Evaluation Of Therapeutic Effect Of Modified Tongxie Yaofang In The Treatment Of Ulcerative Colitis And Network Pharmacology Research

Objective:To evaluate the clinical efficacy and safety of modified Tongxie Yaofang in the treatment of ulcerative colitis with liver depression and spleen deficiency and damp-heat syndrome of intestinal viscera in mild to moderate active stage.To explore the target and mechanism of modified Tongxie Yaofang in the treatment of ulcerative colitis by means of network pharmacology and bioinformatics.Methods:Clinical study:using randomized and controlled trial,patients with mild to moderate active ulcerative colitis with liver depression and spleen deficiency and intestinal viscera damp-heat syndrome were selected as the research object.the patients in the experimental group were treated with modified Tongxie Yaofang combined with mesalazine,and the control group was treated with mesalazine alone.The clinical efficacy,TCM syndrome efficacy and Mayo score were observed before and after treatment,and the safety of medication was evaluated.In the part of network pharmacology,the compounds of modified Tongxie Yaofang prescription and their corresponding targets were screened by TCMSP database,and the related targets of UC were obtained based on DisGeNET and CTDbase database,and the candidate targets were determined by mapping each other.Using String platform,the topological relationship and KEGG analysis of candidate targets were calculated.The interaction network of "modified Tongxie Yaofang-ulcerative colitis" was constructed by using Cytoscape software.Results:Clinical study:(1)The clinical remission rate was 80.00%in the test group and 56.67%in the control group.There was no significant difference in clinical remission rate(P=0.052).(2)The clinical effective rate was 96.67%in the test group and 73.33%in the control group.The clinical effective rate of the test group was better than that of the control group(P=0.03).(3)The mucosal healing rate was 56.67%in the experimental group and 23.33%in the control group,and the mucosal healing rate in the experimental group was better than that in the control group(P=0.018).(4)The curative effect of TCM syndrome:the total effective rate of the test group was 96.67%,and that of the control group was 86.67%.The curative effect of TCM syndrome of the test group was better than that of the control group(P=0.023).(5)The curative effect of TCM symptoms:the curative effect of diarrhea in the experimental group was significantly better than that in the control group from the 8th week(P<0.001),and the symptoms of mucus,purulent and bloody stool and intestinal tinnitus were significantly improved in both groups from the 4th week(P<0.001).The curative effect of the experimental group was better than that of the control group from the 8th week(P<0.05),the abdominal pain symptoms of the experimental group was better than that of the control group at the 2nd week(P<0.05),and from the 4th week,the curative effect of the experimental group was better than that of the control group(P<0.05).The curative effect of the experimental group was better than that of the control group(P<0.05),and the curative effect of the experimental group was better than that of the control group(P<0.05).The symptoms of anal burning and uncomfortable defecation in the experimental group were better than those in the control group(P<0.05).Reduced diet and abdominal distension could significantly improve the symptoms in the experimental group from the second week(P<0.01).(6)The improvement of Mayo score in the test group was better than that in the control group(P=0.05).(7)There was no significant difference in ESR and CRP between the two groups before and after treatment,but both groups could significantly improve FC(P<0.001).(8)There was no significant difference in safety indexes between the two groups before and after treatment(P>0.05),and there were no serious adverse events and complications in both groups.In the part of network pharmacology,3 5 star compounds,72 target targets and 16 related pathways with the most statistical significance were screened,and the action network of modified Tongxie Yaofang in the treatment of ulcerative colitis was constructed.It was found that there were 19 targets with significant differential expression in the intestinal mucosa of ulcerative colitis.Conclusion:Clinical experiments show that modified Tongxie Yaofang combined with mesalazine can further improve the clinical efficacy,improve the clinical symptoms of traditional Chinese medicine,and has good safety.it can be used as a treatment choice for patients with ulcerative colitis.The network pharmacological study confirmed that modified Tongxie Yaofang prescription has the therapeutic characteristics of multi-targets and multi-pathways,which lays a good foundation for further research.