Meta Analysis And Network Pharmacology Of Chaihu Shugan Powder In The Treatment Of Chronic Non Atrophic Gastritis

ObjectiveTo evaluate the clinical efficacy and safety of Chaihu Shugan powder in the treatment of chronic non-atrophic gastritis based on Meta analysis.Through the research method of network pharmacology,this paper discusses the effective components,core targets and possible mechanism of Chaihu Shugan powder in the treatment of chronic non-atrophic gastritis.MethodsAccording to the principles of PICOS,the retrieval strategy and literature inclusion and exclusion criteria were formulated.CNKI,Wanfang,VIP,CBM,PubMed,Embase and Cochrane library databases and paper documents are retrieved by combining computer retrieval and manual retrieval.All clinical randomized controlled studies of Chaihu Shugan powder in the treatment of CNAG from the establishment of the database(Journal)to November 30,2021 were collected.The literatures that meet the inclusion and exclusion criteria were selected and the information was extracted.The literature quality was evaluated according to the bias risk assessment form provided by Cochrane Collaboration Network.Relying on Review Manager5.4 software for meta-analysis,and present the analysis results with forest map.Taking Chaihu Shugan powder compound as the research object,the effective components and predicted target information of the drug were obtained by searching TCMSP database.The target information is transformed into standard gene names with the help of UniProt and Swiss target prediction databases.And the "drug-component-target" network was constructed with Cytoscape bioinformatics analysis software.Search "chronic superfacial gastrotis" in GeneCards database to collect disease-related target information,and the intersection of drug-disease targets was screened by VENNY diagram.PPI network was constructed by using STRING database.The results were imported into Cytoscape software for visual analysis and core targets were obtained.GO function enrichment and KEGG pathway enrichment based on DAVID database were used to analyze Biological pathways involved in intersection genes.ResultsResults of Meta analysis:Finally,19 literatures were included in this study,all of which were in Chinese journals.The result of bias risk assessment was that there was a high risk of bias,because the quality of research methodology and report were generally low.Meta analysis results suggested that Chaihu Shugan powder plus or minus or combined with other drugs compared with western medicine alone in the treatment of CNAG total effective rate[RR = 1.20,95%CI(1.15,1.26),P<0.00001],HP negative rate[RR = 1.18,95%CI(1.05,1.33),P=0.0006<0.05],TCM syndrome score[MD=-5.78,95%CI(-8.73,-2.84),P=0.0001<0.005],improvement rate of gastroscopy efficacy[RR=1.20,95%CI(1.12,1.28),P<0.00001],Reduction of recurrence rate[RR=0.30,95%CI(0.11,0.79),P=0.01<0.05],observation group was better than control group,the difference was statistically significant.There was no significant difference in reducing the incidence of adverse reactions or adverse events[RR=0.43,95%CI(0.13,1.42),P=0.17>0.05].Network pharmacology research results:there are 157 effective components in Chaihu Shugan powder,including 17 kinds of Chai Hu,7 kinds of Chuanxiong,13 kinds of Bai Shao,5 kinds of Fructus aurantii,5 kinds of tangerine peel,92 kinds of licorice and 18 kinds of Cyperus.After merging all active components and removing duplicate compounds,122 candidate compounds were selected,which can regulate 253 protein targets.There are 809 targets related to CNAG and 106 drug disease intersection targets.Through the construction of PPI network,the core targets are IL6,TNF,AKT1,TP53,VEGFA,IL1B,Jun,MMP9,PTGS2,STAT3,etc.There are 735 go enrichment entries closely related to CNAG,including 581 BP,93 MF and 61 CC.There are 114 KEGG pathways,mainly involving PI3K Akt,TNF,MAPK and other signal pathways.Conclusion(1)Chaihu Shugan powder plus or minus or combined with other drugs for the prevention and treatment of chronic non atrophic gastritis is superior to western medicine alone in terms of total effective rate of clinical curative effect,TCM syndrome score,improvement rate of gastroscope curative effect and HP negative conversion rate.(2)Chaihu Shugan powder or combined with western medicine in the treatment of chronic non atrophic gastritis can significantly reduce the recurrence rate and have a good long-term effect.However,it has similar efficacy and general safety in reducing the incidence of adverse reactions or adverse events.(3)Chaihu Shugan powder regulates 106 targets related to CNAG through its core effective components with the functions of anti-inflammatory,anti-oxidation,regulating immunity,promoting apoptosis and regulating cell cycle.And regulate PI3K Akt,TNF,MAPK and other signal pathways,so as to treat CNAG.