Study On Chinese Medicine Injection After PCI Based On Network Meta-analysis And Network Pharmacology

Objective:Based on the network meta-analysis and network pharmacology research methods,this paper comprehensively evaluates the best treatment scheme which is different from traditional Chinese medicine injection combined with western medicine after percutaneous coronary intervention(PCI),and further discusses its potential mechanism.Methods:1.In the first part of this study,medical databases,such as Pub Med,The Cochrane Library,EMbase,Web of Science,CNKI,wanfang,VIP database and Chinese biomedical literature database,were searched by computer,and randomized controlled clinical trials(RCT)of interventional therapy for coronary heart disease with related intervention measures were collected.The retrieval time is from the establishment of the database to November 2020,and the retrieval adopts the combination of subject words and free words.Two researchers independently screened the literature according to strict inclusion and exclusion criteria,extracted the data and evaluated the literature quality,and then analyzed the data and made relevant charts by using Rev Man5.3,Stata 15.1 and ADDIS 1.16.7 software.2.In the second part of this study,based on the results of previous network Meta-analysis,the best treatment scheme was presented in order of probability,and the active components and targets of Zhongdanhong injection were screened out according to the oral bioavailability(OB≥30%)and drug-like property(DL≥0.18)of the drugs by using TCM System Pharmacological Analysis Platform(TCMSP)database.Using STITCH database to obtain targets of active ingredients in western medicine.TTD,Gene card and Drugbank databases were used to obtain the targets of coronary heart disease,and the targets of Danhong injection,western medicine and coronary heart disease were introduced into Venny software screen to find the intersection targets of the three.the molecular interaction network of drug-potential target interaction related to diseases was constructed in Cytoscape3.7.0 software.The network diagram of protein interaction of action target was constructed by String platform,and GO enrichment analysis and KEGG signal pathway analysis were carried out by DAVID 6.8 database.The molecular docking was carried out by using iGEMDOCK software to predict the binding degree of target and key compounds.Results : 1.The results of the first part of this study:(1)A total of 40 literatures were included,including 3544 patients.There was a significant difference in improving the clinical efficacy and cardiac function after PCI with traditional Chinese medicine injection combined with conventional western medicine(P > 0.05).(2)The results of network meta-analysis of five research indicators show that the traditional Chinese medicine injection combined with western medicine is obviously better than that treated with western medicine alone.In the study of effective rate,LVEF and CRP index,Danhong injection combined with western medicine has the best curative effect after PCI;In the study of BNP outcome index,Shuxuetong injection combined with western medicine has the best curative effect after PCI;In the study of c Tn I outcome index,it is concluded that Xuesaitong injection combined with western medicine has the best curative effect after PCI;In the study of CRP outcome index,Chaihu injection combined with western medicine has the best curative effect after PCI.(3)Danhong injection combined with aspirin,clopidogrel and low-molecular-weight heparin is most likely to be the best treatment plan in terms of efficiency,LVEF and CRP after PCI,which reflects to a certain extent that it has the best overall curative effect evaluation,and has outstanding effects in enhancing clinical efficacy,improving cardiac function and protecting vascular endothelium.This study provides the best treatment plan and evidence-based medicine evidence for the second part of this study to further explore its mechanism by using network pharmacology.2.Results of the second part of this study:(1)A total of 75 compounds including Salvia miltiorrhiza and Carthamus tinctorius were collected,with 132 targets and 28 western medicines including aspirin,clopidogrel and low molecular weight heparin.There are 27939 targets of coronary heart disease,which are intersected by Venny analysis tool,and six intersected targets are obtained.Through GO analysis(P < 0.05)and KGEE analysis,it is concluded that they participate in eight biological processes,two cellular components,three molecular interactions and six signal pathways.(2)TP53(tumor suppressor gene),PTGS2(inducible peroxidase synthase),PLAT(platelet tissue plasminogen activator),CD40LG(CD40 ligand),etc.are the most interactive genes.(3)The enrichment is most related to the enrichment of NF-k B signaling pathway,complement,arachidonic acid metabolism signaling pathway and coagulation cascade signaling pathway.(4)According to the topological parameters,it is calculated that the five key compounds with the highest degree score are docked with six common action targets,and the docking results of PLAT(tissue plasminogen activator)and quercetin are the best.Conclusion(s): On the basis of network meta-analysis,combined with network pharmacology,this study comprehensively evaluated the curative effect of Danhong injection combined with western medicine after PCI,and further discussed and predicted its potential mechanism of action.The results of this study provided the best treatment plan and evidence-based medical evidence for clinical practice,and also provided research ideas for prevention and treatment of complications and prognosis after PCI.The conclusions are summarized as follows.The results of the first part of this study are as follows: 1.In improving the clinical efficacy and cardiac function after PCI,most Chinese medicine injections combined with western medicine therapy have obvious advantages over western medicine therapy alone;2.In the treatment scheme with the best main indexes,it is concluded that Danhong injection combined with aspirin,clopidogrel and low molecular weight heparin has a significant effect on enhancing clinical efficacy,improving cardiac function and protecting vascular endothelium after PCI,and has better safety and less toxic and side effects,which improves the quality of life of patients after PCI.3.At present,there are many research results at home and abroad,which confirm that Danhong injection combined with western medicine has a remarkable curative effect after PCI.In the second part,the network pharmacology was carried out to further study its mechanism of action through the best treatment scheme of previous network meta-analysis.The results are as follows: 1.Explore the mechanism of Danhong injection combined with western medicine after PCI,which may be related to the mechanism of inhibiting inflammatory reaction,resisting platelet aggregation,protecting vascular endothelium,regulating cell proliferation,differentiation,apoptosis and regulating immune stress.2.The target biological process of Danhong injection combined with western medicine treatment after PCI may be involved in blood pressure regulation,vascular smooth muscle regulation,anticoagulation,anti-inflammation,anti-oxidative stress response and hemodynamic effects.3.The pathophysiological process of vascular endothelium after 3.PCI may be closely related to quercetin’s activation of NF-κB signaling pathway,arachidonic acid metabolism signaling pathway,complement and coagulation cascade signaling pathway,and fibrinolysis regulation of plasminogen activator in target tissue,which plays a role in coagulation,protection of vascular endothelial cells and cardiac function.