Professor Wei Zixiao’s Experience Mining In The Treatment Of Hyperthyroidism And Preliminary Discussion On The Mechanism Of Core Prescription

Part 1.Professor Wei Zixiao’s experience mining in the treatment of hyperthyroidismObjective:Using the method of data mining to analyze Professor Wei Zixiao’s experience in the treatment of hyperthyroidism with syndrome differentiation and medication.Summarize and extract the core prescriptions.Methods:According to the inclusion and exclusion criteria,the complete initial medical records of patients with hyperthyroidism who were diagnosed and treated by Professor Wei Zixiao from October 2015 to December 2021 were screened and collected,with a total of 105 cases.General information in medical records,information on the four diagnoses(including symptoms and signs related to hyperthyroidism,other symptoms and signs,tongue and pulse),and TCM prescription information(including TCM diagnosis,TCM syndrome,treatment method,and TCM compound)After sorting and normalizing,enter into Microsoft Office Excel(2007),to form a database of Professor Wei Zixiao’s treatment of hyperthyroidism.Using the ancient and modern medical record cloud platform(V2.4.3),the medical record data included in the study were analyzed from four dimensions:statistical analysis,association rules,cluster analysis,and complex network analysis.Law et al.excavated Professor Wei Zixiao’s experience in treating hyperthyroidism from multiple perspectives and summed up the core prescription.Results:The analysis of general data shows that the male to female ratio of 105 patients with hyperthyroidism included in this study is 1:4,and the age distribution of the young group(18-45 years old)is the largest,accounting for 75.24%of the total,which is basically consistent with the epidemiological survey results of hyperthyroidism in my country..In the analysis of the data of the four diagnoses,the symptoms involve multiple systems of the whole body.The main symptoms in the top ten are palpitations,goiter,dry mouth,sweating,insomnia,fatigue,tremor of hands,frequent defecation,fear of heat,and exophthalmos.52.53%;In the tongue image,the tongue shape is mainly tooth mark tongue and fat tongue,the tongue color is mainly red and light red,and the tongue coating is mainly thin,white and slightly greasy coating;Diagnosis and ginseng reflects that the patients with hyperthyroidism included in this study are characterized by stagnation of qi and phlegm,internal resistance of phlegm,yin deficiency and yang hyperactivity,and internal heat of fire.In TCM prescription data,the syndromes are mainly qi stagnation and phlegm obstruction,liver fire exuberance,yin deficiency and yang hyperactivity.Reducing fire,nourishing the kidney and calming the liver,etc.The most frequently used traditional Chinese medicines in prescriptions are turmeric and bupleurum,and other frequently used ones include white peony root,prunella vulgaris,calamus,hedyotis diffusa,and tuckahoe.Mainly cold,warm,and flat,the five flavors are mainly bitter,acrid,and sweet,and enter the liver,heart,lung,spleen,stomach,and kidney meridians.The association rules of traditional Chinese medicines and the results of cluster analysis show that the commonly used drug pairs for the treatment of hyperthyroidism by Professor Wei are Paeonia lactiflora-turmeric,Turmeric-Baihu,Shichangpu-Baishao,etc.,and the cluster analysis suggests that there are Prunella vulgaris and Hedyotis diffusa;Bupleurum,Shichangpu,Curcuma,Baishao;Poria,Fushen;Taizishen,Schisandra,Polygala,Suanzaoren and other 6 groups of frequently used drug combinations According to the TCM syndromes and the four diagnoses,treatment methods,the association rules of TCM and the cluster analysis results of the four diagnoses,those with palpitations,hyperhidrosis,thin tongue coating,white coating,fat tongue body,and tooth marks around the tongue are mostly identified as deficiency of both heart and spleen.Syndrome,the treatment is to invigorate the spleen and remove dampness,and the commonly used drugs are Atractylodes,Codonopsis,Poria,Astragalus,and dried tangerine peel;goiter,thin and white tongue coating,tooth marks around the tongue body,and thin pulse are mostly syndrome of qi stagnation and phlegm obstruction,the treatment focuses on relieving depression and calming the nerves,resolving phlegm and dispersing knots,and the traditional Chinese medicine compound uses Bupleurum,turmeric,white peony root,calamus,prunella vulgaris,polygala,fushen,etc.Goiter,red tongue,tooth