Exploring The Medication Pattern And Action Mechanism Of Traditional Chinese Medicine In The Treatment Of Threatened Abortion Based On Data Mining And Network Pharmacology

Objective:To study the pattern of medication and action mechanism of threatened miscarriage by using data mining and network pharmacology technology,aiming to summarize the experience of modern physicians in the diagnosis and treatment of fetal leakage and fetal irritability,and to provide theoretical basis for improving the clinical rate of fetal preservation and clinical research.Methods:1.As research materials,papers published in China’s National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,and China Science and Technology Periodical Database VIP Database(VIP)over the previous ten years were searched using the search terms "Threatened Miscarriage," "Fetal Leakage," "Fetal Irritability," "Traditional Chinese Medicine," and "Chinese Medicine." The retrieved literature was screened according to the inclusion criteria and exclusion criteria,and the final included literature was extracted and proofread for relevant information data and entered into Excel.2.Chinese medicines for the treatment of threatened miscarriage were analyzed for nature,flavor and attribution,efficacy,association rule analysis,and cluster analysis using the Traditional Chinese Medicine Inheritance Support System v3.0 software.3.The top ten drugs with the strongest association that were finally selected to form the core prescription for the treatment of threatened abortion,the chemical composition of all drugs in the core prescription is searched using TCMSP database and BATMAN-TCM database,oral bioavailability OB ≥30%and drug-like properties DL≥0.18 are used as screening conditions to search the corresponding targets of the components,and then the corresponding target names were transformed into human gene names through the Uniprot database,the Cytoscape v3.9.0 software was used to construct the drug-component-target interactions network;the GeneCards database,DisGeNET database and OMIM database were used to retrieve the disease targets of threatened abortion;the intersection targets of drugs and diseases were analyzed by String database for human protein interactions network,and then the topological parameters of the protein interaction network are analyzed using Cytoscapev3.9.0 software and the core targets are selected according to DC,BC,and CC greater than the median;the GO functional analysis and KEGG enrichment pathway analysis of the intersection targets of drugs and diseases are performed through Metascape database.Results:1.232 prescriptions were included in 222 papers,124 kinds of traditional Chinese medicines were extracted,and the total frequency of use was 2484.2.The medicinal properties were mostly warm,flat and cool,with sweet,bitter and pungent flavors,and most of them belong to the liver meridian,kidney meridian,and spleen meridian.The deficiency tonifying herbs were used most frequently with a total of 1698 times,followed by wind-dampness dispelling herbs and heat clearing herbs;Scutellaria baicalensis,Cortex Eucommia Ulmoides,Semen Cuscutae,Radix Astragali,Radix Codonopsis pilosulae,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Colla Corii Asini were selected as the core prescriptions for the treatment of threatened abortion by association rule analysis.Five groups of new prescriptions were obtained.3.The total number of drug active ingredients in the core prescription after removing duplicate items was 103,with 663 drug targets,1247 disease targets of threatened abortion,155 drug disease intersection targets and 194 KEGG pathways.The main active ingredients of the core prescription for threatened abortion are β-sitosterol,quercetin,kaempferol,isorhamnetin,and mairin etc.;the key targets are TNF,IL6,PTGS2,CTNNB1,EGF,IL1B,CASP3,ALB,EGFR,PTEN,HIF1A,MMP9,VEGFA,CXCL8,TP53,FN1,AKT1;the main biological pathways are the PI3K-Akt signaling pathway,the AGE-RAGE signaling pathway,the cancer pathway.Conclusion:1.Threatened miscarriage is characterized by kidney deficiency,spleen deficiency,qi deficiency,blood deficiency,and blood heat as the basic pathogenesis.It is the common treatment for threatened miscarriage by modern physicians to tonify the kidney,strengthen the spleen,benefit the qi and nourish the blood,coordinating the chong and conception vessels,and clear heat to prevent abortion,often based on the Shoutai pills.2.The medicinal properties are mainly warm,flat and cold;the medicinal flavors are mainly sweet,bitter and pungent;the drug meridians mainly belong to the liver meridian,kidney meridian and spleen meridian;the drug categories are mainly applied to the deficiency tonifying herbs,wind-dampness dispelling herbs and heat clearing herbs.The core prescription for threatened miscarriage were composed according to the 10 most strongly associated drugs:Scutellaria baicalensis,Cortex Eucommia Ulmoides,Semen Cuscutae,Radix Astragali,Radix Codonopsis pilosulae,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Colla Corii Asini.3.Through the network pharmacological study of the core prescription in the treatment of threatened abortion,it is inferred that β-sitosterol,quercetin,kaempferol,isorhamnetin and mairin,the main active ingredients of the core prescription,may regulate the PI3K-Akt signaling pathway,AGE-RAGE signaling pathway,cancer signaling pathway and other related signaling pathways by modulating the targets represented by TNF,IL6,and PTGS2.Intervene in biological processes such as response to hormones,response to nutrient levels,and response to inorganic substances to play a role in the treatment of threatened abortion.