Research On Drug Regularity Of Professor Chi Lili’s In The Treatment Of Chronic Atrophic Gastritis And Network Pharmacology Of Core Prescription

Objective: This study is aimed at concluding the medication rule and core prescription of Professor Chi Lili in treating chronic atrophic gastritis(CAG),exploring the mechanism of core prescription.Methods:To summarize information of patients who visited the outpatient of Professor Chi Lili in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to December 2022,establish the database by Micosoft Excel 2016,SPSS Statistics 25.0 and SPSS Modeler18,then conclude the medication rules and core prescription.TCMSP database and HERB database were used to obtain the active ingredients and potential targets.The target database of CAG was based on Dis Ge NET,OMIM and Gene Cards database.Obtained the common potential target by matching the target of core formulae and CAG disease targets.Inputted prescription-CAG common targets into STRING database to construct a PPI,then obtained prescription-CAG core targets via Cytoscape3.7.2 topological analysis.Finally,conducted the Gene Ontology(GO)enrichment analysis and the Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis by the Metascape platform,to explore the possible mechanism of the core prescription.Results:1.A total of 596 patients were included in this study,296 males and 300 females.The highest prevalence rate was found in people aged 50-59 years,accounting for 38.93% of the population.2.The common clinical manifestations of patients include stomach bloating,stomachache,insomnia,dry mouth,heartburn,acid reflux,partial anxiety,bitter mouth,partial depression,chills,frequent belching,impaired appetite,and poor excretion of stool.The tongue proper is mainly dull red and red.Yellow and white greasy tongue coating accounted for the highest proportion.The pulse manifestation mainly included wiry pulse and wiry fine pulse.3.Prescription statistics:(1)A total of 1457 prescriptions were included.The high frequency drugs included Poria cocos(99.04%),Pinellia ternate(98.70%),Baked Licorice(96.02%),Paridis Rhizoma(88.95%),Santalum album L(79.55%),Malt(78.93%),Salvia miltiorrhiza(78.59%),Paeoniae lactiflora(55.18%),Bupleuri radix(54.98%),Bletilla striata(49.28%).(2)The statistical results of the channel tropism,properties and flavors are shown as follows.The properties are mainly flat(34.30%),cold(30.42%)and warm(26.83%).The flavors are sweet(47.47%),bitter(38.54%)and hot(36.41%).The channel tropism of drugs are mostly attributed to the spleen channel(65.89%),stomach channel(53.96%),lung channel(51.89%).(3)The Apriori algorithm was set with the support degree of 30%,the confidence level of 95%,and the maximum number of the first term was 1.Combined with the clinical practice and application of Professor Chi Lili,the commonly used high-frequency drug pairs were obtained,including Poria cocos-Bran-fried Baizhu,Poria cocos-Codonopsis Radix,Poria cocos-Pinellia ternate,Poria cocos-Coptidis Rhizoma,Eupatorium fortunei-Amomi Fructus Rotundus,Bupleuri Radix-Paeoniae Radix Alba,Santalum album L-Salvia miltiorrhiza,etc.(4)Five traditional Chinese medicine cluster combinations were obtained by cluster analysis.First category: Coptidis Rhizoma,Bambusae Caulis In Taenias,Eupatorium fortunei,Amomi Fructus Rotundus,Coix seed and Lophatherum gracile.The frequency of drug occurrence accounted for 12.44%;Second category: Hordei Fructus Germinatus,Setariae Fructus Germinatus,Bletilla Striata and Sepiae Endoconcha.The frequency of drug co-occurrence accounted for 6.83%;Third category: Codonopsis Radix,Coicis Semen fried with bran,Cyperi Rhizoma and Amomi Fructus.The total occurrence frequency of drugs accounted for 7.84%;Fourth category: Moutan Cortex,Gardenia Jasminoides Ellis,Bupleuri Radix,Paeoniae Radix Alba,Menthae Haplocalycis Herba,Bran-fried Baizhu,Polygala tenuifolia,Poria with hostwood and Longgu.The total occurrence frequency of drugs accounted for 18.95%;Fifth category:Poria cocos,Pinellia ternate,Malt,Paridis Rhizoma,Santalum album L and Salvia miltiorrhiza.The occurrence frequency of drugs accounted for 30.74%.The occurrence frequency and tightness of fifth category drug combinations were the highest,so this prescription was used as the core prescription for the treatment of CAG to explore the mechanism.4.To obtain the effective components and potential targets of the core formulae by TCMSP database and HERB database.CAG disease targets were obtained from Dis Ge NET database,OMIM database and Gene Cards database.A total of 82 common targets of the core prescription and CAG were obtained by matching the two databases.5.STRING platform was used to construct PPI network,and core targets were obtained through topological analysis,including IL6,AKT1,TP53,INS,PTGS2,STAT3,TNF,VEGFA,CASP3 and MYC.Corresponding core active components include baicalein,beta-sitosterol,cryptotanshinone,diosgenin,isorhamnetin,isovitexin,linolenic acid,luteolin,oleic acid,tanshinone IIa,etc.6.GO and KEGG enrichment analysis showed that the action pathway of the core prescription may be related to the intervention of cell proliferation,cell apoptosis and signal transduction.Conclusion: Professor Chi Lili believes that pathogenesis of CAG is deficiency in origin and excess in superficiality,syndrome of deficiency complicated with excessiveness.And the disease mainly lies in the spleen and stomach.She treats CAG base on "Deficiency,Toxicity and Blood Stasis",with strengthening spleen and qi,eliminating turbidity and detoxification,promote qi and remove blood stasis as the basic treatment principles.The core Chinese herbs for the treatment of CAG were Poria cocos,Pinellia ternate,Malt,Paridis Rhizoma,Santalum album L and Salvia miltiorrhiza.The core active components of the formulation are baicalein,beta-sitosterol,cryptotanshinone,diosgenin,isorhamnetin,isovitexin,linolenic acid,luteolin,oleic acid,tanshinone IIa,etc.The core active components plays the role of anti-inflammatory,antioxidant and anticancer.CAG can be treated by intervening in cell proliferation,apoptosis,signal transduction and other pathways.