Clinical Efficacy Of Shugan Sanjie Decoction In The Treatment Of Tumor Stage Plasma Cell Mastitis With Syndrome Of Heat Stagnation In Liver And Stomach And Its Mechanism Based On Network Pharmacology

Objective:To observe the clinical effect of Shugan Sanjie Decoction in the treatment of PCM with syndrome of heat stagnation in Liver and Stomach in the tumor stage,combined with network pharmacology analysis and prediction,and to verify the mechanism through experiments.Method:1.A total of 41 patients with PCM who conformed to various standards of Chinese and Western medicine from January 2020 to August 2021 in nantong hospital of TCM were selected.And the patients were divided into treatment group and control group according to the random number table method.The control group was treated with Landinggeer breast therapy apparatus.for 4 weeks,antibiotics were intravenously infused for 2 weeks,and oral administration was given for 2 weeks.The treatment group was treated with Shugan Sanjie Decoction orally for 4 weeks on the basis of the control group.Observation of symptoms and signs(tumor area,pain,skin color,skin temperature,nipple discharge,body temperature),breast color Doppler ultrasound(tumor size,underarm lymph node size),TCM effect judgment(TCM clinical efficacy,TCM symptom and sign score),laboratory indicators(WBC,CRP,IL-6,ESR,HBP,PRL),anxiety and depression scores.2.Through the research method of network pharmacology,find the intersection of the active ingredients of Shugan Sanjie Decoction and the target of PCM,and establish the possible effect of Shugan Sanjie Decoction in the treatment of PCM target.Combined with the results of clinical experiments,the research objectives of the next animal experiments were determined.3.The rats raised regularly were randomly divided into control group and model group,rat models of plasma cell mastitis was constructed.The rats that were successfully modeled were randomly divided into model group,low-dose Shugan Sanjie decoction group,and high-dose Shugan Sanjie decoction group.Breast conditions were observed,HE staining was observed,and the expressions of IL-6,CD138,EGFR,ESR1 and NOS3 and their effects on JAK2/STAT3 signaling pathway were determined by immunohistochemistry,qPCR,Western blot and other methods.Result:1.After 4 weeks of treatment with Shugan Sanjie Decoction combined with antibiotics and the Landinggeer breast therapy apparatus,the patient’s symptoms and signs(tumor area,pain,skin color,skin temperature,body temperature),the size of the tumor under breast ultrasound,and the clinical effect judgment of traditional Chinese medicine,TCM symptom and sign scores,laboratory indicators(WBC,CRP,IL-6,ESR,HBP,PRL)and anxiety and depression scores were significantly improved,nipple discharge and the size of underarm lymph node remained unchanged.All indicators except body temperature and WBC were better than antibiotics combined with Landinggeer breast therapy apparatus.No adverse events occurred in either group.2.47 potential pharmacological components in the formula were obtained through network pharmacology screening,which synergistically act on key targets such as IL-6,EGFR,ESR1,NOS3,etc.,and participate in the regulation of vascular endothelial function,oxidative stress,inflammatory response,etc.to play a therapeutic role The role of PCM.3.After the treatment of Shugan Sanjie Decoction,the breast redness,swelling and induration,nipple height and nipple diameter of PCM rats were improved compared with the model group,the inflammatory cells and inflammation decreased by HE staining.The expression of IL-6,CD 138 and EGFR decreased by immunohistochemistry.IL-6,EGFR and ESR1 were down-regulated by qPCR method,the expression of did not change significantly.IL-6,EGFR,p-JAK2,p-STAT3,p-JAK2/JAK2 were down-regulated by Western bolt method,and the effect increased with the dose more obvious.4.Conclusion:1.Shugan Sanjie Decoction combined with antibiotics and Landinggeer breast therapy apparatus can effectively improve the local symptoms and systemic symptoms of patients with PCM,improve the symptoms and signs of traditional Chinese medicine,and relieve anxiety and depression of patients,which is safe and effective.2.Treatment with Shugan Sanjie Decoction can reduce the inflammatory response of PCM model rats.And play a role in the treatment of plasma cell mastitis by reducing the expressions of CD138,IL-6,ESR1,EGFR in rat mammary tissue,also inhibiting the activation of IL-6,EGFR and JAK2/STAT3 signaling pathway.