Network Pharmacology Study On Bimin Tongqiao Prescription And Observation Of Its Clinical Efficacy In Treating Pediatric Allergic Rhinitis With Lung Meridian Latent-heat Syndrome

Objective1.To estimate the effectiveness of the Bimin Tongqiao prescription in treating pediatric allergic rhinitis(AR)through using network pharmacology technology to explore and seek potential targets,as well as preliminary explain the intrinsic mechanism.2.To observe whether it is effective of Bimin Tongqiao prescription in treating AR in children and whether there are any adverse reactions during taking the decoction for oral administration.To summarize tutor’s experience of herb using in treating pediatric AR,in order to provide evidence for the clinical treatment of AR in children.Methods1.TCMSP was used to obtain the active chemical components and their interrelated targets in Bimin Tongqiao prescription.Gene Cards,OMIM,PharmGkb,and TTD databases were used to obtain the disease targets of AR.The drug(Bimin Tongqiao prescription)targets and disease(AR)targets were amalgamated to obtain the predicted target.Cytoscape3.8.2 software was used to establish the network diagram of the interaction relationship between drugs,active ingredients and targets.Protein-protein interaction(PPI)network was constructed by STRING platform.Utilizing Systems Dock Web Site to carry through molecular docking of key active ingredients and key targets to verify the results of network analysis.The intersection targets were screened by Venn diagram and clusterProfiler package based on R project,and the target genes were enriched by Geneontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis,and the pathway was drawn.2.A total of 219 cases of AR patients that conformed to diagnostic criteria for AR in children as well as diagnosis of TCM syndrome for lung meridian latent-heat syndrome,were compared before and after treatment.One week was a course of treatment,and two courses were observed.The score for main symptoms and signs(nasal itching,sneezing,stuffy nose,runny nose,nasal mucous membrane),secondary symptoms(eye itching,snoring and mouth breathing,dark circle,body itching),and lung meridian latent-heat syndrome(cough,dry and itching throat,pharyngeal hyperemia,dry mouth vexed hot,epistaxis,dry stool)are counted and calculated before and after treatment.Utilizing SPSS 24.0 software for statistical analysis.Results1.Through network pharmacological study,we discovered that the pivotal compounds of Bimin Tongqiao prescription may be quercetin,kaempferol,wogonin and so on.The key target proteins are IL-6,ICAM-1,etc.The principle pathways is TNF signal pathway,IL-17 signal pathway,CLRS signal pathway,NF-κB signal pathway,HIF-1 signal pathway,Th17 differentiation pathway,most of which related to inflammation.It indicates that Bimin Tongqiao prescription reduce the inflammatory response of AR through acting on inflammation-related targets and pathways.2.219 cases of AR children was treated with Bimin Tongqiao prescription.In one week,the overall response rate(ORR)was 78.54%which has raised to 92.24%in two weeks.It indicated that Bimin Tongqiao prescription had a significant effect in alleviating AR symptoms.After 2 courses of treatment,the associated symptoms and the symptoms of lung meridian latent-heat syndrome were improved.It had a good effect on dry mouth vexed heat,body itch and dry stool(the effective rate was 84.62%,82.61%and 80.95%,respectively).It was slightly inferior to other symptoms of cough,dark circles and mouth breathing(the effective rate was 59.62%,60.71%and 62.50%,respectively).Conclusions1.In this study,network pharmacology was used to analyze the inside mechanism of Bimin Tongqiao prescription in the treatment of AR,indicating that Bimin Tongqiao prescription having its treatment effect in AR through multi-components,multi-targets and multi-channels.2.Bimin Tongqiao prescription has positive effect toward AR patient in children with lung meridian latent-heat syndrome.After 2 weeks oral medication,the dominating symptoms,subordinate symptoms and the syndrome of TCM were improved obviously.During the treatment period,no obvious adverse reactions had come under observation in children which preliminary suggested that it’s safe and effective in treating pediatric AR.