Professor Liu Wen's Experience And Mechanism Analysis Of PBC Treatment Based On Data Mining And Network Pharmacolog

Purpose:This study aims to analyze the medication patterns and mechanisms of Professor Liu Wen’s treatment of Primary biliary cholangitis(PBC)based on data mining and network pharmacology exploration.Methods:The study screened PBC case data information from the HIS system of Beijing Traditional Chinese Medicine Hospital,where Professor Liu Wen practiced,from January 1st,2016 to December 31st,2021,according to the inclusion and exclusion criteria.The data were imported into Microsoft Office Excel 2022 to form a basic database,and the data were cleaned and normalized.Descriptive statistical analysis was conducted on general information,TCM disease names,syndrome differentiation,distribution and frequency of medication.Then,IBM SPSS Modeler 18.0 was used for association rule analysis of TCM prescriptions,and IBM SPSS Statistics 26.0 was used for clustering analysis of TCM prescriptions to explore the medication patterns,commonly used drug pairs,drug combinations and core prescriptions for treating PBC by Professor Liu Wen.Clinical follow-up experience was also considered to summarize the clinical thinking and characteristics of Professor Liu Wen’s treatment of PBC.Based on the results of the above data analysis and mining,network pharmacology analysis was performed on the selected core prescription to identify the main targets and pathways of the core prescription for treating PBC,thereby analyzing the mechanism of the core prescription for treating PBC.Results:This study included a total of 100 primary biliary cholangitis(PBC)patients with a total of 420 visits.In terms of general information,female patients with PBC were more common than male patients,with a male-to-female ratio of approximately 1:6.69.The age of the patients was mainly concentrated in the 50-79 age group,accounting for 90%.In terms of traditional Chinese medicine(TCM)disease names,the most common TCM disease names were liver diseases,accumulation diseases,liver congestion,flank pain diseases,accumulation diseases,liver accumulation diseases,abdominal distension diseases,bloating diseases,jaundice,and liver congestion.In terms of TCM patterns,the four most common patterns were liver-kidney yin deficiency pattern,phlegm turbidity obstruction pattern,liver depression spleen deficiency pattern,and liver-gallbladder damp-heat pattern.In terms of Chinese herbal medicine applications,a total of 420 prescription information was included,involving 318 kinds of Chinese herbal medicines.The commonly used Chinese herbal medicines included astragalus,ophiopogon,angelica,poria,glehnia,scutellaria,citrus peel,wolfberry,glossy privet fruit,dendrobium,mulberry fruit,pinellia ternata,fried white atractylodes rhizome,salvia,prince ginseng,and gentian.The temperature properties of Chinese herbal medicine were mainly warm,neutral,cold,slightly cold,and slightly warm.The flavor properties of Chinese herbal medicine were mainly sweet,bitter,spicy,and salty.The meridian tropism of Chinese herbal medicine mainly involved the liver meridian,lung meridian,stomach meridian,and spleen meridian.Commonly used drug combinations included Acorus tatarinowii and Arisaema erubescens,bitter apricot kernel and Citrus reticulata peel,citrus peel and pinellia ternata,mulberry fruit and raspberry,wolfberry and glossy privet fruit,prince ginseng and Rhodiola rosea,scutellaria and gentian.The core prescription for treating liver-kidney yin deficiency type PBC included rehmannia root,ophiopogon,angelica,wolfberry,mulberry fruit,raspberry,glossy privet fruit,and eclipta.The core prescription for treating phlegm turbidity obstruction type PBC included citrus peel,pinellia ternata,poria,licorice,Acorus tatarinowii,Arisaema erubescens,bamboo shavings,Citrus reticulata peel,and bitter apricot kernel.The core prescription for treating liver depression spleen deficiency type PBC included Bupleurum chinense,turmeric root,Cyperus rotundus,codonopsis,fried white atractylodes rhizome,poria,resin from dragon’s blood,and radix polygalae.The core prescription for treating livergallbladder damp-heat type PBC included scutellaria,gentian,turmeric root,Bupleurum chinense,poria,patrinia,and fried gardenia fruit.In terms of network pharmacology,the core prescription for treating liver-gallbladder damp-heat pattern(qing li gan dan formula)had a total of 68 active ingredients and 262 predicted targets.After retrieval,sorting,and deduplication,a total of 2121 PBC-related targets were obtained,with 142 targets shared by drugs and diseases.The main active chemical components in this prescription for treating PBC were likely to be quercetin.Conclusion:Professor Liu Wen focuses on the differentiation and treatment of PBC from the perspective of dampness-heat,yin-yang,qi-blood,and phlegm-stasis.Specifically,the diag nosis and treatment are combined according to the actual clinical situation.Dampness-heat is t he initial factor for the onset of PBC,and the accumulation of dampness-heat in the liver and g allbladder is the central link of PBC.The principle of yin-yang is emphasized to pay attention to the condition of PBC’s yin fluids and yin blood.The disease mechanism is carefully analyze d based on the principle of qi-blood.PBC is a chronic disease,and long-term disease may lead to the formation of phlegm-stasis.In the treatment of PBC,clearing and eliminating dampnes s-heat,nourishing the liver and kidney,regulating qi-blood,and resolving phlegm and elimina ting stasis are emphasized.The use of classical prescriptions is preferred in the formulation of the prescription,and flexible use of medication is necessary.The mechanism of the treatment of PBC with the formula of clearing and eliminating dampness-heat may be related to anti-infl ammatory,immune-regulating,and inhibition of cancer progression.