| Purpose:By searching,collecting and sorting out the literature of How Net,Wanfang and VIP on the treatment of gallbladder polypoid lesions and biliary tract malignant tumors,this topic studies the prescription and syndrome law of classical and timely prescriptions in the treatment of biliary tract tumors.By searching,collecting and sorting out the medical records of the treatment of polypoid lesions of gallbladder and malignant tumors of biliary tract in the cloud platform of ancient and modern medical records,we studied the addition and subtraction of drugs with probable syndromes of polypoid lesions of gallbladder and malignant tumors of biliary tract.Through network pharmacology,the mechanism of Sinisan,a common prescription,in the treatment of biliary tract malignant tumors was analyzed.This provides data support for clinical prescription selection,medication and research.Material and method:1.Through computer search,we searched the literature of VIP,Wanfang and CNKI on the treatment of biliary tract tumors with traditional Chinese medicine,with "biliary tract cancer,gallbladder cancer,cholangiocarcinoma and biliary tract malignant tumor" as the key words,and then conducted a secondary search with "traditional Chinese medicine,traditional Chinese medicine,classic prescriptions,prescriptions,pills,powder and Decoction" as the key words.Then,we searched the literature of VIP,Wanfang and CNKI on the treatment of gallbladder polypoid lesions with traditional Chinese medicine,with "gallbladder polyp and gallbladder polypoid lesions" as the key words,and then conducted a secondary search with "traditional Chinese medicine,traditional Chinese medicine,classic prescriptions,prescriptions,pills,powder and Decoction" as the key words.The retrieval time is from the establishment of the database to June 2021.2.Search the medical records of ancient and modern medical records cloud platform on the treatment of biliary tract tumors with traditional Chinese medicine,with "biliary tract cancer","biliary tract cancer" and "gallbladder polyp" as the keywords respectively.The retrieval time is from the establishment of the database to June 2021.3.Tcmsp was used to find the chemical components and action targets of Radix Bupleuri,Radix Paeoniae Alba,Fructus aurantii and Radix Glycyrrhizae in Sini Powder,construct compound disease target network,construct drug target protein and disease target protein(PPI),and then go analysis and KEGG pathway enrichment analysis.Results:1.A total of 307 articles on polypoid lesions of gallbladder were retrieved,including 125 articles on CNKI,128 articles on VIP and 54 articles on Wanfang.The repeated literature,review literature,literature on the diagnosis and research of gallbladder polypoid lesions and literature on pathogenesis were excluded,and the literature only treated with western medicine and the literature with incomplete composition of prescriptions were excluded.Finally,29 articles were included.There are 11 addition and subtraction prescriptions of Sinisan(4 for grade II,4 for grade III and 3 for grade V).Among them,4 literatures involved231 cases,and the effective rate was 82.5%-96.9%.The rest of the literature involved 367 cases,and only reported the relief of symptoms after treatment.Dachaihu Decoction plus or minus 6 prescriptions(1 for grade III and 5 for grade V).One of the literatures involved 58 cases,and the effective rate was about 93%.The remaining literatures involved 5 cases,and only reported that hypochondriac pain and other symptoms alleviated or disappeared after treatment.Xiaochaihu Decoction plus or minus 5 prescriptions(3 for grade II,1 for grade III and 1 for grade V).Among them,three literatures involved 274 cases,and the effective rate was 81.1%-95.9%.The rest of the literature involved 61 cases,and the symptoms disappeared after treatment.There are 3 addition and subtraction prescriptions of Xiaoyao Powder(1 in grade III and 2 in grade V),of which one literature involves 62 cases,and the effective rate of treating diseases is about 87.1%.The other literatures involved 2 cases,and the symptoms of hypochondriac pain and abdominal distension were alleviated after taking the medicine.Wendan Decoction added and reduced 1 part(grade II),involving 60 cases.The effective rate of treatment was 83.4%,and the recurrence rate 12 weeks after withdrawal was8.3%.2.A total of 387 literatures on biliary tract malignant tumors were retrieved,including 154 on CNKI,55 on VIP and 178 on Wanfang.Repetitive literature,animal experiment literature,research literature on traditional Chinese medicine extracts,research literature on the diagnosis of biliary malignant tumors,literature on pathogenesis,literature treated only with western medicine and literature with incomplete composition of prescriptions were excluded.Finally,35 articles were included.Yinchenhao Decoction added and reduced 10 prescriptions(3 for