Clinical And Network Pharmacologic Study Of Modified Zhenwu Decoction In Treating Dilated Cardiomyopathy With Yang Deficiency And Flooding Syndrome

Purpose:To observe the clinical study of modified Modified Zhenwu Decoction in the treatment of yang deficiency and flooding syndrome of dilated cardiomyopathy,and to explore the possible mechanism of Modified Zhenwu Decoction on dilated cardiomyopathy by network pharmacology.Method:1.Clinical study:60 subjects who met the inclusion criteria were randomly divided into TCM intervention group and control group.The TCM intervention group was given Zhenwu Decoction combined with conventional western medicine,while the control group only received conventional western medicine therapy.After 4 weeks of treatment,TCM symptom integral,classification of cardiac function,6-minute walking distance,FS,LVEF,LVEDd,NT-proBNP,Scr,BUA and KCCQ-12 were compared between the two groups.Changes in scores,assessing the effectiveness of medical regimens.2.Network Pharmacology:The active ingredients and their targets of Modified Zhenwu Decoction were obtained by TCM pharmacology database and General Protein resource database.Based on Cytoscape software,the intersection of potential targets of each Chinese medicine was plotted,and the active components of Modified Zhenwu Decoction were screened.CytoNCA plug-in was used to build PPI network and carry out topology analysis.Screening the core target of TCM on the disease;Core targets were imported into Metascape database for G0 enrichment analysis and KEGG enrichment analysis.Results:1.Clinical study:No noteworthy divergence in general information was observed between the two groups prior to treatment(P>0.05)in the clinical study.The TCM intervention group’s indexes showed a marked improvement post-treatment,with statistical significance(P<0.05),when compared to before treatment.The TCM intervention group’s scores,efficacy of symptom scores,classification of cardiac function,LVEF,FS,LVEDd,NT-proBNP,Scr,BUA,6-minute walking distance,KCCQ-12 score,and other indices were compared to the control group.The improvement of the TCM intervention group was significantly better than that of the control group.Statistically,the disparities were noteworthy(P<0.05).2.There are 66 active ingredients and 126 core targets have been screened.There are 3780 go entries in the results of go enrichment analysis,including active ingredients in the negative regulation of megakaryocyte differentiation,cell cycle,mitosis,and so on.KEGG pathway enrichment analysis showed that there were 14 pathways.The target genes were enriched in viral carcinogenesis,Salmonella infection,spliceosome,proteoglycan in cancer,etc.Conclusion:1.Modified Zhenwu Decoction in the treatment of dilated cardiomyopathy with yang deficiency and flooding syndrome improved clinical symptoms,related therapeutic indexes,and the quality of life,and no adverse reactions were observed;2.Modified Zhenwu Decoction can treat dilated cardiomyopathy through multiple components,multiple targets and multiple pathways.