Prescription For Pain In Waist And Under Extremity In The Treatment Of Knee Osteoarthritis In Clinical Efficacy And Pharmacological Related Mechanisms

Objective: The author aims to observe the clinical efficacy of the prescription for pain in waist and under extremity in the treatment of Knee Osteoarthritis(KOA)and speculate its mechanism by using the network pharmacological technology and molecular docking technology.Methods: Carrying out a randomized clinical trail(RCT)to observe the clinical efficacy of prescription for pain in waist and under extremity in the treatment of patients with knee osteoarthritis;using TCMSP and TCMID databases to collect the effective ingredients and targets of the prescription for pain in waist and under extremity,using databases such as Gennecards to get the target of knee osteoitis,using String and Cytoscape to build a drug-active ingredients-target network and PPI protein network and analyze them and then perform Go analysis and KEGG analysis;Auto DOCKTools was also used to predict the molecular docking between core ingredients and core targets.Results and Conclusion: 1.The efficacy of Prescription for Pain in Waist and Under Extremity in the treatment of qi stagnation blood stasis knee osteoarthritis is mainly reflected in four aspects: improving the VAS score,WOMAC score,Lequesne index and symptoms and signs/traditional Chinese medicine symptoms.In terms of VAS scores,WOMAC scores,Lequesne index and symptoms and signs/TCM symptoms after treatment of 2,4,and 8 weeks,the experimental group and control group were significantly improved(P <0.05)compared with no treatment;in the single symptom comparison in symptoms and signs /TCM syndrome scores,the experimental group and the control group have significantly improved in improving joint swelling,joint tenderness,flexion and extension,and morning stiffness(P <0.05).The prescription can alleviate the clinical symptoms of patients with knee osteoarthritis and it is effective safe and has no obvious adverse reactions.2.Through network pharmacological analysis,the author found that β-glycols,mountains phenols,wood rhinoplasses,thorns,cordinin,and plant alcohol may be the key component and EGFR,CASP3,AKT1,MAPK3,IL6,TNF,etc.are key target genes.The results of the GO enrichment analysis are concluded that the treatment of knee osteoarthritis is mainly related to the biological process,which contains oxidation stress reactions and fat polysaccharides.The KEGG pathway enrichment analysis shows that there are three pathways significantly related to KOA,including the T cell receptor signal pathway,IL-17 signal pathway,and TNF signaling pathway.3.The molecular docking shows that Quercetin has good binding activity with EGFR,CASP3,AKT1,MAPK3,IL6 and TNF.Kaempferol shows good binding activity with EGFR,CASP3,AKT1,MAPK3,IL6 and TNF,β-sitosterol shows good binding activity with EGFR and TNF.Formononetin shows good binding activity with EGFR,CASP3,AKT1,MAPK3,IL6 and TNF,while Luteolin shows good binding activity with EGFR,CASP3,AKT1,MAPK3,IL6 and TNF.Phytosterols(Stigmasterol)shows good binding activity with MAPK3.The prediction of network pharmacology on the mechanism of prescription for pain in waist and under extremity is verified.