| Purpose:1.Based on data mining technology,this paper analyzes the medication rule of Professor Cao Enze,a national famous Chinese medicine,in treating diabetes and kidney disease,summarizes clinical experience,and obtains core prescription drugs.2.According to Professor Cao Enze’s core drugs for diabetes kidney disease summarized by data mining,the potential mechanism of core prescription drugs for diabetes kidney disease was explored through network pharmacology technology.Data and methods:1.Collect the data of patients who meet the DKD diagnostic criteria and meet the inclusion criteria treated by Professor Cao Enze in the outpatient department of Anhui Provincial Hospital of Traditional Chinese Medicine from January 2021 to December2022,including basic information such as name,gender,age,and patient symptoms,tongue and pulse,diagnosis of western medicine,diagnosis of traditional Chinese medicine,syndrome classification of traditional Chinese medicine,prescription and drug dose,and other relevant case data,and import all data into the auxiliary platform system V2.5 of traditional Chinese medicine inheritance,Establish a patient data database,and summarize the medication rules and core drugs of Professor Cao Enze in treating diabetes kidney disease through statistical methods such as patient basic situation analysis,TCM syndrome analysis,prescription drug frequency analysis,association rule analysis and cluster analysis.2.The TCMSP database and BATMAN-TCM database were used to screen the active ingredients and target proteins of the core drugs,the Uniprot database was used to convert the drug target proteins into standard gene names,and then the Gene Cards database was used to retrieve the disease target gene names of diabetic nephropathy,and the venny platform was used to cross the core drug active ingredient target genes and disease target genes to obtain the cross-target genes of the core drugs and diabetic nephropathy.The PPI network relationship of the drug disease cross-target gene was constructed by using the STRING database,and the "network analyzer" function in Cytoscape software was used to perform topological analysis of the PPI network and screen out the key target genes.Finally,the enrichment analysis of GO function and KEGG pathway was carried out through the Metascape platform,and the results were visualized through the We Chat website to predict the potential mechanism of action of core drug treatment for DKD.Result:1.103 patients were included in this study,and a total of 360 visits were recorded,including 59 male patients and 44 female patients,with a ratio of 1.34:1.The number of patients aged 51-60 and 61-70 was the highest,both accounting for 34%.In TCM syndrome differentiation,the deficiency of qi and yin is the most common,accounting for 44%,and the damp-heat syndrome is the most common,accounting for 47%.There are 121 drugs involved in the prescription,and the ten drugs with the highest frequency are astragalus,cicada slough,coptis chinensis,leech,scorpion,corn whisker,earthworm,zombie silkworm,atractylodes atractylodes,and amomum villosum.Among the nature-flavor meridians,the most common ones are the calmness,coldness,sweetness,bitterness and bitterness,as well as the liver,spleen,stomach and kidney meridians.Among the drug efficacy,the most commonly used drugs are those for tonifying deficiency,calming the liver and calming the wind,promoting water and dampness,and promoting blood circulation and removing blood stasis.The association rule analysis showed that the common drug pair combinations were: coptis chinensis-leech,calcined keel-calcined oyster,corn whisker-astragalus,scorpion-cicada slough,earthworm-zombie silkworm.Five groups of squares were obtained by cluster analysis.The core drugs selected include astragalus,cicada slough,coptis chinensis,leech,scorpion and corn whiskers.2.After screening the core prescription,69 effective active ingredients and 548 drug action targets were obtained,and 203 co-action targets were obtained after intersection with disease targets.The main active ingredients selected include quercetin,crocin,luteolin,berberine,ursolic acid,isorhamnetin,cholesterol,stigmasterol,palmatine,D-mannitol,etc;Key targets mainly include ALB,TNF,AKT1,IL6,INS,TP53,IL1 B,VEGFA,EGFR,CASP3,etc.GO functional enrichment analysis core drugs regulate the response to hormones,lipopolysaccharides,bacteria-derived molecules,cell responses to nitrogen compounds,responses to inorganic substances and other biological processes in membrane rafts,membrane microregions,vesicle cavities,plasma membrane protein complexes,cytoplasmic vesicle cavities and other parts,and play molecular functions such as signal receptor regulator activity,DNA binding transcription factor binding,signal receptor activator activity,transcription factor binding,receptor ligand activity,etc.,to achieve the effect of improving DKD.Through KEGG enrichment analysis,taking into account the weight of count value and p value,and excluding the influence of tumor related factors,combined with the pathological mechanism of DKD,it can be inferred that the signal pathway of six core drugs in the treatment of DKD is mainly involved in the regulation of AGEs-RAGE,lipid atherosclerotic pathway,MAPK and other signal pathways.Conclusion:1.Diabetic nephropathy is based on qi and yin deficiency,humid heat and stasis as the target,the disease is located in the kidney,and it is related to the liver and spleen.Professor Cao Enze in the use of medicine with flat as a supplement,cold as a leak,supplementation and excretion combined,the medicinal taste is mostly sweet and bitter and spicy,and the liver,spleen,stomach and kidney are more drugs.In terms of treatment,we should replenish qi,nourish yin,consolidate the root,clear heat and remove dampness,and promote blood circulation and remove blood stasis.The core drugs are astragalus,cicada slough,coptis chinensis,leech,scorpion and corn whiskers.2.The mechanism of action of the core drug may be that it contains a large number of active ingredients such as quercetin,crocetin,luteolin,and berberine,By influencing ALB,TNF,AKT1,IL6 and other related targets,it regulates the AGE-RAGE signaling pathway,lipid atherosclerotic pathway,MAPK signaling pathway and other related pathways of diabetic complications. |
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