Analysis Of Clinical Efficacy And Active Components Of Jingbi Decoction In The Treatment Of Cervical Spondylotic Radiculopathy Based On The Theory Of “Liver Governs Tendons And Kidney Governs Bones” And Molecular Docking

Objective:Based on the theory of “liver governs tendons and kidney governs bones”,a randomized controlled trial was conducted to investigate the clinical efficacy of Jingbi decoction in treating cervical spondylotic radiculopathy(CSR)type with liver and kidney deficiency.Using molecular docking,we predicted the key action components in Jingbi decoction for the treatment of liver and kidney deficiency type CSR.To provide new ideas to further explore the clinical efficacy and active components of Jingbi decoction for the treatment of CSR.Methods:Using clinical cases,80 patients meeting the criteria were included in the study and divided into treatment group and control group.The treatment group was treated with Jingbi decoction,while the control group was treated with Nimesulide Sustained-release Tablets and Flurbiprofen gel plaster.The scores(VAS pain and numbness score,cervical NDI index score and TCM Evidence Efficacy Score)were used to compare the therapeutic effects of the two groups,which were observed and carried out before treatment,2 weeks after treatment and 4 weeks after treatment.At the same time,under the guidance of the theory of “liver governs tendons and kidney governs bones”,the active components of liver and kidney tonic herbs in Jingbi decoction were screened,and the screened components were molecularly docked with the targets of CSR.The docking scores were used to screen the active components of Jingbi decoction for the treatment of liver and kidney deficiency type CSR.Results:According to the statistics,there was no significant difference in baseline data between the two groups(P > 0.05),which was comparable.After 2 weeks of treatment,the pain score and NDI index score were better in the control group than in the treatment group(P < 0.05).There was no significant difference in the numbness score and TCM Evidence Efficacy Score between the two groups(P > 0.05).After 4 weeks of treatment,the pain score,numbness score and TCM Evidence Efficacy Score in the treatment group were significantly better than those in the control group(P < 0.05).However,there was no significant difference in the NDI index score between the two groups(P > 0.05).It was verified by molecular docking that 54 components,including oleanolic acid,berberine,inophyllum E,sitostenone,β-sitosterol,luteolin,and mairin,bound more closely to the CSR-related targets,indicating that these components may be the pharmacodynamic components of Jingbi decoction for the treatment of liver and kidney deficiency type CSR.Conclusion:The clinical efficacy of Jingbi decoction in treating liver and kidney deficiency type of CSR is excellent,especially in the long term,and the adverse effects are manageable.Jingbi decoction is more advantageous in reducing pain and numbness in patients with long-term CSR,and Jingbi decoction can more effectively improve the TCM evidence of liver and kidney deficiency in patients.In addition,oleanolic acid,berberine,inophyllum E,sitostenone,β-sitosterol,luteolin,and mairin may be the effective components of Jingbi decoction in the treatment of liver and kidney deficiency type CSR.