Shenling Baizhu Powder In The Treatment Of Secretory Otitis Media And Its Network Pharmacological Mechanism

Purpose:The first paper is to explore the clinical efficacy of Shenling Baizhu powder in the treatment of secretory otitis media with spleen deficiency and dampness;the second paper is to analyze the mechanism of Shenling Baizhu powder in the treatment of secretory otitis media with network pharmacology.Material and method:In paper 1,A total of 80 patients with Secretory otitis media(SOM)who met the criteria of spleen deficiency and dampness stagnation from May 2019 to August 2020 were randomly divided into test group and control group by random number table method,each group had 40 cases.The control group was treated with Mometasone furoate nasal spray twice a day,once a day,3 times a day,0.3 g each time,three courses a day;The experimental group is in the Control Group on the basis of oral Shenling Baizhu powder decoction,a daily dose,oral twice,after a warm meal.In statistical analysis,chi-square test was used for counting data,t-test was used for measuring data and Ridit analysis was used for grade data.In the second paper,the effects of the components,targets and pathways of Shenlingbaizhu powder on Secretory otitis media(SOM)were studied through the analysis of network pharmacology,the active components of Shenling Baizhu powder and the target genes of the drugs were obtained on the platform of TCMSP,and the target genes of secretory otitis media(Som)were obtained through Gene Cards database,then,Venn map of drug-disease-target intersection gene was constructed,and PPI network was constructed by STRING database to screen out core genes,finally,the Bioconductor database was used to analyze the GO enrichment and the KEGG pathway enrichment of the core targets,and the related gene function and pathway of the intervention process of Shenlingbaizhu powder on secretory otitis media(SOM)were obtained.Results:The results of the first clinical study showed that: the total effective rate of the experimental group after treatment(87.5%)was significantly better than that of the control group(77.5%),the difference was statistically significant(P < 0.05);the VAS score of the experimental group after treatment(1.45 ± 0.75)was significantly lower than that of the control group(3.05 ± 0.75).After treatment,the etdq-7 score of the experimental group(10.80 ± 2.75)was significantly lower than that of the control group(13.92 ± 2.93).The network pharmacology analysis of the second paper shows that: the mechanism of Shenling Baizhu powder in the treatment of secretory otitis media involves 93 common targets(i.e.intersection genes),146 active components,30 core target genes and 469 biological processes(screening the first 20 core genes for go function enrichment and KEGG pathway enrichment).The main active components include quercetin,kaempferol,luteolin and naringenin,and the main core targets are IL-6,mapk1 and mapk8.Go function enrichment analysis indicates that the biological process and function enrichment of Shenling Baizhu powder in the treatment of secretory otitis media mainly lie in the binding of cytokine receptor;KEGG pathway enrichment analysis indicates that Shenling Baizhu powder in the treatment of secretory otitis media mainly involves the binding of cytokine receptor IL-17,AGE-RAGE,sarcoma associated herpesvirus infection,human cytomegalovirus infection and other signaling pathways.Conclusion:Shenling Baizhu powder has a significant effect on the treatment of secretory otitis media with spleen deficiency and dampness stagnation,which is worthy of clinical promotion and application.Network pharmacology research shows that the pharmacodynamic mechanism of Shenlingbaizhu powder in the treatment of secretory otitis media may be related to the anti-inflammatory function of quercetin,kaempferol,luteolin and other compounds,acting on IL-6,mapk1 and mapk8 target proteins,regulating IL-17 signaling pathway through the function of cytokine receptor binding,so as to further treat secretory otitis media.