Meta-analysis Of Yiqi Yangyin Method Combined With Western Medicine In The Treatment Of IgA Nephropathy And Network Pharmacology Study Of The Core Chinese Medicine

Objective: To systematically evaluate the clinical efficacy of yiqi yangyin method combined with western medicine in the treatment of IgAN.based on the Apriori algorithm and network pharmacology analysis,we explored the potential targets and action mechanisms of the core traditional Chinese medicine in the treatment of IgAN.Methods: Part I: Chinese and English databases including CNKI,VIP,Wanfang,Sino Med Pub Med,Embase and Cochrane Library were retrieved.Retrieval time limit: from database establishment to June 2021.Articles were screened based on evidence-based medicine and the set sodium exclusion criteria.Required Meta in the literature were extracted,and the results of included articles were subjected to meta-analysis using Review Manger 5.3 software.The drug compositions of Chinese medicine prescriptions included in the literature were counted,and the Apriori algorithm in SPSS Modeler software was run to select the core Chinese medicine with the promotion degree > 1 and high support degree and confidence degree.Part II: Chemical compositions of core Chinese medicine materials in TCMSP were retrieved,followed by their SMILES in Pubchem and relevant drug targets in SIB database.Retrieving IgAN related genes in a Genecard database,matching disease genes with drug targets,and screening out common gene targets;PPI network relationships were constructed using STRING platform pairs,and topology analysis of PPI network relationships was performed using Cytoscape software to screen out key targets.GO and KEGG enrichment analyses were performed using the David platform.Results: In the first part,19 articles were included through collection and screening.The meta-analysis results of 19 studies showed that the treatment of IgAN with the method of replenishing qi and nourishing yin combined with western medicine had better clinical efficacy than western medicine alone,in that it could effectively improve the treatment efficiency,reduce the patient’s laboratory indicators,and the incidence of adverse reactions.The core traditional Chinese medicines（HSS）obtained based on data mining were Radix Astragali seu Hedysari,Rhizoma Dioscoreae,and Fructus Corni.In Part II,HSS and IgAN were matched to obtain 178 potential targets,involving 38 compounds in total.The GO enrichment results showed that the GO enrichment mainly regulated cell surface signal transduction,molecular functions,stimulation of protease activity and transcription,and other biological processes.The KEGG enrichment results showed that it was mainly involved in the pathogenic microorganism infection pathway,PI3K-Akt signaling pathway,Jak-STAT signaling pathway,and HIF-1 signaling pathway.Conclusion: The combination of evidence-based medicine and statistics shows that the Yiqi Yangyin method combined with western medicine has better clinical efficacy in the treatment of IgAN than western medicine alone,which can effectively improve the treatment efficiency and reduce the patients’ 24 h urine protein（24h UTP）,urine red blood cell count（urine RBC）,blood creatinine（Scr）,urea nitrogen（BUN）and other aspects.The core traditional Chinese medicines of benefiting qi and nourishing yin method,which are composed of Radix Astragali seu Hedysari,Rhizoma Dioscoreae,and Fructus Corni,may interfere with the progression of IgAN by exerting the effects of anti-inflammation,anti-oxidative stress,protection of podocytes,and anti-renal fibrosis.