Summary Of Professor Yang Shen-Qiu’ Experience In Treating Bile Reflux Gastritis Based On Traditional Chinese Medecine Inheritance Auxiliary Platform

Objective: This study aims to collect and organize medical cases of mentors treating bile reflux gastritis,analyze the core drugs and medica tion characteristics used by mentors in treating bile reflux gastritis,and explore the mechanism of core drugs in intervening bile reflux gastrit s through network pharmacology research.The study also aims to syste matically summarize the clinical experience and provide new ideas for clinical diagnosis and treatment.Methods:1.Collect case data of 156 patients with bile reflux gastritis treated by mentors in the outpatient and inpatient departments of the Departm ent of Liver,Spleen and Stomach of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September 2017 to December 2022,and standardize the cases that meet the criteria.At the same time,enter the standardized case information into the Traditional Chinese Medicine Inheritance Assistance Platform(V2.5).Use frequency statistics,association rule analysis,and entropy clustering analysis to determine the medication characteristics and core drugs used by the mentors.2.The main chemical components and targets of core drugs for the treatment of bile reflux gastritis were collected through TCMSP database,NCBI database,and other methods.Relevant targets of BRG were screened from Gene Cards,OMIM,Drug Bank,and Pharm GKB databases,and the intersection of the two sets of targets was taken.PPI analysis was performed using STRING11.0 database,and GO analysis and KEGG enrichment analysis of the intersection targets were conducted using DAVID database to explore the mechanism of action of core drugs for the treatment of bile reflux gastritis.Results:1.General situation: A total of 156 medical records were included in this study,with 57 male patients and 99 female patients,with a male-to-female ratio of 1:1.74.Theage distribution ranged from 18 to 69 years old,with the highest number of patients being between 40-49 years old.2.Syndrome statistics: This study involved 7 types of syndromes,in cluding 50 cases of liver and stomach depression and heat syndrome,36 cases of liver and stomach qi stagnation syndrome,32 cases of spleen and stomach deficiency-cold syndrome,15 cases of spleen and stomach qi deficiency syndrome,11 cases of spleen and stomach damp-heat sy ndrome,9 cases of stomach yin deficiency syndrome,and 3 cases of stomach meridian obstruction syndrome.The first three types of syndromes are the main syndromes of this disease.3.Medication statistics: Among the 156 prescriptions that meet the standards,129 types of traditional Chinese medicine are involved.The high-frequency drugs are ranked in the following order: Poria cocos,Li corice,Codonopsis pilosula,Pinellia ternata,Cynanchum otophyllum,Ma ssa Medicata Fermentata,Rehmannia glutinosa,Tangerine peel,Magnolia officinalis,and Bupleurum radix.The analysis of the four properties of drugs shows that warm drugs are used most frequently,followed by cold drugs.The analysis of the five flavors of drugs shows that bitter drugs are used most frequently,followed by spicy drugs.The analysis of the meridians of drugs shows that the high-frequency meridians are the spleen,liver,stomach,lung,and heart.The commonly used drug pairs are Codonopsis pilosula-Poria cocos,Licorice-Cynanchum otophyllum,Pinellia ternata-Tangerine peel,and Massa Medicata Fermentata-Poria cocos.The new formula combinations are Arcae concha-Gardeniae fructus praeparatus-Cortex moutan-Sepiae endoconcha-Pollen typhae,Pinellia ternata-Cornus officinalis-Rehmannia glutinosa-Fructus toosendan-Lysimachia christinae,and Licorice-Lysimachia christinae-Cortex moutan-Cynanchum otophyllum-Corydalis rhizoma.4.Network pharmacology research shows that the main active ingredients of core drugs are quercetin,digitoxigenin,kaempferol,and naringenin.There are 10 potential core targets for treating bile reflux gastritis,including AKT1,TP53,IL6,VEGFA,TNF,CASP3,IL1 B,STAT3,HIF1A,and EGFR.The possible signaling pathways for core drugs to inter vene in BRG include the IL-17 signaling pathway,TNF signaling pathway,and PI3K-Akt signaling pathway,which can inhibit inflammation and repair gastric mucosa,thereby playing a therapeutic role in this disease.Conclusion:1.Bile reflux gastritis is located in the bile and stomach,closely related to the liver and spleen.It is mainly caused by spleen and stomach weakness,emotional instability,irregular diet,and external invasion of the stomach.Disharmony between the bile and stomach is the basic mechanism of this disease.2.When treating bile reflux gastritis,the mentor emphasizes the combination of disease differentiation and treatment,the proper use of medication,and the importance of protecting the spleen and stomach.The main treatment methods are tonifying the spleen and stomach,promoting liver and bile flow,andpromoting blood circulation to relieve depression.3.Network pharmacology research shows that the core drugs used by the mentor to treat bile reflux gastritis have the characteristics of multiple components,multiple targets,and multiple pathways by regulating signal pathways such as IL-17,TNF,and PI3K-Akt.This confirms that these drugs can inhibit inflammation and repair gastric mucosa,thereby improving the clinical symptoms of patients.