Study On Clinical Efficacy Evaluation And Network Pharmacological Mechanism Of Yishenjiangzhuo Recipe In The Treatment Of Chronic Kidney Disease Stage 2-3

Objective:Adopting the strategy of network pharmacology to clarify the active sub－stances and potential mechanism of YishenJiangzhuo prescription in the treat-ment of CKD stage 2-3 on the basis of clarifying the functional characteristics and advantages of YishenJiangzhuo prescription in the treatment of chronic kidney CKD.Methods:A retrospective study is used to observe the clinical therapeutic effect of Yishenjiangzhuo prescription on patients with CKD2-3 stage from January 2019 to June 2019.After clarifying the functional characteristics and ad-vantages of Yishenjiangzhuo prescription in the treatment of CKD2-3,the chemical constituents of the prescription were obtained through TSMSP data-base and the main active components were screened out.The targets of active components and the related targets of chronic kidney disease are collected,and PPI networks of drugs and proteins were constructed respectively.Screen-ing the core targets of Yishenjiangzhuo prescription in the treatment of chronic kidney disease.And then explore the potential mechanism of Yishenjiangzhuo prescription in the treatment of CKD stage 2-3 by using enrichment analysis to predict the main signal pathways,cellular components,molecular functions and biological processes of Yishenjiangzhuo prescription.Result:The results of clinical observation showed that the total effective rate of Yishenjiangzhuo prescription in the treatment of CKD stage 2-3 was 78.57%,and the quantitative levels of eGFR,Scr and 24-hour urinary protein were significantly improved(P≤0.01).We found that the improvement of this three indexes was the most obvious after three months of treatment.At the same time,the TCM syndrome scores of patients at each time point changed signif-icantly compared with the baseline,and the variation range of TCM syndrome scores at each treatment point was basically the same.After that,we carried out the network pharmacological analysis.First of all,we got 94 active com?ponents and 251 potential targets.Through PPI network analysis and screening,388 drug-disease core action targets including NPM1,HSPA5,EEF1 A1,HSPA8,FUS and STAU1 were obtained.Through GO analysis,we found that the potential biological processes included the assembly of U2 precleaves,the negative regulation of megakaryocyte differentiation,the establishment of positive regulation of telomere protein localization and the introduction of ribosomal proteins into the nucleus.According to KEGG enrichment analysis,it was found that HIF-1,NF-κB,MAPK,IL-17,Toll-like receptor,AMPK,foxo,mTOR,NLR signaling pathways were the potential action pathways of Yishen-jiangzhuo prescription in treating CKD in stage 2-3.Conclusion:1.Yishenjiangzhuo prescription can effectively increase glomerular filtration rate and reduce creatinine and 24-hour urinary protein in patients in CKD 2-3 stage.What’s more it can maintain the renal function of patients of different ages and renal function levels at a relatively stable level,improve the TCM syndrome score of patients,and improve the quality of life of patients as well;2.Yishenjiangzhuo prescription can quickly regulate renal function in the early stage of treatment,but the improvement rate slows down after reaching the plateau,while the improvement of TCM symptoms can be sustained;3.Yishen Jiangzhuo recipe may protect renal tissue and function by interfering with HIF-1,NF-κB,MAPK,IL-17,Toll-likereceptor,AMPK,foxo,mTOR and NLR signal pathway,which are closely related to renal microinflammation,renal interstitial fibrosis and oxidative stress.However,further experiments are needed to verify the results of this study.