17 signal pathway,TNF tumor necrosis factor signal pathway and Th17 cell differentiation signal.Further screening of core targets and compounds for molecular docking showed that mapk3,mapk1,Jun and TP53 as core targets could stably dock with small molecules of quercetin,kaempferol and naringin Conclusion:Through literature research and expert consensus method,this study has formed an expert consensus on the clinical application of Jianganle granule in the treatment of abnormal liver function,which can provide better guidance for the rational use of Jianganle granule in clinic.It plays a role in the regulation of TNF,map,TNF signaling pathway,tnf-17 signaling pathway,quercetin and so on. |
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