The Clinical Efficacy And Mechanism Of Wuling Powder In The Treatment Of Primary Nephrotic Syndrome Based On Meta-analysis And Network Pharmacology

Objective:This study will explore the clinical efficacy of Wuling powder（ORS）in the treatment of primary nephrotic syndrome（PNS）syndrome through meta-analysis,and further explore the potential targets of Wuling powder in the treatment of PNS through network pharmacology,molecular docking verification,and animal experiments.and possible mechanisms of action.Methods:Studyl:Computer retrieval of China National Knowledge Infrastructure（CNKI）,Wanfang（Wanfang）,VIP（VIP）,China Biomedical Literature Database（CBM）,PubMed,EMbase,Cochrane Library,Web of Science and other databases until 2022 On January 12,2018,the randomized controlled trial（RCT）of Wuling powder in the treatment of primary nephrotic syndrome was manually searched to avoid omission.Develop inclusion and exclusion criteria,include eligible literature,extract required data,and perform risk of bias assessment.Using RevMan5.4.1 software,the clinical response rate,24h urinary protein quantification,serum albumin,total cholesterol,triglyceride,serum creatinine,blood urea nitrogen,adverse reactions and other outcome indicators were statistically analyzed,and a forest chart was drawn;Subgroup analysis and sensitivity analysis were carried out for the outcome indicators with high sex;for the outcome indicators with more than 10 included articles,a funnel plot was used for publication bias analysis.Study2:Obtain the active ingredients and related targets of Wuling Powder through the TSMSP platform,use the UniProt database to standardize the targets,use the genecards database,OMIM database,and dugbank database to obtain disease-related targets,and screen out drug targets and disease targets Point intersection genes,use Cytoscape software to build a "drugingredient-disease-target" network,STRING platform for protein interaction analysis,R software for GO function and KEGG pathway enrichment analysis,AutoDockVina software for active components and core targets Do molecular docking.Wuling Powder was analyzed by mass spectrometry to clarify the compounds with higher expression in Wuling Powder.An animal model of nephrotic syndrome（NS）was constructed,and Wuling powder was used for intervention,and the mechanism of Wuling powder in the treatment of PNS obtained by network pharmacology analysis was verified by in vivo experiments.Results:Study 1:Computer retrieval of China National Knowledge Infrastructure（CNKI）,Wanfang（Wanfang）,VIP（VIP）,China Biomedical Literature Database（CBM）,PubMed,EMbase,Cochrane Library,Web of Science and other databases until January 2022 On May 12,the randomized controlled trial（RCT）of Wuling powder in the treatment of primary nephrotic syndrome was manually searched to avoid omission.Develop inclusion and exclusion criteria,include eligible literature,extract required data,and perform risk of bias assessment.Using RevMan5.4.1 software,the clinical response rate,24h urinary protein quantification,serum albumin,total cholesterol,triglyceride,serum creatinine,blood urea nitrogen,adverse reactions and other outcome indicators were statistically analyzed,and a forest chart was drawn;Subgroup analysis and sensitivity analysis were performed for the outcome indicators of greater sex.Publication bias analysis was performed using funnel plots for outcome indicators with more than 10 included articles.Study 2:Obtain the active ingredients and related targets of Wuling Powder through the TSMSP platform,use the UniProt database to standardize the targets,use the genecards database,OMIM database,and drugbank database to obtain disease-related targets,and screen out drug targets and disease targets Point intersection genes,use Cytoscape software to build a "drugingredient-disease-target" network,STRING platform for protein interaction analysis,R software for GO function and KEGG pathway enrichment analysis,AutoDockVina software for active components and core targets Do molecular docking.Mass spectrometry analysis of Wuling Powder was carried out to clarify the compounds with higher expression in Wuling Powder.An animal model of nephrotic syndrome（NS）was constructed,and Wuling powder was used to intervene,and animal experiments were carried out to verify the mechanism of Wuling powder in the treatment of PNS obtained by network pharmacology analysis.Conclusion:Wuling powder combined with conventional western medicine treatment in the treatment of PNS can improve the total clinical effective rate.There was no significant difference between western medicine treatment alone,and the safety was good.Wuling powder may treat PNS by inhibiting immune inflammatory response and podocyte apoptosis by acting on target genes such as JUN and apoptosis-related molecules（BCL2,Bax,Caspase3）.