| Background:Precancerous lesions of gastric cancer refer to a type of gastric mucosal pathological changes that are prone to cancer,mainly including chronic atrophic gastritis,intestinal metaplasia and gastric intraepithelial neoplasia.Modern medicine mainly includes eradication of Helicobacter pylori,protection of gastric mucosa,supplementation of folic acid and antioxidant vitamins,etc.For high-grade intraepithelial neoplasia,endoscopic surgery such as endoscopic mucosal resection and endoscopic submucosal dissection,etc.However,there is still a lack of specific therapies and drugs in the control and reversal of gastric precancerous lesions.Traditional Chinese medicine has gradually become the preferred treatment because of its obvious curative effect,non-invasiveness,and no obvious toxic and side effects.Huoxue Huayu Kangwei Recipe is the empirical prescription of the tutor Professor Zhu Fangshi.The evidence for clinical efficacy in the treatment of gastric precancerous lesions is still insufficient and the mechanism of action is still unclear.Therefore,in this study,through retrospective analysis,the specific efficacy of this prescription in the treatment of gastric precancerous lesions was summarized and assessed,and the basis for clinical application was provided.Then,the pharmacodynamic material basis and mechanism of action of this prescription on gastric precancerous lesions were explored by using the method of network pharmacology to provide a reference for further in-depth study of the curative effect of the prescription and the development of new drugs.Part Ⅰ:Retrospective AnalysisPurpose:To evaluate the clinical efficacy of Huoxue Huayu Kangwei Recipe in the treatment of precancerous lesions of gastric cancer.Method:The clinical data of 50 patients with precancerous lesions of gastric cancer who completed treatment for 3 months were retrospectively collected.Twenty-five cases in the control group were treated with western conventional medicine,and twenty-five cases in the observation group were treated with western conventional medicine+Huoxue Huayu Kangwei Recipe.The TCM clinical symptom scores,gastroscopic mucosal and pathological scores of the two groups before and after treatment were recorded,and the differences within and between groups were compared and evaluated according to the efficacy evaluation criteria.Result:Gender,age,disease course,and pre-treatment scores were not statistically different between the two groups and were comparable.In the treatment of clinical symptoms of traditional Chinese medicine,mucosal and pathological manifestations under gastroscope,the total effective rates of the integrated traditional Chinese and western medicine group were 88%,96%,96%,96%,and 76%,which were higher than those of the western medicine group of 68%,68%,72%,76%,and 36%,and there were statistical differences in the difference between the two groups before and after the treatment in all scores(P<0.05),indicating that the Chinese and western medicine combination group had a better treatment effect than the western medicine group.Conclusion:The Chinese and western medicine combination can significantly enhance the healing effect than the western medicine alone.For the treatment of precancerous lesions of gastric cancer,based on traditional western medicine treatment,the combination of Huoxue Huayu Kangwei Recipe has superiority.Part Ⅱ:Network Pharmacology ResearchPurpose:To investigate the pharmacodynamic components and mechanism of action of Huoxue Huayu Kangwei Recipe in the treatment of precancerous lesions of gastric cancer.Method:Collecting disease targets of gastric precancerous lesions from the GeneCards database.The components of Huoxue Huayu Kangwei Recipe were collected from TCMSP and BATMAN-TCM databases.Find the SMILES number for any component in the PubChem database.Submission to the SwissTargetPrediction database to screen the components’ targets.Screen common targets of drugs and diseases by drawing Venn diagrams online.Using Cytoscape3.7.2,the network diagram of drug-component-common target was constructed and analyzed,and the key components were screened out.Through the STRING database,set relevant parameters,construct a protein-protein interaction network map of common targets,and import them into Cytoscape 3.7.2 for analysis to screen out important targets.Send important targets to the DAVID database,set relevant parameters and perform GO enrichment analysis and KEGG metabolic pathway enrichment analysis,and screen out key pathways.The network diagram of the components,common targets and pathways was constructed and analyzed by Cytoscape3.7.2.Result:170 pharmacological components were collected,139 targets and 41 common targets.The key pharmacological components mainly include quercetin,luteolin,kaempferol,etc.There are 11 important targets,and SRC is predicted to be the most core target.GO analysis enriched 40 biological processes,15 related to molecular function and 4 related to cellular composition.KEGG analysis enriched 26 metabolic pathways.Conclusion:The mechanism of action of Huoxue Huayu Kangwei Recipe in the treatment of precancerous lesions of gastric cancer is to use a variety of pharmacological components such as quercetin to play a role by regulating apoptosis and proliferation processes,and intervening in multiple metabolic pathways such as VEGF. |
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