Clinical Observation And Network Pharmacology Study Of Tiaoping Qingwei Decoction In The Treatment Of Refux Esophagitis (Syndrome Of Heat Stagnation In Liver And Stomach)

Objective:1.To observe the clinical efficacy of Tiaoping Qingwei Decoction in the treatment of reflux esophagitis with syndrome of heat stagnation in liver and stomach.2.To investigate the effective components,related targets and efficacy mechanisms of Tiaoping Qingwei Decoction in the treatment of reflux esophagitis based on network pharmacology.Methods:1.Clinical observation of Tiaoping Qingwei Decoction in the treatment of reflux esophagitis with syndrome of heat stagnation in liver and stomach.Sixty patients with reflux esophagitis with syndrome of heat stagnation in liver and stomach who met the inclusion criteria,and were divided into treatment and control groups with 30 cases in each group using the random number table method.The control group was treated with rabeprazole sodium enteric-costed tablets for 8 weeks,and the treatment group was treated with Tiaoping Qingwei Decoction for 8 weeks on top of the control group.TCM syndrome scores,RDQ scales cores,and endoscopic esophageal mucosal inflammation were recorded before and after treatment in both groups,and the patients were followed up 8weeks after the end of treatment to count the recurrence rate.2.A network pharmacological study on the treatment of reflux esophagitis with syndrome of heat stagnation in liver and stomach with Tiaoping Qingwei DecoctionThe TCMSP was combined with literature to find the active ingredients and potential targets of Tiaoping Qingwei Decoction,and all targets were standardized using the Uniprot database.The target information of reflux esophagitis was collected in Genecards,OMIM and Dis Ge NET databases,and the intersection of TCMSP and reflux esophagitis targets was taken.We used Cytoscape 3.9.1 to construct the relationship network diagram of "Tiaoping Qingwei Decoction-Active Ingredient-Target",and used the protein interaction network to screen the core targets of Tiaoping Qingwei Decoction for reflux esophagitis,and imported the core targets into David6.8 database for enrichment of Kyoto genes and genomic encyclopedic pathways,and the encyclopedic pathway analysis.The core targets were imported into David6.8 database for enrichment of Kyoto genes and genomic encyclopedic pathways,functional analysis of gene ontology to obtain relevant pathways and biological processes,and Cytoscape 3.9.1 was used to construct the "active ingredient-intersection target-core pathway" network map to screen out the core active ingredients.Results:1.Clinical observation(1)Comparison of baseline data: Before treatment,the differences were not statistically significant(P>0.05)between the two groups in terms of gender,age,disease duration,TCM syndrome points,RDQ scale points,and endoscopic grading,and were comparable.(2)Comparison of TCM syndrome scores: the individual TCM syndrome points of both groups decreased after treatment compared with those before treatment(P<0.05),and the reduction of points in heartburn,acid reflux,distention and fullness of the abdomen,belching and irritability was better in the treatment group than in the control group(P<0.05).the total TCM syndrome scores of patients in both groups decreased after treatment compared with those before treatment,and the treatment group was better than the control group(P<0.05).(3)Comparison of the efficacy of TCM scores: the total effective rate was90% in the treatment group and 75.86% in the control group,and the effective rate of the treatment group was higher than that of the control group(P<0.05).(4)Comparison of RDQ scale scores: the total RDQ scale scores of both groups decreased after treatment compared with those before treatment,and the treatment group was better than the control group(P<0.05).(5)Comparison of the efficacy of RDQ scale: the total effective rate was86.67% in the treatment group and 62.07% in the control group,and the effective rate of the treatment group was higher than that of the control group(P<0.05).(6)Comparison of endoscopic grading: the endoscopic grading of patients in both groups improved after treatment compared with that before treatment,and the difference was not statistically different(P>0.05).(7)Comparison of the efficacy of endoscopic grading: the total effective rate was 86.67% in the treatment group and 72.41% in the control group,with no statistical difference(P>0.05).(8)Comparison of recurrence rate: the recurrence rate was 6.67% in the treatment group and 27.59% in the control group,and the recurrence rate in the treatment group was lower than that in the control group(P<0.05).2.Network pharmacology(1)A total of 122 active ingredients and 260 action targets were obtained from Tiaoping Qingwei Decoction,and the core active ingredients were: quercetin,lignocaine,baicalin,kaempferol,baicalin,etc.(2)1622 disease targets were obtained from reflux esophagitis,and there were 126 intersecting targets between Tiaoping Qingwei Decoction and reflux esophagitis,among which 22 core targets were RELA,TNF,IL-6,HIF-1,VEGFA,etc.(3)GO enrichment analysis obtained 424 entries and KEGG enrichment obtained 169 results of pathways,involving PI3K-Akt signaling pathway,TNF signaling pathway,IL-17 signaling pathway,p53 signaling pathway,etc.Conclusion:1.Tiaoping Qingwei Decoction can relieve the clinical symptoms of reflux esophagitis with syndrome of heat stagnation in liver and stomach patients.2.Tiaoping Qingwei Decoction can relieve the inflammatory state of esophageal mucosa and reduce the recurrence rate of reflux esophagitis.3.Tiaoping Qingwei Decoction acts on reflux esophagitis mainly through RELA,TNF,IL-6,HIF-1,VEGFA,PI3K-Akt signaling pathway,TNF signaling pathway,IL-17 signaling pathway,p53 signaling pathway to treat reflux esophagitis.