| Objective:(1)Study 1 systematically evaluated whether traditional Chinese medicine combined with western medicine was superior to western medicine alone in the treatment of coronary heart disease angina pectoris(phlegm and blood stasis syndrome).(2)The second study explored the medication ideas of angina pectoris of coronary heart disease(phlegm and blood stasis syndrome)based on literature research,in order to provide reference for prescription medication.(3)In Study 3,the network pharmacology of Pinellia ternata-Trichosanthes-Allium macrostemon,the basic prescription excavated in Study 2,was studied in order to clarify its mechanism of action.Methods:(1)In Study 1,meta-analysis was conducted.The clinical research on the treatment of coronary heart disease angina pectoris(syndrome of phlegm and blood stasis)with traditional Chinese medicine in Wanfang database,CNKI full-text database and VIP database was searched by computer.Relevant literatures were included according to the inclusion and exclusion criteria of literatures,and revman5.3 was used for meta-analysis of the included literatures.(2)In Study 2,the drug use law of the literature was analyzed.The formula data used in the literature were included in the meta-analysis and entered into the excel table.The database was established for drug frequency statistics.SPSS modeler 18 was used for association rules and SPSS statistics 25 was used for high-frequency drug cluster analysis to obtain common drug combinations.(3)In Study 3,the network pharmacology was discussed.The related compounds and action targets of Pinellia ternata-Gualou-Xiebai,the basic prescription obtained in Study 2,were found from the relevant network platform.At the same time,the related targets of coronary heart disease were found from the relevant database.After taking the intersection of the two,they were imported into the Cytoscape software to build the Chinese medicine compound regulation network.Then,the PPI network,go enrichment and KEGG pathway enrichment analysis were carried out on the intersection targets using the relevant software and platform,And visual processing.Result:(1)A total of 4804 patients in 64 literatures were included in meta-analysis,including2411 patients in the experimental group and 2393 patients in the control group.The results of meta-analysis showed that the treatment of angina pectoris of coronary heart disease(phlegm and blood stasis syndrome)in the experimental group improved the curative effect of TCM syndromes(rr=1.27,95%ci=[1.22,1.32],P < 0.00001),angina pectoris(rr=1.31,95%ci=[1.25,1.37],P < 0.00001),nitroglycerin reduction rate(rr= 1.26,95%ci=[1.17,1.36],P < 0.00001),ECG(rr=1.30,95%ci=[1.22,1.38],P < 0.00001),Lower total cholesterol(md=-0.71,95%ci=[-0.87,-0.55],P < 0.00001),triglycerides(md=-0.45,95%ci=[-0.55,-0.34],P < 0.00001),low-density lipoprotein(md=-0.48,95%ci=[-0.61,-0.34],P < 0.00001)and higher high-density lipoprotein(md=0.21,95%ci =[0.19,0.23],P < 0.00001)were better than those in the control group.(2)A total of 56 traditional Chinese medicine prescriptions were included in this study.The results showed that the top 15 drugs were Salvia miltiorrhiza,Trichosanthes,Pinellia ternata,Allium macrostemon,Ligusticum chuanxiong,liquorice,safflower,peach kernel,Poria cocos,red peony,Fructus aurantii,tangerine peel,astragalus,angelica,turmeric,Bupleurum chinense,Cinnamon Twig,hawthorn,Fructus aurantii Immaturus and earthworm.The medicinal properties are mainly warm,cold and mild.The medicinal tastes are mostly bitter,pungent and sweet.The meridians are mainly liver and spleen meridians.According to the association rules and high-frequency drug statistics,the basic formula Pinellia ternata-Gualou-Xiebai was obtained.Three groups of core drugs were obtained by cluster analysis.(3)In this network pharmacology study,a total of 33 active compounds involved in the regulation network of Pinellia ternata,Trichosanthes and Allium macrostemon were screened,193 cross regulation targets and 193 core target proteins were screened in PPI network.In go enrichment analysis,795 items were enriched in BP,96 items in CC and 160 items in MF.KEGG obtained 179 pathways,among which lipids and atherosclerosis,the role of AGE-RAGE signaling pathway in diabetes complications,fluid shear stress and atherosclerosis were significantly enriched.Conclusion:(1)It is preliminarily discussed that traditional Chinese medicine combined with western medicine has a significant effect on angina pectoris of coronary heart disease(phlegm and blood stasis syndrome),which is better than western medicine alone.(2)This paper analyzes the prescription law of traditional Chinese medicine in treating angina pectoris of coronary heart disease(syndrome of phlegm and blood stasis),and obtains the basic formula of Pinellia ternata-Gualou-Xiebai.(3)It explored the multi-component,target and pathway mechanism of Pinellia ternata-Gualou-Xiebai in the treatment of coronary heart disease based on network pharmacology,and preliminarily revealed that Pinellia ternata-Gualou-Xiebai in the treatment of coronary heart disease mainly through quercetin β-Sitosterol,naringin,baicalein and other active ingredients act on mapk3,Jun,mapk1,AKT1,TP53 and other targets,involving lipid and atherosclerosis,the role of AGE-RAGE signal pathway in diabetes complications,fluid shear stress,atherosclerosis and other signal pathways. |
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