| Objective:1.A systematic evaluation of the clinical efficacy of Chinese medicine in the treatment of plasma cell mastitis(PCM)using an evidence-based medicine approach.2.Using the use of data miner method clinical herbal prescription for the treatment of PCM to explore and analyze the dosing pattern,to provide a certain reference for the treatment of PCM in Chinese medicine.3.To analyze the potential mechanism of action of the core drug combinations of TCM for the treatment of PCM through a network pharmacology approach.Methods:1.Evidence-based medicine methodChina Biomedical Network,China Knowledge Network,Vipshop(VIP),Pubmed,Cochrane and Wanfang were retrieved,and randomized controlled trials(RCTs)combining Chinese and Western medicine with Western medicine alone for the treatment of plasmacytoid mastitis were collected according to the inclusion criteria.The quality evaluation of the included randomized controlled trial literature was performed;The relatively risk ratio(RR)between the combined Chinese and Western medicine group and the Western medicine only group for the treatment of this disease was used as a valid index.and a fixed-effects model(Meta-analysis)was selected,and RR was fused after concordance testing,as well as bias assessment.Also,the qualityevaluation of the included randomized controlled trials was performed using Revman 5.3 software Meta-analysis.2.Methods of data miningThe Chinese biomedical network,China Knowledge Network,Vipshop(VIP),Pubmed,Cochrane,and Wanfang were searched,and the prescriptions for TCM treatment were included according to the nadir criteria,and the processed data were included in Microsoft Excel 2020 to establish an Excel table,and the relevant data were counted by Microsofot Excel 2020,and then imported into the software for association rules,clustering analysis,and other data mining statistics.The pharmacological rules of PCM treatment in Chinese medicine were obtained.3.Network pharmacology methodFor the core drug combinations obtained from data mining,the compounds of related TCM and the corresponding targets of the compounds were searched in the Traditional Chinese Medicine Systems Pharmacology Databaseand Analysis Platform(TCMSP).We used the Swiss Target Prediction tool to predicted the targets of the volatile ingredients of Chaihu,Radix Paeoniae,and Xia Ku Cao.The protein targets related to PCM were retrieved by OMIM,Drug Bank,Genecard,and TTD.The acquired drug targets as well as disease targets were made into Evenn plots,and the potential targets of the core drug combinations for PCM were intersected.Using Cytoscape 3.6.1 software and String platform,Protein-Protein Interaction(PPI)analysis was performed to obtain the core targets.The shared potential targets were then entered into the DAVID platform to obtain GO biofunction and KEGG metabolic pathway analysis.Results:1.Through evidence-based medicineA total of 261 kinds of literature were reviewed,and after the screening,16 kinds of literature were finally included in the study,with combined Chinese and Western medicine were used as the test groups,and Western medicine alone was used as the control group,with 591 and 591 cases,respectively.The 16 pieces of literature in this study,after theχ~2test,I~2=0,and P=0.95 for the Q test,suggest that there is no heterogeneity among the literature selected for this study.the RR value for the summary of the 16 kinds of literature was 0.16,with a 95%confidence interval of0.12-0.20 and statistically significant,Z=7.59,P<0.00001,indicating that the combination of Chinese and Western medicine for the treatment of plasma cell mastitis,its experimental efficacy is significantly better than that of Western medicine alone.The difference in the total effective rate between the two groups was statistically significant.The results of sensitivity analysis showed that the results of this study are more reliable and have reference values.Quality of life assessment,and heterogeneity test showed:I~2=0,P=0.72,suggesting no heterogeneity.The religious recurrence rate in the combined Chinese and Western medicine group was lower than that in the Western medicine only group.It is confirmed that there exists unique efficacy of TCM in the treatment of PCM.2.Data mining methodAccording to the clinical staging of plasma cell mastitis in TCM treatment,the prescriptions collected regarding the three stages of the mass stage,abscess stage,and sinus tract stage.Sixty-eight TCM prescriptions with 127 herbal medicines were obtained for the mass stage;50 prescriptions with 95 herbal medicines for the abscess stage;and 44 prescriptions with 95 herbal medicines for the sinus tract stage.The analysis results indicated that the Chinese herbal medicines with a frequency greater than or equal to 19 in the mass stage were Dandelion,Chai Hu,Red Peony,Scutellaria,Xia Gu Cao,Jin Yin Hua,Lian Qiao,Angelica,Licorice,Soapberry,Salvia,and White Flowering Snake Tongue Herb.The main treatment is to clear heat and detoxify the toxin,expel blood stasis and drain pus,and eliminate swelling and disperse nodules.In the abscess stage,the treatment is based on Chai Hu,Dandelion,Soapberry,Radix Paeoniae,Angelicae Sinensis,Glycyrrhiza glabra,Radix Angelicae Sinensis,Forsythia Sinensis,and Salviae Miltiorrhizae,to clear heat and detoxify,expel pus and eliminate swelling,and support the righteousness and dispel evil.The drugs with a frequency greater than or equal to 12 in the sinus period were Angelica sinensis,Radix et Rhizoma Chai Hu,Radix et Rhizoma Paeoniae,Dandelion,Radix Astragali,Radix et Rhizoma Saponariae,Radix et Rhizoma Ginseng,Radix et Rhizoma Glycyrrhizae,Radix Curculigo,Radix et Rhizoma Goldenseal,Radix et Rhizoma Forsythiae,and Poria,which were mainly used to activate blood circulation and eliminate blood stasis,and to support positive and dispel evil.By correlation analysis,cluster analysis,and setting the confidence level of 100 for the mass phase,abscess phase,and sinus tract phase of PCM,the common drug pairs Chai Hu,Radix Paeoniae,and Xia Gu Cao can be obtained.And the network pharmacology study was conducted with these 3 drugs.3.Network pharmacology methodNetwork pharmacology methods were used for the analysis of the common core drug pair Chai Hu-Radix Paeoniae-Xia Gu Cao obtained by data mining.The results showed a total of 35 disease and drug targets,and 116 pathways in KEGG were optimized by cross-targeting enrichment analyses of-GO and KEGG.The network diagram of"disease-pathway-target-active ingredient-Chinese medicine"was analyzed by Cytoscape software,and core components such as Cubebin were obtained,and EGFR,TNF,ERBB2,STAT3 targets were found to be more closely related to the treatment of PCM.Conclusion:1.The efficacy of combined Traditional Chinese and Western medicine in the treatment of plasmacytic mastitis is superior to that of Western medicine alone.and has greater advantages in the near or long term,or terms of quality of life.This suggests that TCM is more effective in treating berry mastitis.2.The data mining results showed that the treatment of plasmacytoid mastitis by TCM was based on clearing heat and detoxifying,reducing swelling and pain in the lump phase,and adding swelling and pus-removing drugs to the lump phase in the abscess phase.In the sinus stage,the treatment is based on assisting righteousness,activating blood circulation and eliminating blood stasis,and supporting righteousness and eliminating evil.Network pharmacology predicts that EGFR,TNF,ERBB2,and STAT3 are more closely associated with the treatment of plasmacytic mastitis. |
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