| OBJECTIVE: To analyze the clinical effectiveness of Xiao Qing Long Decoction in the treatment of bronchial asthma based on evidence-based medicine,and to explore the predicted mechanism of action of Xiao Qing Long Decoction in the treatment of bronchial asthma using network pharmacology.METHODS:1.We searched the databases of VIP,Wanfang,CBM,CNKI and Pub Med,and then searched the relevant literature by hand.Randomized controlled trial（RCT）studies of Xiao Qing Long Decoction for bronchial asthma were searched,and after formulating and following the corresponding inclusion and exclusion criteria,the literature was screened and flowcharted.Then data from relevant materials were extracted and literature risk assessment was performed using the Jadad scoring scale.Meta-analysis was performed using Rev Man software.2.Based on the TCMSP database,the drug active ingredients in Xiao Qing Long Decoction were obtained and their corresponding target protein gene names were obtained by Uni Prot database specification to construct Xiao Qing Long Decoction drug-ingredient-target network diagram.We obtained the bronchial asthma disease targets from Genecards database,and obtained the intersecting targets through the jvenn platform.By importing the intersecting targets into STRING database,protein interaction analysis was performed and PPI network maps were constructed.The validated targets were analyzed by GO function and KEGG pathway enrichment using Metascape platform,and the component-target-pathway network map was constructed by Cytoscape software.RESULTS:1.Seven papers with a total of 631 patients were included in this study.Meta-analysis results showed that the combination of Xiao Qing Long Decoction on top of conventional Western medical treatment was effective in improving FEV1 [SMD=0.41,95% CI[0.19,0.62].p=0.0002],FEV1/FVC [SMD=4.54,95% CI [3.37,5.71],p<0.00002],PEF [SMD=0.53,95% CI[0.38,0.68],P<0.00001],improved cough [SMD=-0.31,95% CI[-0.34,-0.28],P<0.00001],and total effectiveness [SMD=1.23,95% CI[1.11,1.36],P< 0.0001] were superior to conventional Western treatment alone,and the difference was statistically significant,and the difference in improving wheezing [SMD=-0.21,95% CI [-0.79,0.37],P=0.48] was not statistically significant.2.The study showed that 169 active ingredients and 256 targets of Xiao Qing Long Decoction were screened for the treatment of bronchial asthma,and the main active ingredients were compounds such as quercetin,kaempferol,and luteolin.The main targets were AKT1,TP53,IL1 B,etc.The PPI network topology analysis calculated30 key targets,etc.The GO enrichment analysis involved the following processes: biology process（BP）1951,cellular component（CC）55,molecular function（MF）134,and Ketamine（K）134.The KEGG pathway enrichment analysis resulted in 165 pathways related to bronchial asthma.The main effects were on signaling pathway-AGE-RAGE,signaling pathway-tumor necrosis factor,etc.This study showed that Xiao Qing Long Decoction treatment of bronchial asthma involves multiple signaling pathways and biological processes.Conclusions:1.Xiao Qing Long Decoction combined with Western medicine is more effective than conventional Western medicine alone in the treatment of bronchial asthma,but due to the small amount of literature selected for inclusion in this study and the low quality of the literature.Therefore,it is still necessary to conduct a high-quality,large-sample multicenter randomized controlled trial to improve the reliability of the Meta-analysis results and provide a stronger basis for the clinical application of Xiao Qing Long Tang Decoction.2.In this study,network pharmacology was used to predict the mechanism of action of Xiao Qing Long Decoction in the treatment of bronchial asthma,such as MMP9,IL-1β,AGE-RAGE signaling pathway and tumor necrosis factor（TNF）.However,the limitations of network pharmacology do exist,and the results may be biased due to various reasons,which need to be further validated by molecular docking or clinical trials. |
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