Chief Physician Zhang Chunyan's Medication Rules And Core Prescription Network Pharmacology Research In The Treatment Of Rheumatoid Arthriti

ObjectiveTo summarize the medication rules of chief physician Zhang Chunyan in the treatment of rheumatoid arthritis,and predict the action mechanism of core prescription in the intervention of RA.MethodData mining part:The medical cases of RA patients in the outpatient department of Chief Physician Zhang Chunyan,from June 2021 to December 2022 were collected according to the scheduling standard.The Ancient and Modern Medical Records Cloud Platform(V2.3.5)was applied to establish the database and preprocess the data,and the modules of frequency analysis,association analysis,cluster analysis and complex network analysis were used for data mining.The medication rules of tutor were summarized and the core prescription was obtained.Network pharmacology part:The core prescription active ingredients and related targets were screened by searching the TCMSP database,and the drug-component-target network was constructed.RA-related targets were screened by searching GeneCards,DRUGBANK,OMIM and TTD databases.Venny2.1.0 software was used to obtain the component-disease intersection target.String database was used to construct PPI network.Metascape platform was further used to obtain the target function module,and analyze GO function and KEGG pathway enrichment of intersection target,and finally the componenttarget-pathway network was constructed.ResultsData mining part:A total of 117 RA cases and 259 prescriptions were included in this study.The average age of 117 cases is 51.97±13.46 years,with a male to female ratio of 1:4.5 years,ranging from 23 to 83 years.According to the statistics of 259 TCM syndrome types,the three most frequent syndrome types are damp-heat obstruction syndrome,wind-dampness obstruction syndrome and Qi Yin deficiency syndrome.The 259 prescriptions contain 207 herbs,and the total frequency of use is 5372 times.The top 10 prescriptions are Astragalus,Honeysuckle,Angelica,licorice,Gentiana,Honeysuckle,Cassia branch,Parsnip,Earthdragon,Poria.The medicinal properties are mostly flat,warm and cold,the medicinal tastes are mostly sweet,bitter and pungent,the meridians are mostly liver,spleen and lung,and the efficacy are mostly wind and dampness dispelling,deficiency tonic and heat clearing.Association analysis results show that the top 10 drug pairs of support are Honeysuckle→Astragalus,Astragalus→Honeysuckle,Angelica sinensis→Astragalus,Astragalus sinensis→Licorice,licorice→Astragalus,Honeysuckle→Angelica,Angelica honeysuckle→Licorice,Licorice→Angelica.A total of 4 clusters are obtained by cluster analysis:Cluster 1 is Astragalus,honeysuckle,Angelica,licorice;cluster 2 is Bombyx mori,Herba Siegesbeckiae,Gentiana,Parsnip,Honeysuckle,Herba Siegesbeckiae;cluster 3 is Ground dragon,Pangolin,Poria Coix seed;cluster 4 is ripe Rehmannia Rehmannii,cassia twigs,white peony root,Red Peony root,suberect spatholobi,turmeric,mulberry twigs,Qingfengteng,sea wind vine.The core prescriptions obtained by complex network analysis are Astragalus,Honeysuckle,Angelica,licorice,Cassia branch,Paeoniae alba,Routone,Red Peony,Herba Siegesbeckiae.Network pharmacology part:A total of 164 core prescription active ingredients and 270 related targets are screened in this study.The top 10 active ingredients are quercetin,kaempferol,luteolin,βsitosterol,7-O-Methylisomucronulatol,5-methyl-7-methoxyisoflavones,naringin,baicalin,stigmasterol,calycoisoflavones.A total of 1097 RA-related targets and 127 component-disease intersection targets are selected.The top 10 targets of the moderate value of PPI network map are ALB,TNF,IL6,AKT1,TP53,VEGFA,IL1B,PTGS2,JUN and CASP3,and a total of 5 functional modules are obtained.A total of 4517 items are obtained by GO functional enrichment analysis,including 1722 biological process items,99 cell component items and 2696 molecular function items.A total of 188 pathways,including PIK3/Akt,IL-17,TNF,MAPK and other signaling pathways,are obtained through enrichment analysis of KEGG pathway.The composition-target-pathway network is composed of 266 nodes and 1503 edges,among which the top 10 active components are quercetin,luteolin,kaempferol,naringin,baicalin,isorhamnetin,β-sitosterol,p-carotene,formononetin,licorice chalcone A.The top 10 targets of degree value are PTGS2,ESR1,NOS2,PPARG,MAPK14,PTGS1,ESR2,RXRA,ADRB2,and MAPK1.The signaling pathways involves include lipid and atherosclerosis,PI3K/Akt,TNF,IL-17,and MAPK.CONCLUSIONData mining part:The common drugs used by the tutor in the differentiation and treatment of RA are Astragalus,Honeysuckle,Angelica,licorice,Gentiana,honeysuckle,etc.The common drug pairs are Honeysuckle-Astragalus,Angelica-Astragalus,Astragalus-Licorice,Honeysuckle-Angelica,etc.The core prescriptions are Astragalus,Honeysuckle,Angelica,licorice,Cassia branch,Paeoniae alba,Routone,Red Peony,Herba Siegesbeckiae.Network pharmacology part:Core prescription plays a role in the treatment of rheumatoid arthritis through multi-component,multi-target and multi-pathway.Quercetin,luteolin,kaempferol,naringin,baicalin may be the core components of the intervention of core prescription in rheumatoid arthritis,and PTGS2,ESR1,NOS2,PPARG and MAPK14 may be potential targets.Its pathway of action is related to lipid and atherosclerosis,PI3K/Akt,TNF,IL-17,MAPK and other biological processes,as well as inflammatory response,negative regulation of cell population proliferation,response to estradiol,and regulation of apoptotic signaling pathways.