Professer Mao Jingyuan’s Characteristics Of Chinese Medicine In Treating Patients With Paroxysmal Atrial Fibrillation

Objective: To summarize the medication characteristics of Professor Mao Jingyuan in the treatment of paroxysmal atrial fibrillation(AF),and to explore network pharmacology mechanism of core prescription.Method: 1.This project adopts the method of retrospective study to collect the effective cases of paroxysmal atrial fibrillation treated by Professor Mao Jingyuan in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from March 2016 to March2021.The frequency statistics,association rules and complex system entropy cluster analysis were carried out by using the Traditional Chinese Medicine Inheritance platform(V2.5)to explore the syndrome differentiation and medication characteristics of Professor Mao Jingyuan in the treatment of paroxysmal atrial fibrillation.2.Through TCMSP,ETCM,HERB and CNKI,the active ingredients and targets of the core prescription were selected,and the related targets of atrial fibrillation were inquired based on Gene Cards database.The target of traditional Chinese medicine and the target of disease were mapped and screened,and the intersected genes were used to construct the “prescription target disease” network by Cytoscape software.With the help of GO function enrichment and KEGG pathway enrichment,the potential mechanism of Professor Mao Jingyuan’s core prescription for the treatment of paroxysmal atrial fibrillation was analyzed.Results: 1.The study included 97 patients with paroxysmal atrial fibrillation,including 60males(61.86 %)and 37 females(38.14 %),the youngest was 35 years old,the oldest was 93 years old,with an average age of 63.70 ± 11.16 years old.The first diagnosis dates were mainly in March,and fluctuated throughout the year.The common syndrome elements included in the cases include blood stasis,Yin deficiency,sputum,fire [heat],Qi deficiency and Yang deficiency.The syndrome types are mainly deficiency and solid inclusion,among which Yin deficiency and blood stasis,phlegm-blood stasis,Yin deficiency and phlegm heat blood stasis,etc.There are 82 prescriptions,most of which are salvia miltiorrhiza,repared rehmannia root and fructus aurantii;the commonly used drugs are divided into 8 categories according to their efficacy,most of which are nourishing Yin and blood drugs,resolving phlegm and eliminating dampness drugs,promoting blood circulation and removing blood stasis drugs;the most of which are warm drugs,bitter drugs and liver meridian drugs according to the classification of drug taste.Based on the analysis of drug association rules,commonly used combinations mainly include "repared rehmannia root-salvia miltiorrhiza" and "cornus officinalis-salvia miltiorrhiza" had the effect of nourishing Yin and promoting blood circulation,"salvia miltiorrhiza-poria cocos" and "dried tangerine peel-salvia miltiorrhiza" had the effect of dissipating phlegm,dehygrosis and promoting blood circulation,etc.The core drugs were salvia miltiorrhiza,repared rehmannia root,fructus aurantii,dried tangerine peel,poria cocos,cornus officinalis,scorpion safflower,ophiopogon japonicus and cortex moutan.Based on entropy clustering,68 drug combinations were predicted,such as repared rehmannia root-scorpion,etc.2.Through TCMSP,ETCM,HERB,CNKI database screening,131 core prescription active ingredients were obtained,corresponding to 308targets;based on Gene Cards database query and screening,300 targets with strong association with atrial fibrillation disease were obtained,and 28 core prescription targets for the treatment of paroxysmal atrial fibrillation were obtained,mainly including SCN5 A,CALM1,NR3C2,KCNH2,CHRM2,PPARG,ADRB1,MMP2 and so on.Through Gene Ontology analysis,741 biological processes,27 cellular components,and 30 molecular functions were obtained.Biological processes mainly involve blood coagulation,regulation of DNA-binding transcription factor activity,response to oxidative stress and so on.Cellular components mainly involve membrane raft,membrane microdomain,secretory granule lumen and so on.Molecular functions mainly involve serine-type endopeptidase activity,serine-type peptidase activity,serine hydrolase activity and so on.Conclusion: Professor Mao Jingyuan’s syndrome differentiation of paroxysmal atrial fibrillation can be divided into deficiency and excess,and mainly based on Yin deficiency,blood stasis and phlegm.If there are Qi deficiency,fire [heat] and other syndrome elements,it should be supplemented with Qi tonifying and heat clearing products.The principle of treatment is to harmonize Yin and Yang,and reinforce and reduce simultaneously.The methods of treatment is nourishing Yin and blood,promoting blood circulation and removing blood stasis,resolving phlegm and dispersing stasis,calming liver and calming wind.The characteristics of medication are nourishing yin and promoting blood circulation,being good at promoting blood circulation and resolving phlegm,being good at relieving wind and spasm with insects,and being good at matching with Qi regulating drugs.The core prescription may regulate relaxin signaling pathway,AGE-RAGE signaling pathway,fluid shear stress and atherosclerosis,estrogen signaling pathway,cellular senescence and other signaling pathways,regulate the ion channel current of myocardial cells,resist myocardial fibrosis,improve vascular endothelial function,affect the ion channel protein expression of myocardial cells,and delay the apoptosis cellular senescence and other ways can prevent the occurrence and development of paroxysmal atrial fibrillation.