Clinical Observation And Network Pharmacological Analysis Of Wenweiyang Decoction In The Treatment Of Helicobacter Pylori Associated Gastritis Of Spleen-stomach Yang Deficiency Type

Objective: To observe the clinical efficacy of Wenweiyang Decoction in treating Helicobacter pylori-associated gastritis of spleen-stomach Yang deficiency type,and to analyze the biological function and pathway information by using network pharmacology technology,and to explore the mechanism of Wenweiyang decoction in treating Helicobacter pyloriassociated gastritis of spleen-stomach Yang deficiency type.Methods: Clinical research part: 70 patients with Helicobacter pyloriassociated gastritis who met the spleen-gastric yang deficiency type in Liuzhou Traditional Chinese Medicine Hospital from January to December2022 were collected,randomly divided into 35 cases in the control group and35 cases in the observation group,and the control group was treated with quadruple therapy,namely amoxicillin capsule 1g bid,clarithromycin capsule0.5g bid,rabeprazole enteric-coated tablet 10 mg bid,colloidal pectin bismuth capsule 100 mg TID,and discontinued after 14 consecutive days.The observation group took warm stomach yang decoction at the same time on the basis of quadruple therapy,and the course of treatment in both groups was 14 days.The TCM syndrome score and efficacy index of the patients before and after treatment were recorded,and the carbon-14 urea breath test was reexamined in January after the end of the course of treatment,the Hp eradication rate of the two groups was counted,and the adverse events during the treatment were recorded.Network pharmacology research part: TCMSP and Herb traditional Chinese medicine database were used to collect drug active ingredients and target genes.The Uniprot database was used to convert drug target genes into corresponding standard gene names.Through the three disease databases of Gene Cards,OMIM and Disgenet,the disease target genes of Helicobacter pylori-associated gastritis were collected,the intersection map of drugs and disease genes was constructed,and the visual network diagram of drug components and targets was made with Cytoscape3.7.2 software.The targets of the intersection of traditional Chinese medicine and disease were imported into the STRING database,the protein interaction network diagram was made,and then the core target protein was screened out from large to small according to the Degree value and the PPI network diagram was drawn.Finally,the gene ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were analyzed through the DAVID database,and the top 10 GO function analysis results and the top 15 signal pathway information were screened.Results: In terms of clinical research: a total of 70 patients were included in clinical observation,and 67 cases were finally completed,of which 1 case was shed in the control group,1 case was excluded,33 cases were completed in the study,1 case was dropped in the observation group,and 34 cases were completed in the study.There were no statistically significant differences in general data between the two groups.The post-treatment Hp eradication rates of the control group and the observation group were 84.84% and 97.05%,respectively,and there was no statistical difference in the eradication rate between the two groups(P>0.05).In terms of TCM syndrome score,the total score of TCM syndrome in the post-treatment observation group was lower than that of the control group(P<0.05).A total of 7 TCM symptoms in the observation group improved more than those in the control group,namely: "cold pain in the stomach","abdominal distension after eating","heartburn","nausea and vomiting","salivation in the mouth","cold limbs" and "loose stool",which were statistically different compared with the control group(P < 0.05).The rate of adverse reactions in the observation group during treatment was lower than in the control group(P<0.05).Network pharmacology: 45 active ingredients of drugs were obtained in network pharmacology analysis,with 1036 effective targets,2068 disease targets,and290 intersection targets between drugs and diseases.The top 5 core target proteins were AKT1,IL-6,TP53,TNF,and ALB,and GO function showed a total of 560 items for major biological processes(BP),59 items for cell composition(CC),and 99 items for molecular function(MF).The results of KEGG pathway enrichment analysis showed that the signaling pathways mainly involved in the treatment were cancer regulatory pathways,lipid and atherosclerosis-related pathways,and JAK/STAT,P13K/Akt,Fox O and other pathways related to inflammatory response.Conclusion: The Hp eradication rate of HPAG in the treatment of spleengastric yang decoction combined with quadruple therapy was comparable to that of quadruple therapy alone,but the participation of warm gastric yang decoction was more effective in improving clinical symptoms,and the incidence of adverse drug reactions during treatment was lower and the safety was higher.The mechanism of action of warm stomach yang decoction is to reduce inflammation,promote gastric mucosal repair,inhibit cancer-related signal pathways and other effects.Warm stomach yang decoction has clinical application value for the treatment of Helicobacter pylori-associated gastritis with spleen and stomach yang deficiency type,and is worth promoting.