To Explore The Medication Rule Of Professor Zhang Nianzhi In The Treatment Of Mild To Moderate Asthma During Acute Stage Based On Data Mining And Network Pharmacology Of Core Prescription

Objectives:Based on data mining,the clinical data of professor Zhang Nianzhi in treating patients with mild-to-moderate acute asthma were analyzed,the medication rules were summarized,the core prescriptions were summarized,and the therapeutic experience of famous Chinese medicine practitioner was generalized.All of that can provide reference for clinical practice.Based on network pharmacology,the material basis,targets and involved signal pathways of core prescription in treating asthma were discussed from microscopic level,which can explain the molecular mechanism of core prescription,and provide a theoretical basis for the clinical application and follow-up research.Methods:Clinical data were screened by inclusion and exclusion criteria.The frequency analysis method were used to analyze data as patients’ sex,age,visiting time,syndrome types,symptoms,as well as of the nature and taste of traditional Chinese medicine and channel tropism.The Analysis of Association rules were used to analyze association between TCM and TCM,TCM and syndrome types.The clustering analysis were used to analyze high-frequency TCM.The complex network analysis were used to analyze TCM and TCM,TCM and syndrome types,TCM and symptoms.Above all,the clinical characteristics and medication regularity of asthma patients can summarized.Combined with the theory of traditional Chinese medicine,Zhang Nianzhi’s experience in the treatment of mild-to-moderate acute attack of asthma also can summarized.The effective components and related targets of the core prescription were obtained by TCMSP,literature review,Swiss database.The related targets of asthma were obtained in the disease database.The former is standardized by the Uniprot and intersects with the latter.The intersection targets of asthma and the core prescription,Chinese herbs,components,and diseases were constructed to network graph by Cytoscape software.And then,the network graph was analyzed topologically to screen the core components.The intersection targets were imported into String database to analyze the interaction,after forming the network,the core targets were obtained.The significant gene functions and involved signaling pathways were explained by enrichment analysis on Metascape database.Results:1 Data mining :(1)From October 1,2020 to October 31,2022,a total of 675 asthma outpatient records,a total of 156 patients,of which 95 were diagnosed with acute asthma exacerbation,and 65 patients were screened and included,with a total of 191 consultations and 191 first prescriptions.(2)A total of 65 patients were enrolled,including 30 male patients(46.15%)and 35 female patients(53.85%).The ratio of male to female was 0.85:1.The average age was(39.38 ± 18.84)years.(3)Visiting time were clustered in August,October and November.(4)In 191 visits,the highest frequency of syndrome type was wind-phlegm obstructing lung syndrome,most of them were complicated with allergic rhinitis,and the perennial symptoms were cough,expectoration,chest tightness,white phlegm,asthma,nasal obstruction,runny nose and large amount of sputum.The common tongue and pulse conditions of the patients were light tongue,light red tongue,dark red tongue,white fur,thin white fur,white greasy fur,string slippery pulse,slippery pulse,etc.(5)32 High-frequency herbal medicines are combined with licorice,mu butterfly,dirong,lily of the valley,stiff silkworm,zi su zi,yam,hou pu,etc.In general,the top three medicinal properties are warm,flat and cold;the top three medicinal flavours are sweet,bitter and pungent;and the normal channels are mostly in the lung,stomach and spleen;more drugs are used to tonify deficiency,resolve phlegm,relieve symptoms.Commonly used pairs and horny herbs include,lily of the valley and loquat leaves,stiletto and cicada,dahurica,xing yi and celosia,codonopsis,atractylodes and poria,mullein,yam,hou pa and perilla.(6)Five clustered formulas were obtained:(1)dried ginger,hosanna,schisandra,schisandra,codonopsis,poria,fengfeng,astragalus,atractylodes,huang jing,(2)burdock seeds,mulberry leaves,cicada molts,(3)zhe bei mushroom,bitter almonds,astragalus,echinacea,lycopodium,bupleurum,winter flowers,ochre,(4)xing yi,dahurica,cang er zi,(5)lily of the valley,loquat leaf,wood butterfly,yam,perilla,thick park,licorice,dirong,stiff silkworm.(6)One core prescription was extracted,composed of wood butterfly,dirong,lily of the valley,perilla,yam,huang jing,thick park,atractylodes.2 Network pharmacological: The core prescription exerts pharmacological effects on 7potential substances: β-sitosterol,quercetin,stigmasterol,α-linolenic acid,leucine-valine,baicalein and luteolin.It may affect 10 gene targets such as EGFR,MAPK3,PTGS2,JUN,SRC,MMP9,IL6,TP53,ALB,and TNF.The signaling pathways affected by the core prescription in asthma include AGE-RAGE signaling pathway,IL-17 and Th17 cell differentiation signaling pathway,PI3K-AKT signaling pathway.Conclusions:Through the analysis and induction of clinical data,the core prescription of Professor Zhang Nianzhi for the treatment of acute asthma exacerbation and treatment experience are obtained:(1)Visceral deficiency as the foundation,regulating the lungs,spleen and kidneys;(2)When wheezing,phlegm and qi are reversed first,and phlegm and qi are treated together;(3)Often add insect drugs to expel "Fu Xie",which can provide clinical reference.With the help of network pharmacology research methods,it was found that the core prescription plays a therapeutic role by affecting multiple gene targets and multiple signaling pathways through multiple traditional Chinese medicine components,laying a theoretical foundation for subsequent research.