grade II,3 for grade III and 4 for grade V).Among them,three literatures involved 119 cases,and the effective rate was 83%-94.4%.The rest of the literature involved 129 cases.After treatment,the symptoms of jaundice and ascites decreased,and TBIL,DBIL,ALT and AST decreased.Dachaihu Decoction plus and minus 8 prescriptions(1 for grade II,1 for grade III and 6 for grade V).A total of 49 cases were involved.Alt,AST,TBIL and DBIL decreased significantly after treatment,and the symptoms of vomiting and fever were improved.Wendan Decoction plus and minus 6 prescriptions(2 for grade II,1 for grade III and 3 for grade V).Two literatures involved 160 cases.After treatment,CD4 + and CD8 +were higher than those before treatment,and higher than those in the control group(P < 0.05).The other literatures involved 38 cases,and the symptoms of jaundice and vomiting were alleviated after treatment.There were 5 modified prescriptions of Sinisan(2 in grade II and 3in grade V),of which one literature involved 40 cases.The curative effect was evaluated according to the symptoms of abdominal pain,jaundice,abdominal mass,lack of appetite,loose stool or irregular loose knot.The effective rate of TCM syndrome in the treatment group was 94.74%,which was significantly higher than that in the control group(P < 0.01).The rest of the literature involved 71 cases.After treatment,the symptoms improved and various indexes returned to normal.Xiaochaihu Decoction plus or minus 2 prescriptions(grade II).One document involved 64 cases.The curative effect was evaluated according to the symptoms of anorexia,jaundice,pain,fatigue,nausea and vomiting.The effective rate of TCM syndrome was 93.75% higher than that of the control group(P < 0.05).The other literatures involved 46 cases,and the symptoms of nausea and vomiting were lower than those in the control group(P < 0.05).Wuling powder plus or minus 2 prescriptions(1 for grade II and 1 for grade V).One document involved 100 cases,and the effective rate was about 88%,which was higher than that of the control group(P < 0.05).The rest of the literature involved one case,and the symptoms of pain and fever were alleviated after treatment.3.94 medical cases of gallbladder polypoid lesions were retrieved,excluding repeated medical cases,medical cases without gallbladder polypoid lesions as the main complaint,medical cases with incomplete prescriptions,and medical cases without clear symptom improvement.Finally,33 medical cases were included.49 medical records of biliary tract malignant tumors were retrieved,excluding repeated medical records,incomplete medical records of prescriptions and drugs,and medical records without clear symptom improvement.Finally,35 medical records were included.A total of 28 probabilities were involved.There were 5 cases of fatigue,including 4 cases of Astragalus membranaceus and 2 cases of Dendrobium.The fatigue was reduced after use.There were 7 cases of poor sleep at night,including 3 cases of Albizzia bark,2 cases of wild jujube kernel and 2 cases of Poria cocos.The symptoms of insomnia were relieved.There were 9 cases of poor appetite,4 cases of Shenqu,4 cases of malt,3 cases of hawthorn and 3 cases of radish seed.The appetite improved and the anorexia and greasiness decreased.There were 4 cases of bitter mouth,including 3 cases of Bupleurum and 2 cases of Scutellaria baicalensis.There were 4 cases of dry mouth,of which 2 cases were treated with ginseng,and the symptoms of dry mouth disappeared.There were 6 cases of hypochondriac pain,including 2 cases of neem,2 cases of Bupleurum and 2 cases of Scutellaria baicalensis.There were 2 cases of red pain in urination,of which 2 cases used plantain,and the urination was normal.Three cases of vertigo were treated with gastrodia elata.Vertigo was reduced and blood pressure returned to normal.There were 2 cases of diarrhea,including 2 cases of Astragalus membranaceus.The number of stool cases decreased and loose stools alleviated.There were 3 cases of chest tightness,including 3 cases of Trichosanthes and 2 cases of Allium macrostemon.The chest tightness was relieved and the cooling in front of the chest was improved.There were 5 cases of acid reflux vomiting,including 4 cases of Coptis chinensis and 4 cases of Evodia rutaecarpa.The acid reflux heartburn was weakened and the vomiting was relieved.There were 4 cases of abdominal pain,of which 2 cases were treated with bupleurum,and the abdominal pain was relieved.There were 4 cases of epigastric fullness,of which 2 cases were treated with large abdominal skin,and the symptoms were relieved.There were 3 cases of yellow body and eyes,of which3 cases were treated with Herba Artemisiae,the jaundice was reduced,and the liver function was normal.4.Common drug pairs of probable syndrome of biliary tract tumor: bupleurum,Scutellaria baicalensis: there were 4 cases of probable syndrome of bitter mouth and hypochondriac pain, relieving