Based On Network Pharmacology To Explore The Mechanism And Clinical Efficacy Of Qiangshenyishou Decoction In The Treatment Of Senile Osteoporosis (Spleen And Kidney Deficiency Syndrome)

Objective:To explore the mechanism of Qiangshenyishou Decoction in treating senile osteoporosis（spleen and kidney deficiency syndrome）based on the method of network pharmacology;Through clinical observation to evaluate the efficacy and safety of Qiangshenyishou Decoction in the treatment of senile osteoporosis（spleen and kidney deficiency syndrome）,and to provide basis for clinical treatment.Methods:1.Obtain active pharmaceutical ingredients and targets through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP）,Traditional Chinese Medicine Integrated Database（TCMID）;Using Cytoscape 3.7.2 to construct a network diagram of“drugs-active ingredients-targets”;Search for targets of senile osteoporosis（SOP）through Gene Cards database,TTD database,OMIM database and DRUGBANK database;Use the R language to draw the“drug-disease”Venn diagram;use the STRING11.0 database for protein-protein interaction（PPI）analysis;use the Metascape platform for potential Gene Ontology（GO）and Kyoto Encyclopedia of Genes and Genomes（KEGG）signal pathways Analyze and visually analyze the data results through the bioinformatics platform.2.Sixty patients who were diagnosed with SOP in the geriatric ward or outpatient clinic of Shandong University of Traditional Chinese Medicine Affiliated Hospital from 11 2020 to 11 2021,and were over 60 years old were selected.Randomly divided into two groups according to the table of random numbers,the treatment group and the control group,with 30 cases in each group.The treatment group received Qiangshenyishou decoction combined with calcium carbonate D₃tablets and calcitriol capsules;the control group received calcium carbonate D₃tablets combined with calcitriol capsules for three months.Through statistical analysis of TCM syndrome quantitative scores before and after medication,bone mineral density（BMD）,parathyroid hormone（PTH）,25-hydroxyvitamin D（25-（OH）D）and serum calcium（Ca）,the two differences between groups are compared.Results:In terms of network pharmacology research,a total of 401 active ingredients of Qiangshenyishou Decoction were obtained,and a total of 146targets were obtained;a total of 947 targets were obtained for SOP;68“drug-disease”intersection targets were obtained;34 core targets were screened according to the median PPI connectivity value.GO analysis showed that Qiangshenyishou Decoction was involved in the biological process of apoptosis and muscle cell proliferation in the treatment of SOP.At the same time,KEGG pathway analysis found that Qiangshenyishou Decoction could treat SOP by participating in PI3K-Akt,VEGF,thyroid hormone and other signaling pathways.In the evaluation of clinical efficacy,BMD,25-（OH）D,and Ca of the treatment group and control group increased significantly after treatment compared to before treatment,and the treatment group was significantly higher than the control group.Compared with before treatment,the parathyroid hormone levels in both patient groups decreased significantly after treatment,and the treatment group was significantly lower than the control group.The above difference was statistically significant（P<0.05）.TCM syndrome significantly improved after treatment compared to before treatment in both groups of patients.The above difference was statistically significant（P<0.05）.The urine routine,blood routine,stool routine,liver function,renal function,and electrocardiogram of the two groups of patients before and after taking the medicine were normal,and there was no obvious adverse reaction.Conclusion:Qiangshenyishou Decoction through Quercetin,Iuteolin,Kamanol,Tanshinone IIa and other active ingredients,the prescription canregulate RUNX2,IRF1,AR,VEGFA and act on P13K-Akt,VEGF,thyroid hormone and other signaling pathways,so as to play a role in the treatment of SOP.It embodies the network pharmacology characteristics of multi-component,multi-target and multi-pathway of traditional Chinese medicine compound.Qiangshenyishou Decoction can effectively improve BMD,25-（OH）D,Ca,reduce PTH,reduce TCM syndrome scores,and improve patients’quality of life in SOP patients,without obvious adverse reactions and toxic side effects.To sum up,Qiangshenyishou Decoction is an effective formula for treating SOP of spleen and kidney deficiency syndrome,which can be widely used in clinical practice.