Clinical Observation And Network Pharmacological Analysis Of Guanfang Decoction In The Treatment Of Herpes Zoster

Objective:(1)To explore the clinical efficacy and safety of Guanfang Decoction combined with fire needle in the treatment of herpes zoster.(2)Based on the method of network pharmacology and molecular docking,the mechanism of Guanfang decoction in the treatment of herpes zoster was explored.Methods:(1)60 patients with herpes zoster who met the inclusion criteria were randomly divided into treatment group(group 1)and control group(group 2)(n=30).Both groups were treated with valaciclovir capsule,fire needle and external Zilian ointment,and the treatment group was treated with oral Guanfang decoction.The clinical efficacy,VAS score,blister stop time,scab formation time,scab removal time,the score of the Arsens insomnia scale,whether there was sequela neuralgia,and adverse reactions were counted after treatment.After collecting and sorting out the data,statistical analysis was performed using SPSS26.0,and P<0.05 was statistically significant.(2)The active compounds of Guanfang Decoction were obtained through the TCMSP and BATMAN-TCM databases.Then the compound screening and target prediction were carried out in Swiss ADME and Swiss Target Prediction databases.The targets of herpes zoster were identified by databases such as OMIM and Gene Cards,etc.Protein-Protein Interaction Network construction is performed in STRING and Cytoscape.Enrichment analysis of key targets is conducted in a database,which is called DAVID.Molecular docking of major active ingredients and key targets is completed in AutoDock and Pymol.Results:(1)A total of 60 cases were completed in this study.The total effective rate was96.67% and 83.33% in the group 1 and group 2,respectively.(1)The time of blister arrest,scab formation and scab removal in the group 1 was better than that in the group 2,P<0.05.(2)VAS scores were lower in the group 1 than the other one after treatment,P<0.05.(3)The scores of the Athens insomnia scale after treatment were lower in the group 1 than those in the group 2,P<0.05.(4)There was 1 case of post-herpetic neuralgia in the group 1 and 2 cases of post-herpetic neuralgia in the group 2.After statistical analysis,P>0.05,the differences were not statistically significant,so it could not indicate that the group 1 was better than the group 2 in controlling the incidence of post-herpetic neuralgia.(5)In the treatment group,1 case of adverse reaction occurred during the treatment period,which was characterized by diarrhea.The patient was again instructed to take warm Chinese medicine half an hour after eating,and the adverse reaction disappeared without special treatment.No adverse reactions occurred in the control group.(2)There were 38 active ingredients and 694 potential targets in Guanfang Decoction,and 462 targets in herpes zoster.Venn diagram showed that there were 64 common targets of Guanfang Decoction and herpes zoster.142 signal pathways were screened by KEGG pathway enrichment analysis,and 412 results were obtained by GO function enrichment analysis.At the molecular docking level,main ingredients,which contain procyanidin,scutellarin,quercetin and kaempferol,have good docking with key target proteins.Conclusion:(1)The treatment of herpes zoster with Guanfang Decoction combined with fire needle has a good effect on shortening the course of the disease,reducing pain,improving sleep.The treatment has fewer adverse reactions,and is safe and effective.(2)Guanfang Decoction exerts its therapeutic effect on herpes zoster through multiple targets and pathways,which can provide theoretical basis for follow-up clinical research and clinical development of Guanfang Decoction.