| Object:Based on data mining of modern literature and TCM prescriptions for gouty arthritis(GA)in clinical practice,the characteristics and formulations of TCM for the treatment of gout were explored,the literature was combined with clinical practice,and the common core drug combinations were analyzed by network pharmacology.By predicting the potential targets and signal pathways of core drug combinations,the mechanism of action for gout treatment is explored to provide theoretical support for the flexible application of Traditional Chinese medicine in gout treatment,so as to better guide clinical application.Methods:1.China National Knowledge Internet(CNKI)was used as the database,AND advanced search mode was used to search the literatures published in China in the past 10 years with "gout" OR "gouty arthritis" OR "bi syndrome" AND "Traditional Chinese medicine" OR "Traditional Chinese medicine" as the search terms.After consulting the literature,select the literature that meets the requirements according to the literature arrangement criteria and download it to the local.By the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine outpatient service system,to collect between September 2019 and December 2021,see a doctor in the hospital kidney disease outpatient service by yu-lan Yang li rheumatism lead of the chief physician treated,discharge standard of gouty arthritis prescriptions of Chinese medicine,and the patient’s name,gender,age,time and other related information.Excel2019 was used to statistics and analyze the distribution of drugs in literature and clinical prescriptions,such as sex,taste,regression and efficacy.SPSS Modeler18.0 and SPSS Statistics 25.0 were used to analyze drug association rules and cluster analysis to explore drug use rules.To analyze the treatment characteristics of gout arthritis with Traditional Chinese medicine.2.After analyzing the drug use rules of literature prescription and clinical prescription respectively,the same core drug combinations in literature drug use and clinical drug use were explored according to the analysis results,and the active ingredients of core drug combinations were screened using TCMSP database.Swisstarget Prediction database was used to predict the target of the screened drug active ingredients.The target information of gout arthritis disease was collected by searching OMIM database,Drug Bank database and Gene Cards database and referring to relevant literature.All target information was imported into Uniprot database for standardization processing.Cytoscape software was used to draw drug-component-target network diagram and drug-intersection target-disease network diagram respectively to visualize the relationship among drugs,components,targets and diseases.The intersection target genes were imported into STRING database to generate protein interaction network diagram,and the core targets were screened.GO function and KEGG pathway enrichment analysis of intersection target genes were conducted to explore the potential mechanism of core drug combination in the treatment of gout arthritis.Results1 Literature and clinical distribution of prescription drugs for goutLiterature study of the communist party of China in 1397 Chinese medicine prescription,prescription mining involves 352 kinds of traditional Chinese medicine,clinical medicine prescription,a total of 512 in the mining,contains 199 kinds of traditional Chinese medicine(TCM),the overall drug use frequency distribution results,there were glabrous greenbrier rhizome,Bi Xie,liquorice,clematis root,honeysuckle stem,such as mountain,angelica,arrowhead,fresh mushroom medicine as a treatment for the high frequency of gouty arthritis drugs.The distribution of drug properties in literature was as follows: cold drugs(47.58%)>warm drugs(28.32%)> flat drugs(22.49%)> cool drugs(0.95%)> hot drugs,and the distribution of drug flavor was as follows: Sweet(31.84%)> bitter(30.99%)> spicy(20.53%)> light(9.75%)> sour(3.32%)> salty(3.25%)> astringency(0.69%).The distribution of drug properties in clinical drugs was as follows: cold drugs(49.12%)> warm drugs(28.66%)> flat drugs(21.30%)> cool drugs(0.9%)> heat drugs(0.02%),and the distribution of drug flavor was as follows: Bitter drugs(33.06%)> sweet drugs(28.13%)>spicy drugs(22.77%)> salty drugs(5.28%)> light drugs(4.94%)> astringency drugs(3.72%)> sour drugs(2.10%).Literature and clinical cure gout drug distribution of nature and flavour,all give priority to with the use of cold resistance,in the distribution of ingredients,the literature and clinical drug distribution in the first three ingredients including bitter medicine,adjuvant,and herbs,literature first drug distribution is grape drugs,but because of its differ with bitter drugs application,Bitterness drugs were also considered as the main drug distribution in the literature."Bitter and cold" was the main drug in the distribution of taste and nature of both drugs.In the distribution of meridian,the liver meridian is the first,followed by the stomach meridian,spleen meridian and lung meridian.The distribution of drug efficacy was dominated by heat-clearing drugs,followed by different efficacy orders,but they were all beneficial to water infiltration and dampness drugs,drugs promoting blood circulation and removing