Clinical And Network Pharmacology Study Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Phlegm-qi Interlocking Type Of Laryngopharyngeal Reflux Disease

Purpose:Thesis I: To observe the clinical effect of combined traditional Chinese and western medicine on laryngopharyngeal reflux disease through clinical treatment experiment.Thesis 2: Based on network pharmacology,this study explored the effective chemical components and key gene targets of Magnolia Pinellia Magnolia Decoction and Ganju Decoction in the treatment of laryngopharyngeal reflux disease,constructed interaction diagram,and explored the mechanism of action of Magnolia Pinellia Decoction and Ganju Decoction in the treatment of LPRD.Material and method:Paper I: A total of 80 patients diagnosed as laryngoparyngeal reflux disease(TCM syndrome differentiation is cuspidor interjunction type)were selected from the outpatient department of otolaryngology department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from June 2019 to June 2020.They were randomly divided into the experimental group and the control group,with 40 patients in each group.The control group was given Eexomeprazole magnesium enteric-coated tablet,20mg/ time,twice a day,taken orally about 30 min before meals,for 8 consecutive weeks.Patients in the control group,on the basis of combined with pinellia decoction and magnolia bark Gan Jie tonga subtraction to guide qi and hysteresis,fights sputum elimination(basic components: pinellia 12 g,ginger 15 g,9 g magnolia bark,poria cocos,platycodon grandiflorum 9 g,12 g,basil,licorice root 6 g,6 g paste dosage form),1 bag each time,about 30 minutes after a meal in the morning and evening heating oral,continuous oral 8 weeks;Adopt the filiform needle acupuncture method to acupuncture points: Lianquan,Tiantu,Fenglong,once a day,each time 30 minutes.Both the control group and the experimental group received electronic laryngoscopy before treatment and 8 weeks after treatment.According to the doctor’s view of the laryngoscopy,the RFS scale was filled out,and the patients filled out the RSI rating scale and the laryngopharyngeal reflux symptom questionnaire.The VAS score was performed jointly by the patients and the doctor.In this study,SPSS 25.0 statistical software was used to analyze the collected data.In the second paper,the chemical components of seven kinds of traditional Chinese medicines in Pinellia magnolia decoction and tangerine decoction were searched on the TCMSP website.The effective components were screened out according to OB≥30% and DL≥0.18,and the first five important effective components were selected through Sytoscape3.7.2.Then the target genes corresponding to the active components were obtained by running the Perl script on the website at the same time,and the target genes were annotated through the Uniport database.Gene Cards database was used to establish gene database of laryngopharyngeal reflux disease.Venny.r script was run to conduct Venn analysis on all targets in Pinellia magnolia decoction and Ganji decoction and all targets related to laryngopharyngeal reflux disease,and the common gene targets of both were obtained.Using the symbol2 id.R script,run rx644.0.3 to get the ID corresponding to the intersection gene name.Key targets of drugs and diseases were obtained through topology analysis of String database and Cytoscape 3.7.2.Through the software Sytoscape3.7.2,the traditional Chinese medicine,active chemical components and key gene targets were linked together to draw a viewable view of the interaction relationship between "traditional Chinese medicine-active components-key targets".Finally,R script and Perl script were used for GO and KEGG enrichment analysis of proteins in PPI network.Results:Results The symptoms,signs and quality of life of the control group and the experimental group were significantly improved after 8 weeks of treatment,and there were significant differences in RSI,RFS and VAS scores between the control group and the experimental group before and after treatment(P < 0.05).After treatment,there were also statistical differences in RSI,RFS and VAS scores between the control group and the experimental group(P < 0.05),and the differences were statistically significant.After treatment,the total effective rate of the control group was 70.6%,and the total effective rate of the experimental group was 91.7%.The control group was less than the experimental group,indicating that both groups could improve symptoms,but the treatment effect of the experimental group was much higher than that of the control group.Thesis 2: Results There were 150 active components in Pinellia magnolia decoction and camellia decoction.Through screening,the main active chemical components were β-sitosterol,stigmasterol,spinosterol and luteolin,and 251 gene targets were identified.A total of 1206 gene banks were found to be related to laryngopharyngeal reflux disease.There were 117 gene targets of intersection between the two.PPI network diagram of protein interaction contains 117 protein nodes and 5086 interaction relationships.By Degree value,30 key core targets such as ALB,VEGFA,AKT1,IL6,EGFR and MAPK3 are screened out,so as to draw a viewable view of the interaction of "traditional Chinese medicine-active ingredient-key target".In GO functional enrichment analysis,126 GO items were generated according to Pvalue < 0.05.In the enrichment analysis of KEGG pathway,a total of 151 KEGG enrichment pathways were generated,mainly involving AGE-RAGE signaling pathway,cancer signaling pathway,TNF signaling pathway,IL-17 signaling pathway and other pathways.Conclusion:Paper one: combine traditional Chinese and western medicine therapy for nitrogen mutual junction throat reflux disease clinical curative effect,can improve the symptom such as laryngeal is unwell,can also reduce bronchial foreign body sensation and limb tiredly,stay nitrogen ease the situation,combine traditional Chinese and western medicine treatment has a wide range,with obvious therapeutic effect and side effects of small advantages,is worth promoting.Paper 2: pinellia decoction and Gan Jie decoction on the treatment of throat reflux disease relies mainly on the beta sitosterol,stigmasterol,bo’s sterol and mignonette element such as chemical composition,role in propagated,VEGFA,AKT1,IL6 and target genes such as EGFR,MAPK3,inflammatory pathways through,cells and cell apoptosis,kinase regulating mechanism,to achieve the purpose of that pinellia decoction and Gan Jie decoction on the treatment of throat reflux disease is through multi-channel interaction,multiple targets to work.