The Clinical Efficacy Of Tanreqing Injection On The AECOPD Patients With Different Cell Types

OBJECTIVE: With the existence of different inflammatory types of AECOPD as the research background,the clinical efficacy of Tanreqing Injection in the treatment of different cellular types of AECOPD was explored through clinical studies and network pharmacology to provide a basis for the precise clinical use of Tanreqing Injection and enrich the scientific connotation of Tanreqing Injection.METHODS: Network pharmacology part: use literature search to collect the active chemical components of Tanreqing injection,use Pubchem and Ch EMBL databases to collect the targets of active components;use OMIM,Drug Bank,Genecards,Disgenet databases to search the relevant targets of chronic obstructive pulmonary disease(hereinafter referred to as slow obstructive pulmonary disease);take the intersection of Tanreqing Injection The core targets were obtained by taking the intersection of the targets of sputum fever and slow lung disease;the core targets were imported into String platform for protein interaction analysis,constructing PPI network diagrams and mining the potential protein functional modules;based on the PPI network diagrams,we screened 10 key targets according to their Degree values,and used Metascape to enrich the key targets with GO and KEGG.We used Cytoscape software to construct the network map of slow lung disease and signaling pathways.Finally,the top 10 genes and active ingredients of Degree value were molecularly docked using Auto Dock Vina.Retrospective cohort study part: case data were collected from January 1,2015 to December 31,2020 from inpatients with AECOPD in Jiangxi Provincial Hospital of Integrative Medicine.The electronic medical record data were screened by inclusion and exclusion criteria and entered into a self-constructed database.Patients were divided into the Tanreqing injection treatment cohort(TRQ)and the nonTanreqing injection treatment cohort(NON-TRQ)according to the exposure factor(whether to use Tanreqing injection or not).The following indicators were used: general information/demographic data such as age,sex,body temperature,admission blood pressure,Body Mass Index(BMI),global initiative forchronic obstructive lung disease(GOLD)grading,and the patient’s health status,COPD Assessment Test(CAT),Modified British Medical Research Council(m MRC),age-adjusted Charlson Comorbidity Index(CCAI),and other general/demographic data.Charlson Comorbidity Index(a CCI),blood count,CRP(C-reactive protein),history of previous smoking,history of inhaled drugs,history of AECOPD exacerbation,treatment with sputum fever liquid(TRQ)and conventional Western medical treatment,and the observation endpoints were Inpatient Length of Stay(ILOS)as of the time of discharge from the hospital.The factors that may affect the length of stay were analyzed univariately,and the variables affecting the length of stay were brought into a multiple regression model to construct three regression models,i.e.,a model with no adjustment for the influencing variables,a model with partial adjustment for the influencing variables,and a model with full adjustment for the influencing variables,to obtain the effect of the use of phlegm fever Qing injection on the length of stay.Stratified analysis was performed to see whether this effect result was variable across age groups,gender,and different cell types of AECOPD in each substratum.RESULTS:Network pharmacology part: 107 effective chemical components,1722 drug targets,6525 COPD targets were obtained,and finally 1327 core targets were obtained.The main components of phlegm fever clear injection for the treatment of COPD were coumarin,caffeic acid,6-aminohexanoic acid,etc.The key targets were TP53,HSP90AA1,SRC,etc.Inhibition of neutrophil inflammation is associated.The molecular docking results showed that the binding energies were all ≤-3.8 k J?mol-1,indicating that the core components had good activity.In the retrospective cohort study part: univariate analysis revealed that age,BMI,admission temperature,white blood cell count(WBC),red blood cell count(RBC),neutrophil count(NEUT),lymphocyte count(Lymphocyte count(LYM),absolute eosinophil count(AEC),CRP,CAT score,m MRC score,GOLD classification,and frequency of hospitalization were correlated with the length of hospitalization for AECOPD.The adjusted multiple regression model found that the use of phlegm fever solution injection reduced the length of hospitalization,with an effect value β=-3.9,95% CI(-4.8,-3.0)(P≤0.01).In stratified analysis and interaction test,Tanreqing injection was found to be more effective in reducing the length of hospital stay in the neutrophil subgroup.It was also found to be more effective in patients with milder disease and BMI >17.CONCLUSIONS:Tanreqing Qing injection is a multi-component,multitarget,multi-pathway treatment for chronic obstructive pulmonary disease.The use of Tanreqing injection in patients hospitalized with AECOPD can shorten the length of hospitalization,and the effect is more significant in patients with neutrophilic AECOPD.