Research On The Medication Rules And Mechanism Of Action Of Professor Wang Chengxiang In The Treatment Of Chronic Cough With Wind And Phlegm Syndrom

Objective:To analyze the prescription medication pattern of Professor Wang Chengxiang’s clinical use of Chinese medicine for the treatment of chronic cough with wind and phlegm based on data mining technology,and to verify the prescription use of high-frequency drugs and core medicinal flavors using network pharmacology.By summarizing and refining the therapeutic experience of Prof.Wang,we deepen our rational understanding and provide new prescription ideas and experience for the diagnosis and treatment of clinical cough patients.Methods:We screened the medical records of patients with the diagnosis of cough and the diagnosis of "wind-phlegm interruption" and "wind-phlegm heat" from September 2020 to October 2022 in the outpatient clinic of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine by Professor Wang Chengxiang.After collecting and recording their medical records,the corresponding contents were extracted to establish a database,and the data were analyzed by data mining methods such as frequency statistics,association rules,and cluster analysis through Excel 2019,IBM SPSS Statistics 22.0,and SPSS Molder 18.0 software to analyze the core drugs and drug pairs(groups)patterns.Screening of core herbal combinations for network pharmacology analysis.Based on the Traditional Chinese Medicine Systematic Pharmacology Analysis Platform(TCMSP),retrieve the relevant compounds and rake points of the Chinese medicines in the core formula,retrieve the chronic cough disease targets in OMIM and Gene cards databases,and construct a network diagram of disease-pharmacological components-targets by Cytoscape 3.7.2 software;The potential action targets were uploaded to STRING 11.0 database to construct PPI network to obtain the core action targets,and GO functional enrichment analysis and KEGG pathway enrichment analysis were performed to obtain the main action signaling pathways,so as to explore the action mechanism of this group of core Chinese medicines for the treatment of wind and phlegm cough.Results:1.Data mining:In this study,142 patients were screened,and a total of 232 prescriptions were collected from initial and follow-up outpatient consultations.Patients were accompanied by concurrent symptoms such as itchy pharynx,insomnia,cachexia,weakness,chest tightness,loose stools,fear of cold,cold limbs,easy to catch cold,acid reflux and heartburn,etc.The tongue texture was mostly light red tongue,light white tongue,and thin yellow and white greasy tongue coating.(2)A total of 97 drugs were included in this study,with a frequency of 3723 times,and each prescription consisted of 16 drugs on average.In terms of the frequency of medicinal properties,48.69%were hot>37.33%were cold>13.96%were flat,and three types of drugs,bitter,pungent and sweet,were used most frequently,1770,1676 and 1323 times,respectively,and mainly belonged to the lung meridian(3098 times).They were followed by the spleen meridian(1429 times)and the stomach meridian(1252 times),and were mainly classified by drug efficacy as cough and asthma relievers,symptom relievers and heat purifiers.(3)Drug association rules were used to obtain the core drug combinations of prescriptions:dried ginger,wu wei zi,loquat leaf,Qing semi Xia,bitter almond,roasted licorice,poria,scutellaria,cicada molasses and hosin,and the top 30 high-frequency herbs were clustered into 4 categories:category 1 drugs were Ling Gan Wu Wei Jiang Xin Tang with flavor;category 2 drugs were reduced by the addition of cough suppressant;category 3 drugs were reduced by Sang Bai Pi Tang;and category 4 drugs were Zuo Jin Wan.Jinwan.2.Network pharmacology:(1)Professor Wang Chengxiang’s core prescription has 178 main ingredients and contains 312 active molecules,the key chemical components are quercetin,kaempferol,B-sitosterol,dousterol,isorhamnetin,etc..(2)screening disease targets 4454,drug-disease intersection targets 235,PPI network results show AKT1 protein kinase,IL6 interleukin 6,vascular endothelial growth factor VEGFA,epidermal growth factor receptor(HER)family member gene EGFR,IL1B interleukin 1,and MMP9 protease are the key potential sites for drug action.(3)In the enrichment analysis,three GO information results were collected:937 results for biological process BP.196 results for molecular function MF and 111 results for cell composition CC,and 177 results for KEGG pathway enrichment analysis,mainly involving viral infection and inflammation-related pathway mechanisms.Conclusion:1.Prof.Wang Chengxiang believes that the deficiency of positive qi,retention of phlegm in the lungs,susceptibility to wind,external wind leading to internal wind,wind disturbing phlegm,phlegm blockage,and upward rebellion of lung qi are the causes of this disease,and the medicine is mainly used to warm the lung and dissolve phlegm,stop cough and phlegm,calm asthma,and also to clear heat and dissolve phlegm,and harmonize the stomach and eliminate gangrene.The disease is mainly located in the lung and is closely related to the spleen,stomach and liver.Professor Wang Chengxiang grasps the core pathogenesis in the clinical evidence,selects drugs to warm the lung and dissolve drinks,dissolve phlegm,stop cough and calm asthma,relieve wind and spasm,regulate qi,harmonize the stomach and eliminate gangrene,disperses external wind and relieves internal wind,selects the poly 1 drug Ling Gan Wu Wei Jiang Xin Tang with Qing Ban Xia and bitter almonds,combines with the poly 2 drug Stop Loudspeaker San,poly 3 drug Sang Bai Pi Tang,poly 4 drug Zuo Jin Wan,etc.,according to the specific clinical manifestations of the patient,add and reduce the treatment according to the symptoms,the clinical feedback effect is The clinical feedback is good.2.The active ingredients of the core prescription,such as quercetin,kaempferol,B-sitosterol,dousterol and isorhamnetin,can act on AKT1,IL6,VEGFA,MMP9 and other targets,and exert anti-inflammatory effects through IL-17 signaling pathway,TNF tumor necrosis factor pathway,hypoxia-inducible factor HIF-1 pathway,PI3K-Akt pathway,EGFR pathway,viral infection signaling pathway and Toll-like receptor signaling pathway.The results demonstrated the combined effects of multiple components,multiple sites and multiple pathways in the treatment of chronic cough,and provided a theoretical basis for subsequent studies.