Meta-analysis And Network Pharmacology Study Of Compound Danshen Dripping Pills In The Treatment Of Diabetic Retinopathy

Study 1:Meta-analysis of Compound Danshen Dripping Pills in the treatment of diabetic retinopathyObjective:To systematically review the efficacy and safety of Compound Danshen Dripping Pills in the treatment of diabetic retinopathy.Method:Databases such as CNKI,WanFang,VIP,Pubmed,Web of Science,Embase,were searched on Randomized Controlled Trial/Quasi-Randomized Controlled Trial about Compound Danshen Dripping Pills in the treatment of diabetic retinopathy,the studies were screened according to inclusion and exclusion criteria.Risk of bias evaluation tools were adopted to conduct quality evaluation.The total efficiency,visual change,visual improvement rate,microhemangiomas,hemorrhage,exudate,macular thickness,vision,FBG(fasting blood-glucose)and HbA1c,etc.were Meta analyzed with Cochrane Collaboration RevMan 5.3 software,and safety evaluation was conducted.Reslut:Eventually 24 trials were included,including 2432 case of patients with diabetic retinopathy.Results of Meta-analysis indicated that total therapeutic efficiency(P<0.00001,OR 3.70,95%CI[2.77,4.96]),vision changes(P=0.0001,MD 0.09,95%CI[0.06,0.12]),vision improvement rate(P<0.00001,OR 2.54,95%CI[1.75,3.68]),microhemangiomas(P<0.00001,MD-3.53,95%CI[-4.24,-2.81]),hemorrhage(P<0.00001,MD-0.57,95%CI[-0.64,-0.49]),macular thickness(P<0.00001,MD-61.08,95%CI[-63.00,-59,17]),vision(P<0.00001,MD-1.03,95%CI[-1.08,-0.99]),FBG(P<0.00001,MD-1.11,95%CI[-1.18,-1.04]),HbA1c(P<0.00001,MD-0.83,95%CI[-0.94,-0.72])and other aspects were statistically significant compared with the control group.There was no significant difference in exudate from the control group.Conclusion:Compound Danshen Dripping Pills has the clinical efficacy and safety in treating diabetic retinopathy.However,limited by the poor quantity of studies,more high-quality randomized controlled trials are needed to ensure the objective,reliability,and scientificity of the conclusions to make them more convincing.They will provide a reliable clinical evidence for the treatment of diabetic retinopathy with Compound Danshen Dripping Pills.Study 2:Study on the mechanism of Compound Danshen Dripping Pills in the treatment of diabetic retinopathy based on network pharmacologyOBJECTIVE:The aim of this paper is to predict the multi-compound,multi-target and multi-pathway mechanism of Compound Danshen Dripping Pills in treating diabetic retinopathy based on netework pharmacology.METHODS:By using Traditional Chinese Medicine Systems Pharmacology(TCMSP)database,main active compounds of Compound Danshen Dripping Pills were screened out based on oral bioavailability(OB)and Drug-likeness(DL).Then the targets of active compounds of Compound Danshen Dripping Pills were predicted based on the PharmMapper.The prediction was conducted by screening the target genes associated with diabetic retinopathy through GeneCards databases.By using the STRING database and Cytoscape3.7.2 software,the protein interaction(PPI)network was plotted and analyzed.Then GO biological process,molecular function,cell component analysis and KEGG pathway analysis of the target were carried out with the help of Metascape and DAVID databases.The "active compounds-target-pathway" network of Compound Danshen Dripping Pills was constructed and analyzed by Cytoscape3.7.2 software.RESULTS:The expected results showed that there were 50 active compounds and 429 targets for Compound Danshen Dripping Pills,and 821 known diabetic retinopathy-related therapeutic targets.A total of 98 common targets were obtained by mapping Drug and disease targets.Protein interaction network analysis showed that ALB,AKT1,MMP9,MAPK1 and others might be the core target of Compound Danshen Dripping Pills in the treatment of diabetic retinopathy.GO enrichment analysis identified 60 items(P<0.05),and KEGG pathway enrichment analysis identified 109 related signaling pathways,including pi3k-akt signaling pathway,Ras signaling pathway,Rapl signaling pathway,MAPK signaling pathway,FoxO signaling pathway,VEGF signaling pathway and HIF-1 signaling pathway.CONCLUSIONS:Compound Danshen Dripping Pills have the characteristics of multi-pathway and multi-target effect on treating diabetic retinopathy.The results suggest that Compound Danshen Dripping Pills could exert anti-diabetic retinopathy effect by regulating cell metabolism and immune,anti-inflammatory,promoting angiogenesis and improving anaerobic metabolism,which provide a theoretical basis for further elucidating pharmacological mechanisms of Compound Danshen Dripping Pills in the treating diabetic retinopathy.