Study On Medication Regularity And Network Pharmacology Of Traditional Chinese Medicate In Treating Simple Obesity

Objective:Through sorting out and data mining the effective outpatient cases of simple obesity treated by endocrinology department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,this study summarized and analyzed the TCM syndrome differentiation and medication rules of simple obesity treated by endocrinology department,and further explored the action mechanism of core prescription in treating simple obesity,providing a scientific basis for the treatment of simple obesity with traditional Chinese medicine.Methods:The outpatient cases of simple obesity patients who were treated in the Department of Endocrinology,First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from September 2019 to December 2021 were collected.According to the inclusion and exclusion criteria,the basic information of patients,four diagnostic data and Chinese medicine prescriptions were entered into EXCEL software,and the database of patients’ medical records was established.By using the "data analysis" module in the traditional Chinese medicine inheritance computing platform(V3.0),the incidence characteristics,syndrome distribution characteristics,symptom characteristics,frequency of use of traditional Chinese medicine,four qi and five flavors,channel tropism,drug pair combination and core drugs of simple obesity were statistically analyzed,and the core prescription was extracted.According to the core formula obtained from the analysis of traditional Chinese medicine inheritance computing platform(V3.0),network pharmacology research is carried out.The effective chemical components in the core formula were obtained by searching TCMSP database,and then converted into corresponding target genes by Uniprot database.Search the disease gene database to collect the gene targets related to simple obesity,and use the online Wayne diagram to obtain the potential action targets of the core prescription in treating simple obesity.The protein interaction network(PPI)of simple obesity,which is the core formula,was constructed by STRING database and Cytoscape 3.7.1 software.At last,the enrichment analysis of GO and KEGG pathways is carried out by using Metascape database.Results:1.Basic characteristics of patients:(1)Among the 13 1 cases that met the inclusion criteria,there were 97 female patients and 34 male patients.(2)Symptoms:From high to low,the frequency is limb drowsiness,fatigue,yellow urine,abdominal distension,hyperhidrosis,sticky stool,poor sleep,menorrhagia and loose stool.(3)Tongue image:The first four places of tongue appearance are red tongue,light red tongue and dark red tongue respectively;The first four features of tongue coating are white greasy coating,yellow greasy coating,thin white coating and thin yellow coating.(4)Syndrome:from high to low,the order is phlegm-dampness in excess(25.95%),spleen deficiency and stagnation(22.14%),qi stagnation and blood stasis(14.50%),spleen and kidney yang deficiency(19.85%)and stomach heat stagnation(17.56%);(5)Treatment methods:from high to low frequency,they are eliminating dampness and resolving phlegm(53 times),invigorating spleen and qi(37 times),promoting qi and promoting blood circulation(37 times),tonifying spleen and kidney(26 times),regulating qi and eliminating pimples(23 times),etc.2.Medication regularity:A total of 131 prescriptions and 130 traditional Chinese medicines were included in the study.The statistical analysis results showed that:(1)The top 10 traditional Chinese medicines were Poria cocos(109 times),Lotus leaf(100 times),Coix seed(95 times),Glycyrrhiza uralensis(72 times),Pericarpium Citri Tangerinae(89 times),Alisma orientalis(85 times)and Pinellia ternata(82 times).(2)Medicinal properties:the proportion of warm drugs is the largest(32.53%);Cold drugs took the second place(31.90%).(3)Five flavors:sweet drugs have the highest frequency(35.85%);Followed by bitter medicine(30.96%).(4)Channel tropism:the top five channels are spleen channel(1659 times),stomach channel(117 5 times),lung channel(1117 times),liver channel(924 times)and heart channel(671 times)in turn.(5)Five new formula combinations were obtained by cluster analysis:New formula 1:Coix seed,Poria cocos,lotus leaf,Alisma orientalis,Pericarpium Citri Tangerinae and Coptidis Rhizoma;New formula 2:Poria,Glycyrrhiza uralensis Fisch,Codonopsis pilosula,Atractylodes macrocephala Koidz,Pericarpium Citri Tangerinae,Epimedium Herba;New formula 3:Poria,lotus leaf,Salvia miltiorrhiza,Glycyrrhiza uralensis Fisch,Coix seed and Cyperus rotundus;Formula 4:Pinellia ternate,Glycyrrhiza uralensis Fisch,Oyster,Poria,Os Draconis and Coicis Semen;New formula 5:Coptidis Rhizoma,lotus leaf,Alismatis Rhizoma,Poria,Glycyrrhrizae Radix and Coicis Semen.(6)Extract the core formula consisting of Poria cocos,lotus leaf,coix seed,licorice,dried tangerine peel,Alisma orientalis,Pinellia ternata and Atractylodes macrocephala.3.Research on network pharmacology:(1)A total of 134 effective compounds were obtained in this study,among which quercetin,kaempferol,naringenin,i sorhamnetin,β-sitosterol,etc.were the main compounds with high degree,which mainly acted on PTGS2,AR,PPARG,NOS2,NCOA2 and other targets.(2)ProteinProtein Interaction Networks show that its core targets are AKT1,TNF,IL6,PPARG,IL1Bβ,TP53,VEGFA,PTGS2,CASP3,JUN,CAT and EGFR.(3)The biological process of GO mainly includes the reaction to hormones,the reaction of cells to organic cyclic compounds,the reaction of cells to lipids,etc.Molecular functions mainly include nuclear receptor activity,ligand-activated transcription factor activity,adrenergic receptor activity,etc.The cells are mainly composed of membrane rafts,membrane domains,receptor complexes,etc.(4)KEGG enrichment analysis mainly includes cancer pathway,lipid and atherosclerosis,fluid shear stress and atherosclerosis,AGE-RAGE signaling pathway in diabetic complications,IL-17 signaling pathway,TNF signaling pathway,etc.Conclusion:1.In this study,there are more women than men in patients with simple obesity.The onset age is mostly young and middle-aged people aged 21-40 years.The clinical syndromes are phlegmdampness syndrome and spleen deficiency syndrome.2.Most of the traditional Chinese medicines used in this study are warm and cold,and their tastes are sweet,bitter and pungent,which mainly belong to spleen,stomach,lung and liver meridians.3.Extract the core drugs:Poria cocos,lotus leaf,coix seed,licorice,tangerine peel,Alisma orientalis,Pinellia ternata and Atractylodes macrocephala,and draw up the core prescription for treating simple obesity.4.Through the network pharmacology research of the core formula,it was found that its effective components are mainly quercetin,kaempferol,naringenin,isorhamnetin,β-sitosterol,etc.,which can act on PTGS2,AR,PPARG,NOS2,NCOA2 and other targets.5.The core prescription can treat simple obesity mainly by intervening cancer pathway,inflammatory pathway and metabolic pathway,regulating gene targets such as AKT1,TNF,IL6,PPARG and IL1β,improving chronic inflammatory response,reducing insulin resistance and regulating glucose and lipid metabolism,thus playing a role in treating simple obesity.