Efficacy Review Of Bushen Tongluo Jiedu Method In The Treatment Of Stage Ⅲ-Ⅳ Diabetic Kidney Disease And Core Prescription Network Pharmacology Research

Objective : To analyze the efficacy and safety of the ’ core prescription ’ of Bushen Tongluo Jiedu method in the treatment of Diabetic Kidney Disease stage III-IV(kidney deficiency and stasis toxin syndrome),and to screen the effective components and targets of the ’ core prescription ’ in the treatment of DKD stage III-IV,and to explore the possible mechanism of the ’ core prescription ’ in the treatment of DKD,so as to provide scientific basis for the treatment of DKD.Methods : The first part : From January 1,2020 to December 31,2021,patients with diabetic nephropathy stage III-IV treated with the ’ core prescription ’ of tonifying kidney,dredging collaterals and detoxifying method in the outpatient department and treatment area of the Department of Nephrology,Affiliated Hospital of Changchun University of Traditional Chinese Medicine were screened in strict accordance with the criteria of inclusion and exclusion,and the basic data and four diagnostic data of traditional Chinese medicine were collected.The observation nodes were before treatment,1 course of treatment,2 courses of treatment,and 4 courses of treatment(15 days for 1 course of treatment).The observation efficacy indicators included ALBU,24 h UTP,FBG,BUN,and Scr,and SPSS23.0 software package was used for data processing and analysis.The second part : The effective active ingredients and targets of the ’ core prescription ’ of tonifying kidney,dredging collaterals and detoxifying method were screened from TCMSP and Herb database.DKD-related targets were collected from the Gene Cards database;the network diagram of drug-effective component-target was drawn by Cytoscape 3.7.2 software.Venny2.1 was used to intersect the predicted targets of ’ core prescription ’ with DKD-related targets and draw Venn diagram.PPI network diagram and topology analysis were made by Cytoscape3.9.1 software.KEGG enrichment analysis and Go enrichment analysis were performed by DAVID platform.Results : Part I : A total of 100 patients with DKD were collected,including 61 males and 39 females,with an average age of 56.6 years.The course of DM in stage III patients was mainly concentrated in 6-10 years,while that in stage IV patients was mostly 10-15 years.The incidence of hypertension in other diseases was 71 %.The ALBU,24 h UTP,BUN and FBG in the laboratory indexes were lower than those before treatment,and the difference was statistically significant(p0.05).The total effective rate of stage III patients was 82.3 %.The total effective rate of stage IV patients was 73.5 %.The scores of TCM symptoms were lower than those before treatment,and the difference was statistically significant(p < 0.05).The second part : 113 active components and 5515 related targets of10 traditional Chinese medicines in the ’ core prescription ’ of tonifying kidney,dredging collaterals and detoxifying method were obtained in the TCMSP and Herb databases.A total of 3286 DKD-related targets were obtained in the Gene Cards and OMIM databases,and 449 intersection targets were obtained by drawing the Venn diagram.The compound-target-disease network diagram was constructed in Cytoscape,with a total of 563 nodes and 3892 lines.The main components were liquiritigenin,alisol B,sitosterol,acacetin,luteolin,etc.PPI network analysis obtained core components,mainly AKT1,GAPDH,TNF,etc.A total of 1751 items were obtained by GO functional enrichment,mainly involving protein phosphorylation,plasma membrane,protein binding,etc.A total of 193 pathways were enriched in KEGG function,mainly involving cancer signaling pathways,AGE-RAGE signaling pathways in diabetic complications,etc.Conclusion : The ’ core prescription ’ of tonifying kidney,dredging collaterals and detoxifying method can improve the clinical symptoms and laboratory indexes of patients with stage III-IV diabetic nephropathy.