stasis,drugs dispelling wind and dampness,and drugs supplementing deficiency.The combined use frequency of these five efficacy exceeded half of the total use frequency,forming the main distribution of drug efficacy in treating gout.2 Rule of gout medication based on association rule and cluster analysisIn the literature prescription association rules,there were three association rules:Tufuling-Bixie,Phellodendron-Cangzhu,Tufuling-Shancimushroom.Article 17 the three association rules,which support the highest drug combinations of Cangzhu-Phellodendron &semen coicis,confidence of drug combination for Tufuling-edible tulip & Bi Xie,sorted according to the support of three association rules,the top three of six associated results involved in traditional Chinese medicine(TCM)of cortex phellodendri,rhizoma atractylodis,achyranthes,semen coicis 4 kinds of drugs,All of them were composed of Simiao pill prescription.Except for simiao Pill prescription,tufuling-Weilingxian & Beixie medicine combination had a higher degree of support in three association rules,while tufulingWeilingxian & Beixie Medicine combination had a lower degree of support.Among the association rules of clinical prescriptions,there were 18 pairs of association rules,among which,the drug pair with the highest degree of support was Dioscorea Septemloba,and the drug pair with the highest degree of confidence was Dioscorea Septemloba turmeric.There are 53 association rules.Among them,the drug combination with the highest degree of support was Bixie-Weilingxian-Tufuling,while Tufuling-Chinese Angelica-Bixie,with the highest degree of confidence.In the results of two association rules,the drug pair of Tufuling and Dioscorea Septembes and the drug combination of Tufuling-Dioscorea SeptembesWeilingxian occupies an important position in the literature and clinical prescriptions of Traditional Chinese medicine.After clustering the high-frequency drugs in literature,a total of 8 different cluster combinations were obtained,including baihu plus Guizhi Decoction,Qianghuo Shengshi Decoction,Xuanbi Decoction,Yinchen Wuling Decoction and Simiao pill as the basis of the drug combination.After the clinical high-frequency drugs were clustered,three different cluster combinations were obtained,including the cluster combination formed by simiao Pill and Simiao Yong ’an Decoction.3 Network pharmacologic analysis of a combination of Medicine from Tufuling-BixieWeilingxian.Diosgenin,quercetin,naringin,stigmasterol,panosterin Ib,3-epidoanolic acid,limothrin,β-sitosterol and other active components in the core drug combination were associated with disease targets,and played a role in the treatment of gout.Drug target genes such as VEGFA,SRC,PTGS2,STAT1,PIK3 CA,MMP9 and PPARG have many associations in the protein interaction network,which are the key targets of drug combination in the treatment of gout.KEGG pathway enrichment results include disease pathway,metabolic pathway,biological system pathway,environmental information processing pathway and other types of pathways,through which these pathways act on corresponding targets to produce a variety of biological processes related to the pathological process of gout.It shows that this drug combination has the characteristics of multiple components,multiple targets and multiple pathways in the treatment of gout.Conclusion1.In the literature and clinical prescriptions,there were high frequency drugs such as Tufuling,Dioscorea Septemloba,Glycyrrhiza dioscorea,Weilingxian,Lonicera japonicum,Edible tulip,Angelica sinensis,etc.In the distribution of drug sexual taste,there were "bitter cold" drugs.2.In literature and clinical prescription,the liver meridian was the first,followed by the stomach meridian,spleen meridian and lung meridian.3.The drug efficacy,headed by the application of heat medicine,the follow-up effect distribution is slightly different,literature in the follow-up effect distribution in the order:water wet medicine,promoting blood circulation to remove blood stasis drugs,antirheumatic medicine,tonic medicine,clinical prescription drug effect distribution in the order:antirheumatic medicine,water permeability and virtual medicine,promoting blood circulation to remove blood stasis drugs.4.In the two association rules,the core drug pairs of Tufuling and Dioscorea Septemba were found in both literature and clinical prescriptions.Among the three association rules,the core drug combination composed of Tufuling-Bixei-Weilingxian occupies an important position in literature and clinic.5.A total of 8 clusters were obtained in literature prescriptions,including the cluster combinations formed based on Baihu plus Guizhi Decoction,Qianghuo Shengshi Decoction,Xuanbi Decoction,Yinchen Wuling Decoction and Simiao Pill;Three clusters were obtained in clinical prescriptions,including the cluster combination formed by simiao Pill prescription and Simiao Yong ’an Decoction.6.Through the network pharmacology analysis found that Tufuling-Bixie-Weilingxian drug combination through multiple components,multiple targets,multiple pathways involved in together,played a role in the treatment of gout.Its possible mechanisms include inhibition of inflammatory response,regulation of uric acid level and regulation of immunity. |
PDF Full Text Request