Clinical Observation And Network Pharmacology Study Of Liqi Tongfu Decoction In The Treatment Of Slow Transit Constipation

Purpose:Observe the clinical efficacy of Liqi Tongfu decoction in the treatment of slow transit constipation(intestinal qi stagnation type),and further predict the material basis and molecular mechanism of its efficacy through network pharmacology,and finally summarize the clinical experience of the tutor professor Zhang Hongxi in the treatment of slow transit constipation.Material and method:1.Sixty patients with slow transit constipation who were admitted to the outpatient service of anorectal hospital of Liaoning province from January 2019 to December 2020 were included and randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was given Liqi Tongfu decoction orally,200 ml each time,twice a day in the morning and evening.The control group was given oral Mosapride Citrate Tablets 5mg each time,3 times a day.Both groups were treated for two courses,each course was two weeks.After two courses of treatment,the improvement of intestinal qi stagnation and constipation-related symptoms of the two groups were observed.All data should be statistically analyzed using SPSS20.0 to draw conclusions.2.Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)screened out the effective active ingredients and target points of main and adjuvant medicine in Liqi Tongfu decoction.Screen out disease targets of slow transit constipation through Gene Cards,OMIM,TTD,DRUGBANK databases.Use R software to draw a Venn diagram of the target gene intersection of Liqi Tongfu Decoction and slow transit constipation and construct a PPI network through STRING.Cytoscape was used to construct a network diagram of Chinese herb components-disease-targets.Finally,the relevant plug-ins of R software were used to analyze the GO and KEGG enrichment of the targets.Results:1.Clinical efficacy evaluation: After the treatment period,the total effective rates of the treatment group and the control group were 86.67% and 73.33%,respectively.The rank sum test yielded z=-3.25,P=0.01<0.05,indicating that there are statistical differences between the two groups.It is suggested that the treatment group has a significant effect.2.Constipation symptom score evaluation: At the end of the treatment course,the treatment group has an advantage over the control group in improving bowel time(P < 0.05).Comparing within the group,the symptom score of laborious defecation in the treatment group was significantly lower than that before treatment,P<0.01,with a very significant difference;the three symptom scores of defecation time,abdominal fullness and pain,and emotion were P<0.05,and the effect was significant.The scores of the two symptoms of laborious defecation and frequency of defecation after treatment in the control group were significantly different at P<0.01;the scores of symptoms of abdominal distension and pain were P<0.05,and the curative effect was significant.3.Obtained effective compounds from TCMSP database: 19 aster,7 platycodon,7atractylodes,5 tangerine peel,and 521 targets.A total of 3375 genes related to slow transit constipation were screened from the Gene Cards,OMIM,TTD,and DRUGBANK databases,and 3306 related genes were obtained after merging and deleting duplicate values.Find the intersection of Liqi Tongfu decoction and slow-transmission target genes,draw a Venn diagram,and obtain 165 targets that may be related to drug treatment of diseases.GO analysis of BP mainly involves the cellular response to chemical stress,response to oxidative stress,etc.CC mainly involves membrane rafts,membrane microdomain,membrane region,etc.MF mainly involves phosphatase binding,nuclear receptor activity,etc.Enrichment analysis of the KEGG pathway,175 pathways were obtained after running.Studying related literature found that the PI3K-Akt signaling pathway is the most relevant to the mechanism of slow transit constipation.Conclusion:1.Liqi Tongfu decoction is better than mosapride citrate in the treatment of slow transit constipation.Compared with the control group,the improvement of defecation time in patients is more significant.The safety of the two groups of drugs is relatively reliable and worthy of clinical promotion.2.Using network pharmacological methods,it was preliminarily verified that Liqi Tongfu decoction has the characteristics of multi-target,multi-component,and multi-path intervention in the treatment of slow transit constipation and predicted its more likely targets and mechanisms.Cell experiments provide theoretical support,provide theoretical support for further animal and cell experiments in the later period.