Exploring Yang Bilian's Experience And Mechanism Of Using Drugs To Treat Psoriasis Based On Data Mining And Network Pharmacolog

Objective:1.GraphPad Prism 9.5.0 statistical software was used to statistically analyze the scores of psoriasis area and severity index(PASI),pruritus degree,Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)in patients with psoriasis vulgaris(PV)before and after oral Chinese medicine treatment.Observe the clinical treatment effect.2.Using the ’ancient and modern medical case cloud platform V2.3.5’ software to analyze the medication characteristics of Chief Physician Yang Bilian in the treatment of PV,excavate its core drugs and compatibility methods,summarize the medication experience,draw the core prescription,and form the effective prescription application law.3.The network pharmacology method was used to explore the potential key targets and pathways of the core prescription in the treatment of PV.Methods:1.The medical records of PV patients who visited the outpatient department of Yang Bilian,director of Dongfang Hospital of Beijing University of Chinese Medicine from January 2019 to December 2022 were collected.According to the inclusion and exclusion criteria,the patients who met the criteria were screened,and the data of PASI,pruritus,HAMA and HAMD scales were sorted out as the final efficacy observation indicators.The results were processed and analyzed using GraphPad Prism 9.5.0 statistical software.2.The included medical case data were standardized and entered the ’ancient and modern medical case cloud platform V2.3.5’ software.From the analysis of the frequency of traditional Chinese medicine use and the attributes of traditional Chinese medicine(four qi,five flavors,meridian tropism and efficacy),the commonly used traditional Chinese medicine combinations were analyzed by correlation analysis,point mutual information and chi-square test,and the core prescriptions were extracted by complex network method.3.Through the TCMSP database,with OB%≥30%and DL≥0.18 as the standard,the main active components and targets of each Chinese medicine in the core prescription were screened,and the UniProt protein database was used to query the gene name corresponding to the target protein.Through the DrugBank database,GeneCards database and OMIM database,with ’Psoriasis vulgaris’ as the keyword,the disease-related targets were obtained,merged and deduplication;the drug targets in the core prescription and the disease targets of PV were intersected to obtain the common targets,and the ’drug-active ingredient-target’ network was constructed by Cytoscape 3.9.1 software.PPI network was constructed by STRING database.KEGG signaling pathway and GO biological enrichment analysis were performed using the Metascape database.Results:1.In this study,50 PV patients with complete and standardized data were screened according to the inclusion and exclusion criteria.PASI,pruritus,HAMA and HAMD scales were evaluated before and after oral Chinese medicine treatment.Excel was used for data entry and collation.GraphPad Prism 9.5.0 statistical software was used for processing and analysis.The results showed that after 12 weeks of treatment,the lesion area,erythema,scales,infiltration degree and PASI total score,pruritus score,HAMA and HAMD scores were significantly decreased(P<0.05).The total effective rate of clinical treatment was 64%.2.In a total of 110 medical records,97 kinds of traditional Chinese medicine were involved,and the frequency of use of traditional Chinese medicine was 2167 times.The top ten traditional Chinese medicines with the highest frequency of use are:Radix Isatidis,Radix Paeoniae Rubra,Hedyotis diffusa,Smilax glabra,Rehmannia glutinosa,Scutellaria barbata,Forsythia suspense,Lonicera japonica,Moutan Cortex,Licorice;the main categories of drugs used are heat-clearing and detoxifying drugs,heat-clearing and blood-cooling drugs,evacuation wind-heat drugs,stasis-dissipating and pain-relieving drugs,and heat-clearing and dampness-drying drugs;the top three medicinal properties are cold,slightly cold and flat.The top three taste distribution are bitter,sweet and pungent.The top three meridians are the liver,heart and lung meridians.3.By using association rules and pointwise mutual information analysis,the commonly used traditional Chinese medicine combinations in clinical practice are summarized as follows:Radix Isatidis-Radix Paeoniae Rubra,Radix Isatidis-Herbal Hedyotis diffusa,Hedyotis diffusa-Radix Paeoniae Rubra,Citron-Foshou-Longdan-Yinchen,Atractylodes-Chenpi-Magnolia officinalis,Linderae Radix-Salvia miltiorrhiza-Spatholobus suberectus,etc.Using chi-square test,patients with fatigue symptoms,commonly used Poria;dry mouth,pharyngeal itching,sore throat,commonly used burdock,Radix Isatidis,Radix Reed,Radix Scrophulariae,Polygonum bistorta,Radix Glehniae;abdominal distention,commonly used tangerine peel,radish seed;insomnia,dreaminess,commonly used Albizia julibrissin,Coptis chinensis,bamboo leaves;diarrhea,commonly used atractylodes,Poria,dried ginger,cinnamon.Using chi-square test,blood heat syndrome commonly used Sanguisorba officinalis,Antelope horn,Radix Isatidis,Folium Isatidis,honeysuckle;blood stasis syndrome commonly used Sparganii Rhizoma,Curcumae Rhizoma,Euonymus alatus,Sargentodoxae Caulis,Spatholobi Caulis;damp-heat syndrome commonly used Huangqin,Huanglian,Huangbai,Huzhang;blood dryness syndrome commonly used Radix Paeoniae Alba,Radix Rehmanniae,Radix Scrophulariae,Radix Ophiopogonis,etc.4.Using complex network analysis method,the core prescription composition was obtained as follows:Radix Isatidis,Radix Paeoniae Rubra,Hedyotis diffusa,Smilax glabra,Scutellaria barbata,Cortex Moutan,Flos Lonicerae,Forsythia suspense.5.The core prescription was analyzed by network pharmacology,and 169 effective active components were obtained,mainly including quercetin,kaempferol,luteolin,wogonin,catechin,β-sitosterol,naringenin,etc.There were 105 intersection targets of prescriptions and diseases,with PTGS2,PTGS1,TNF,MAPK1,IL-6,MAPK14 as the main targets.The results of GO enrichment analysis showed that the core prescription acting on PV was mainly enriched in hormone response,response to inorganic substances,cell response to lipids,bacterial response,etc.KEGG pathway enrichment analysis showed that the key pathways mainly included cancer pathway,lipid and atherosclerosis,hepatitis B,IL-17 signaling pathway,TNF signaling pathway,etc.Conclusion:1.According to the changes of PASI score,pruritus degree,HAMA and HAMD scores before and after treatment,it is suggested that traditional Chinese medicine treatment of PV can not only improve the skin lesions and pruritus degree of patients,but also improve the accompanying symptoms of patients,including emotional abnormalities,insomnia,abdominal distension and diarrhea,chills and cold limbs,mental fatigue and so on.2.Yang Bilian’s treatment of PV is based on ’cause’,and explores the causes of pathological factors such as ’blood heat,dampness,blood stasis,dryness and qi stagnation’.The core prescription is based on clearing heat and detoxifying,cooling blood and eliminating plaque.The drug composition is Radix Isatidis,Radix Paeoniae Rubra,Hedyotis diffusa,Poria,Scutellaria barbata,Cortex Moutan,Flos Lonicerae,Forsythia.3.Through the network pharmacology analysis of the effective components in the core prescription,it is inferred that the prescription is treated in a comprehensive way of multi-component,multi-target and multi-channel.The mechanism may be to regulate IL-17,TNF and other related signaling pathways by regulating TNF,MAPK1,IL-6,MAPK14 and other targets,thus playing a therapeutic role in PV.