Study On The Treatment Of Chronic Heart Failure With Zhenwu Decoction Based On Meta Analysis And Network Pharmacology

1 ObjectiveMeta analysis was used to analyze the RCTs of Zhenwu decoction in the treatment of chronic heart failure,and to evaluate the clinical efficacy of Zhenwu decoction in the treatment of CHF;network pharmacology was used to preliminarily explore the related mechanism of Zhenwu decoction with multi-component,multi-target and multi action pathway,and to point out the basic research direction,so as to provide evidence-based medicine and basic research evidence for the clinical application of traditional Chinese medicine.2 MethodsMeta analysis,seven databases including CNKI,China Info,VIP database,CBM,Pub Med,EMBASE and Cochrane library were searched by using corresponding search strategies,and the relevant literature information was recorded after searching the relevant search terms.Strictly according to the established inclusion and exclusion criteria,select the literature that meets the research conditions,extract the clinical efficacy and relevant indicators in the included literature,input them into Rev Man5.3 software and Stata15.1 software for relevant analysis,and then get the results.Network pharmacology,find out the related compounds,potential targets and chronic heart failure related targets of Zhenwu decoction,get the intersection of Zhenwu decoction target chronic heart failure regulatory network,and carry out visualization processing.The protein interaction network construction,GO analysis and KEGG enrichment analysis were carried out by using related software and package.3 Results(1)Through searching and screening,50 articles were included;(2)The clinical effect,Minnesota Living with Heart Failure Questionnaire,BNP,LVEF,6MWT,CRP of Zhenwu decoction and Western medicine conventional treatment group were better than those of Western medicine conventional treatment group(P < 0.05);(3)Minnesota Living with Heart Failure Questionnaire,BNP,LVEF groups have different degrees of heterogeneity;sensitivity analysis shows that the results of this study are relatively stable;published bias test shows that clinical efficacy,LVEF has published bias.(4)26 active compounds and 90 regulatory targets(chronic heart failure targets)were screened out;(5)90 regulatory targets were used to construct PPI network,and 102 core target proteins were screened;(6)There are 1080 items in BP,137 items in MF and 54 items in CC in go enrichment analysis;(7)A total of 131 pathways were identified by KEGG enrichment analysis,including fluid shear stress pathway,atherosclerotic pathway and tuberculosis pathway.4 Conclusion(1)It is preliminarily confirmed that Zhenwu decoction has therapeutic effect on chronic heart failure,but the poor quality of the literature may lead to the bias of the research results.(2)The network pharmacology means preliminarily explore its mechanism of action,reflect that Zhenwu decoction is a multi-faceted common role in the treatment of chronic heart failure,confirm that traditional Chinese medicine treatment is a multi-component,multi-target,multi-channel synergistic effect,and point out the direction for the next related basic research.