| Objective:The clinical efficacy of Erzhi pill in treating postmenopausal osteoporosis(PMOP)with liver and kidney deficiency was investigated by using modern clinical randomized controlled experimental method.Then,the molecular mechanism of erzhi pill intervention on PMOP was further explored by using network pharmacology database and methods.Methods:Eighty eligible patients were selected and divided into two groups according to random number table method,namely control group and treatment group,with 40 patients in each group.All patients were given calcium carbonate D3 tablet and calcitriol soft capsule,alendronate sodium tablet in control group and Erzhi pill in treatment group.The treatment period was 24 weeks.Visual analog scale(VAS),bone mineral density(BMD)and TCM syndrome quantitative score were observed and compared between the two groups before and after treatment,and the treatment effects were compared between the two groups.At the same time,the prediction targets of Erzhi pill and PMOP were obtained by using network pharmacology related technology,the interaction network between the targets was constructed,and the core targets were screened.Gene enrichment and annotation of the core targets were carried out,and the mechanism of erzhi pill intervention on PMOP was analyzed and predicted.Results:1.Comparison of VAS scores: AFTER 12 and 24 weeks of continuous treatment,VAS scores of the two groups were significantly lower than those before treatment(P<0.01).After 12 and 24 weeks of treatment,VAS scores of the two groups had similar treatment effects(P>0.05);2.Comparison of hip BMD: after 12 and 24 weeks of continuous treatment,THE BMD of the two groups was significantly higher than that before treatment(P<0.01).After 12 weeks of treatment,the efficacy of the control group was better than that of the treatment group(P<0.05),and after 24 weeks of treatment,the efficacy of the two groups was similar(P>0.05);3.Comparison of total scores of TCM syndromes: After 12 and 24 weeks of continuous treatment,the total scores of TCM syndromes of the two groups were significantly lower than before treatment(P<0.01),and after 12 and 24 weeks of treatment,the treatment group was significantly better than the control group(P<0.01);4.Analysis of TCM syndrome efficacy: after 24 weeks of continuous treatment,the total effective rate of TCM syndrome quantitative score of the two groups was compared,76.3% in the control group and 89.2% in the treatment group.The curative effect of TCM syndrome in treatment group was better than that in control group(P<0.05).Network pharmacology: The drugs composed of Erzhi pills were searched by the pharmacology database of traditional Chinese medicine,and 20 active components and 218 predictive target genes were obtained.After searching the human disease database,177 target genes related to PMOP were obtained,and 40 overlapping target genes were obtained by mapping the two genes.Using software and related data packets to analyze the intersection target genes,it was found that there were 413 relationships among the 40 target genes,and 13 active components selectively acted on the 40 intersection target genes.Gene functional enrichment analysis showed that 119 related pathways may play an important role in the treatment of PMOP,among which there are more genes enriched and highly correlated through lipid and atherosclerotic pathway,fluid shear stress and atherosclerosis pathway and interleukin-17 signal pathway.Conclusion:Erzhi pill can significantly reduce the VAS score of PMOP patients with liver and kidney deficiency,and clearly improve BMD and TCM syndrome score of these patients.Through the network pharmacological analysis,it is found that Erzhi Pill contains a variety of active ingredients,and a large number of targets are activated to regulate a variety of biological functions and pathways in the body,regulate bone metabolism and interfere with the development of PMOP. |
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