mark tongue,white tongue coating,and stringy pulse are mostly symptoms of yin deficiency and yang hyperactivity.The main treatment method is to nourish yin and reduce fire.Commonly used Hedyotis diffusa,Chuanxiong,saponin thorn,and arborvitae leaves etc;Hedyotis diffusa,dandelion,skullcap,etc.The complex network analysis of the included Chinese herbal formulas showed that turmeric,bupleurum,white peony,calamus,prunella,Hedyotis diffusa,and tuckahoe constitute the core prescription of Professor Wei Zixiao in the treatment of hyperthyroidism.Conclusion:Professor Wei Zixiao believes that the pathological changes of hyperthyroidism mainly involve liver,kidney,heart and spleen.The primary deficiency is mainly yin deficiency,gradually becoming qi deficiency,and those with severe yin deficiency will see hyperactivity of yang turning into fire.The treatment advocates the combination of disease differentiation and syndrome differentiation.In the use of expelling pathogens,it also pays attention to the use of righting drugs,which reflects the treatment idea of taking into account the specimens.Part 2.Discussion on the mechanism of core prescription.Objective:Using the method of network pharmacology,the core traditional Chinese medicine compound of Professor Wei Zixiao in the treatment of hyperthyroidism obtained by complex network analysis in the first study was analyzed,and its active ingredients,target and potential mechanism of action were explored.Methods:Use TCMSP to retrieve the active ingredients of core prescriptions to obtain the corresponding targets.The target genes that the active ingredients act on were retrieved from Uniprot.Using the OMIM database and the Gene Cards database,the hyperthyroidism target genes were searched with the keywords "hyperthyroidism"and "Graves’ disease",and the final disease gene list was obtained after integrating the data and removing duplicates.Use Venny 2.1.0 software to draw Venn diagrams and save disease-core prescription common target genes.Using cytoscape V3.9.1 software,draw the gene network diagram of core traditional Chinese medicine compound-active ingredients-disease-common target,and calculate the degree value of each node,so as to screen the core active ingredients of drugs.The common target genes were imported into the String V.11.5 database to construct a protein interaction network.Using the Metascape database,GO and KEGG enrichment analysis was performed on common target genes,and the core traditional Chinese medicine compound-active ingredients-target gene-pathway network map was made.Results:Based on complex network analysis,the core traditional Chinese medicine compound contains seven traditional Chinese medicines:turmeric,bupleurum,white peony,calamus,Prunella,Hedyotis diffusa,and Poria.The main active ingredients are:quercetin,kaempferol,beta-sitosterol,luteolin,naringenin,Stigmasterol,etc.The core target genes are:AKT1,TNF,IL6,IL1B,TP53,VEGFA,etc.GO enrichment results showed that in terms of biological processes,target genes were mainly related to the body’s response to inorganic substances,lipopolysaccharide,oxygen content and other substances,and were also involved in the regulation of cell adhesion and cell migration.In terms of molecular biological functions,target genes are related to protein-protein interactions,signal transduction,and DNA transcription.At the cellular level,the proteins synthesized by common target genes are mostly related to the cell membrane,extracellular matrix,and vesicle lumen.The KEGG pathway enrichment analysis was performed on the core traditional Chinese medicine compounds,and the obtained pathway enrichment results showed that the core traditional Chinese medicine compounds were mostly involved in the body’s immune response,inflammatory response,lipid metabolism,regulation of cell proliferation,and apoptosis.Conclusion:Professor Wei Zixiao’s core traditional Chinese medicine compound for the treatment of hyperthyroidism contains a number of active ingredients,mainly flavonoids,which can inhibit immunity,resist oxidative stress,anti-inflammatory,protect liver,improve hemodynamic abnormalities,improve insulin resistance,improve Lipid metabolism disorder,protecting neurons,inhibiting tumor cell proliferation,promoting tumor cell apoptosis,etc.,acting on multiple targets,regulating immune function,inhibiting inflammatory factors,improving insulin resistance,regulating cell growth,differentiation,proliferation,etc.Multi-target intervention in the treatment of hyperthyroidism.