| Objective: To explore the clinical experience and medication characteristics of Professor Chen Bainan’s medical cases of arteriosclerosis obliterans(ASO)with blood stasis syndrome.The network pharmacology analysis of the core drug combination is carried out to explain the active ingredients,targets and mechanism of action of the core drug combination in the treatment of ASO.Methods: In the research of data mining,according to the inclusion and exclusion criteria,the data of ASO patients with blood stasis syndrome diagnosed and treated by Professor Chen Bainan in the Department of peripheral vascular diseases,Affiliated Hospital of Shandong University of traditional Chinese medicine from January 2014 to October 2020 were collected,data mining methods such as frequency analysis and association rules were used to analyze the frequency of medication,common drug combinations and core drug combinations,and summarize the characteristics of medication.In the research of network pharmacology,the active ingredients and targets of the core drug combinations obtained from data mining were searched through TCMSP database.The relevant targets of ASO were searched in Gene Cards、OMIM、TTD、Dis Ge NET databases.The drug target and the disease target were mapped to obtain the intersection target.Using STRING database to construct protein-protein interaction network.Go pathway analysis and KEGG enrichment analysis were performed by using Metascape database to predict the mechanism of action of its core drug combination in the treatment of ASO.Results: In the research of data mining,a total of 306 prescriptions and 104 traditional Chinese medicines were included.The top ten drugs were Angelica sinensis,Astragalus membranaceus,Ligusticum chuanxiong,sangsheng,radix paeoniae rubra,Cornus officinalis,Radix Angelicae Pubescentis,Eucommia ulmoides,Pueraria lobata and Caulis Spatholobi.Among the drugs with more than 30 drug frequency,warm drugs were used the most,followed by mild and mild cold drugs.Among the five flavors,sweet medicine was used most,followed by spicy medicine.Among the channels,the liver and kidney channels were the main channels.Among the drugs with more than 30 drug frequency,11 kinds of traditional Chinese medicine were involved.Among them,the first three categories of drugs were tonifying deficiency drugs,dispelling wind and dampness drugs and clearing heat drugs,while the second three categories were clearing heat and cooling blood drugs,tonifying blood drugs and dispelling wind,cold and dampness drugs.Based on association rules,the top ten commonly used drug combinations were Astragalus membranaceus,angelica;Chuanxiong,angelica;Angelica,mulberry parasitism;Chuanxiong,Astragalus membranaceus;Chuanxiong,Astragalus,Angelica;Astragalus and Mulberry parasitism;Astragalus membranaceus,angelica,mulberry parasitic;Red peony root,angelica;Chuanxiong,Mulberry Parasitism;Chuanxiong,angelica,mulberry parasitism.The core drug network diagram was drawn,and 9 drug combinations of Astragalus membranaceus,Angelica sinensis,Morus mulberry,Ligusticum chuanxiong,Cornus officinalis,Red Peony,Eucommia ulmoides,Duhuo and Radix Puerariae were obtained.In the research of network pharmacology,105 active components and 150 targets corresponding to the core drug combination were obtained,including β-sitosterol,quercetin,stigmasterol,kaempferol and formononetin.There were 1000 ASO related targets.A total of79 intersecting targets were obtained by mapping drugs and disease targets.The key targets involved IL6,TNF,NOS3,TP53,VEGFA,PTGS2,EGF,etc.Go analysis showed that the biological processes were mainly concentrated in oxidative stress,positive regulation of MAPK cascade,cell response to nitrogen compounds,cell proliferation regulation and so on.Cell components were mainly involved in membrane rafts,vesicle lumen and extracellular matrix.Molecular functions were involved in G protein-coupled amine receptor activity,nuclear receptor activity,phosphatase binding,oxidoreductase activity and so on.KEGG enrichment analysis showed that the enrichment pathway mainly involved in IL-17 signaling pathway,NF-κ B signaling pathway,inflammatory mediators regulation of TRP channel,c GMP-PKG signaling pathway,relaxin signaling pathway,fluid shear stress and atherosclerosis,Serotonergic synapse,complement and coagulation cascades pathway,etc.Conclusion: Professor Chen thinks that the disease is caused by the joint action of positive deficiency and evil excess.Blood stasis is the basic pathogenesis."Blood stasis and toxin" is the key to pathogenesis,blood stasis for a long time,accumulation of blood stasis and toxin.In terms of treatment,Professor Chen emphasizes that the treatment should be based on syndrome differentiation,and the method of promoting blood circulation and removing blood stasis should be used throughout.Professor Chen proposes to use functional groups of drugs as prescription.For ASO patients with blood stasis syndrome,through data mining,combined with Professor Chen’s clinical medication,it is the first time to summarize the treatment of ASO patients with blood stasis syndrome by Professor Chen Bonan,which is mainly composed of blood activating and stasis removing medicine groups,which can be divided into blood enriching and blood activating medicine group,blood activating and collateral activating medicine group,Qi Benefiting and blood activating medicine group,blood cooling and blood activating medicine group,kidney benefiting and blood activating medicine group,Astragalus membranaceus,Angelica sinensis,sangsheng,chuanxiong and Shanzhu Fructus Corni,radix paeoniae rubra,Cortex Eucommiae,Radix Angelicae Pubescentis and Radix Puerariae are the core drug combinations.In Professor Chen’s core drug combination,active ingredients such as β-sitosterol,quercetin,stigmasterol,kaempferol and formononetin can treat ASO by regulating oxidative stress response,MAPK cascade reaction,diseases,inflammation,metabolism,blood and signal transduction pathways. |
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