liver qi and clearing liver and gallbladder heat.Asparagus and Ophiopogon japonicus: there were 2 cases of dry mouth and night sweat,nourishing yin and moistening dryness.Evodia rutaecarpa and Coptis chinensis: there were 4 cases of acid reflux probable syndrome.The drug composition of Zuojin Pill.It has good effect in relieving acid reflux,heartburn and vomiting.Gualou and Xiebai: there were 3 cases of chest tightness in the probable syndrome,broadening the chest and relieving depression.5.To screen the active components of Sini Powder.Radix Bupleuri,Radix Paeoniae Alba and Fructus aurantii were screened according to the screening conditions ob ≥ 30% and DL ≥0.18.Licorice was an adjuvant,so they were screened according to the screening conditions ob ≥ 60% and DL ≥ 0.18.17 active ingredients of bupleurum,13 white peony,22 Fructus aurantii and 23 licorice were obtained.The repeated active ingredients were deleted and 75 were retained.The compound target network of Sinisan for the treatment of biliary tract malignant tumors was constructed,and the compound target network diagram was obtained,with a total of 240 nodes and 789 edges,including 58 active ingredient nodes and 182 target nodes.The median value of degree is 2.Through screening,the core active components are mol000098(quercetin),mol000006(luteolin),mol000422(kaempferol),mol004328(naringin)and mol005828(nobiletin).A total of 2317 items were obtained from go bioaccumulation analysis,including 2166 biological processes,74 cell components and 184 molecular functions.A total of 191 pathways were obtained by KEGG pathway enrichment analysis.Conclusion:1.The common prescriptions of patients with polypoid lesions of gallbladder are similar to those of patients with malignant tumors of biliary tract.Including Chaihu prescriptions: Sini Powder,Xiaochaihu Decoction,Dachaihu decoction,Xiaoyao Powder,Chaihu Guizhi Decoction and Xuefu Zhuyu Decoction.Banxia recipe: Wendan Decoction.Rhubarb formula:Yinchenhao Decoction.Huangqi recipe: Fangji Huangqi decoction.Guizhi recipe: Wuling powder,roasted licorice soup.2.Patients with polypoid lesions of gallbladder are similar to patients with malignant tumors of biliary tract.Among them,Sini Powder is used to soothe the liver and regulate qi.Xiaochaihu Decoction and Dachaihu Decoction regulate qi,protect the spleen and stomach,attack and supplement at the same time.Xiaoyao Powder is an addition and subtraction formula of Sini Powder.On the basis of Sini Powder,add Jianpi and blood tonifying drugs,Chaihu Guizhi Decoction regulate qi and reconcile Ying and Wei,and Xuefu Zhuyu Decoction regulate qi,promote blood circulation and remove blood stasis.Wendan Decoction and Yinchenhao Decoction are often used to treat patients with biliary tumor and jaundice.Fangji Huangqi decoction is often used to treat patients with malignant tumor of biliary tract,long-term disease,loss of yin and Yang of spleen and kidney,swelling and edema.Wuling powder is used to treat dampness and detoxification,the water channel is smooth,and the evil poison comes down with urination.Zhigancao Decoction is a tonic for both qi and blood.It is often used in patients with asthenia and fatigue who have been ill for a long time.3.Addition and subtraction of drugs in patients with biliary tract tumors: if they are weak,add Astragalus and Dendrobium.If night sleep is poor,add Albizia bark,sour jujube kernel,Poria cocos,etc.Ruonacha adds Divine Comedy,malt,hawthorn and radish seeds.Add Bupleurum and Scutellaria baicalensis to your bitter mouth.If your mouth is dry,add ginseng.If hypochondriac pain,add neem,bupleurum and Scutellaria baicalensis.If the urine is red and painful,add it to the front of the car.If dizzy,add Gastrodia elata.If diarrhea,add Astragalus.If chest tightness,add Trichosanthes and Allium macrostemon.If acid reflux vomiting,add Coptis chinensis and Evodia rutaecarpa.If you have abdominal pain,add Bupleurum.If the epigastric distension is full,increase the abdominal skin.If the body and eyes are yellow,add wormwood,etc.4.Radix Bupleuri and Radix Scutellariae are commonly used to treat symptoms of liver depression and qi stagnation such as bitter mouth and hypochondriac pain.Asparagus and Ophiopogon japonicus are commonly used to treat Yin deficiency symptoms such as dry mouth and night sweat.Evodia rutaecarpa,Coptis chinensis and Zuojin Pills are commonly used to treat acid reflux symptoms.5.Based on network pharmacology,the main active components of Sinisan in the treatment of biliary malignant tumors are quercetin,luteolin,kaempferol,naringin and nobiletin.The main biological functions involved are gene transfer,protein ligation and so on.A total of 191 pathways were analyzed by KEGG pathway enrichment analysis,including PI3K-Akt signaling pathway,tumor necrosis factor signaling pathway,IL-17 signaling pathway,toll-like receptor signaling pathway,etc. |
PDF Full Text Request