Professor Park Yongzhu’s Medication Law And Network Pharmacology In The Treatment Of Acute Gouty Arthritis

Objectives:1.Use the data mining technology to explore the medication rules and core drugs of the tutor in the treatment of acute gouty arthritis material,and sum up the clinical experience of the instructor in the treatment of this disease.2.Study the action mechanism of the core drugs for the treatment of acute gouty arthritis by my tutor through the network pharmacology.Methods:1.This dissertation collects 183 first-diagnosed cases of acute gouty arthritis diagnosed and treated by my tutor in the First Affiliated Hospital of Heilongjiang University of traditional Chinese medicine from January 2019 to December 2021 and standardizes the treatment information and prescription drugs of outpatient cases.We use Excel to establish a database and upload to traditional Chinese medicine inheritance calculation platform V3.0 software.Through conducting frequency analysis,association rule analysis,and cluster analysis on case data,we excavate the tutor’s medication rules and core drugs for treating acute gouty arthritis,and summarize the tutor’s clinical experience in treating this disease.2.This dissertation conducts network pharmacology analysis on the tutor’s core drugs for the treatment of acute gouty arthritis and obtains the active ingredients and targets of the core drugs through TCMSP.We also obtain disease targets through Genecards,Dis Ge NET,and OMIM.We use Draw Venn Diagram to obtain intersection targets,and draw a Venn diagram.We construct a "drug-active ingredient-target" network by Cytoscape software and import the intersection target data set into the STRING database to obtain a PPI network.We perform GO enrichment analysis and KEGG pathway analysis by R software and construct the target-pathway network using Cytoscape.Results:1.Among the 183 cases in this study,men accounted for 92.35% of the total number and women accounted for 7.65% of the total number.The age of onset is mostly 30-59 years old,and the average age is 44 years old.2.Among the 183 cases in this study,a total of 27 symptoms were collected,of which 15 had a frequency greater than 30.The top 6 symptoms were redness,swelling,heat and pain of the first metatarsophalangeal joint,local burning on the touch,acute onset,and pain,refusal to press,unfavorable flexion and extension,and severe pain at night.The frequency of red tongue was 144 times,and the frequency of yellow and greasy tongue coating was 115 times.The maximum frequency of pulse slip is 87 times.3.A total of 107 Chinese medicines were counted in this study,of which 25 were high-frequency Chinese medicines with a frequency of ≥35.The top 15 Chinese medicines were Sinomenium acutum,Caulis Trachelospermi,Sargentodoxa cuneata,Piper futo Kadsura,desmodium stracifolium,Hedyotis diffusa,Herba Patriniae,millettia dielsiana,Motherwort,Smilacis Glabrae Rhixoma,Dioscorea septemloba Thunb,Atractylodis Rhizoma,phellodendron a murense rupr,Cyathula officinalis Kuan,Coix seed.In the classification of drug efficacy,the top five from high to low are heat-clearing,water-dampening,expelling rheumatism,blood-activating and blood-stasisremoving,and damp-removing.The frequencies of the four qi are cold,flat,warm,cool,and hot in descending order.The frequencies of the five flavors of the drug from high to low are bitter,sweet,pungent,salty,and sour.The frequencies of drug returning to the meridian from high to low are liver,stomach,kidney,spleen,lung,bladder,heart,gallbladder,large intestine,small intestine,Sanjiao,and pericardium.4.In this study,the prescription analysis in the data analysis module of the platform was used.The number of support degrees was set to 135.The confidence level was 0.95,80 medication patterns and 106 association rules were obtained.Nine core medicines were obtained such as Sinomenium acutum,Caulis Trachelospermi,Sargentodoxa cuneata,Piper futo Kadsura,desmodium stracifolium,Hedyotisdiffusa,Herba Patriniae,millettia dielsiana,Motherwort.The drug combination commonly used by the tutor is Sinomenium acutum,Caulis Trachelospermi,Sinomenium acutum,desmodium stracifolium,Herba Patriniae,Sargentodoxa cuneata,millettia dielsiana,Caulis Trachelospermi,Hedyotis diffusa,Caulis Trachelospermi,Piper futo Kadsura and Sinomenium acutum.5.Through K-means clustering analysis,the core drug combinations obtained are: Combination1: Sinomenium acutum,Caulis Trachelospermi,Piper futo Kadsura,Sargentodoxa cuneata,Hedyotis diffusa,Cyathula officinalis Kuan,millettia dielsiana,desmodium stracifolium;Combination2: Sargentodoxa cuneata,Sinomenium acutum,Piperfuto Kadsura,Caulis Trachelospermi,Hedyotis diffusa,Herba Patriniae,Alisma orientalis,motherwort;Combination3:Sinomenium acutum,Caulis Trachelospermi,Sargentodoxa cuneata,Piper futo Kadsura,motherwort,Motherwort,Smilacis Glabrae Rhixoma,desmodium stracifolium,Dioscorea septemloba Thunb;Combination4: Sinomenium acutum,Piper futo Kadsura,Caulis Trachelospermi,Sargentodoxa cuneata,Herba Patriniae,millettia dielsiana,desmodium stracifolium,motherwort;Combination 5: Caulis Trachelospermi,Sargentodoxa cuneata,phellodendron a murense rupr,Hedyotis diffusa,Sinomenium acutum,millettia dielsiana,Smilacis Glabrae Rhixoma,Dioscorea septemloba Thunb;Combination6:Caulis Trachelospermi,Sinomenium acutum,Sargentodoxa cuneata,millettia dielsiana,Piper futo Kadsura,desmodium stracifolium,Atractylodis Rhizoma,and Hedyotis diffusa.6.Network pharmacology: There are 89 active ingredients and 234 targets in the core drug,285 genes related to acute gouty arthritis,39 intersection genes between the core drug and acute gouty arthritis,and 10 key targets.The key components of the core drug are quercetin,kaempferol,luteolin,stigmasterol,and beta-sitosterol.We found 1479 biological processes,102 molecular functions,and39 cellular components through GO enrichment analysis.The results of KEGG pathway analysis showed that there were multiple signaling pathways such as AGE-RAGE,TNF,and IL-17.The results of combined analysis of intersection targets and pathways revealed that MAPK1,MAPK14,RELA,and other targets also play an important role.Conclusions:1.Among the 183 patients with acute gouty arthritis in this study,most of them were male,and the high-frequency symptoms were redness,swelling,heat and pain of the first metatarsophalangeal joint,local burning on touch,acute onset,refusal to press the sore spot,unfavorable flexion and extension,Painful at night.High-frequency tongue images are red tongue with yellow and greasy fur.The high-frequency pulse is the slippery pulse.2.My tutor treats this disease with five types: clearing heat,diverting dampness,dispelling rheumatism,promoting blood circulation and removing blood stasis,and removing dampness.The main channels of the drug are liver,stomach,kidney,and spleen.The four qi are mainly cold,flat,and warm.The five flavors are mainly bitter,sweet and acridwarm.3.The core drugs of my tutor in the treatment of acute gouty arthritis are Sinomenium acutum,Caulis Trachelospermi,Sargentodoxa cuneata,Piper futo Kadsura,desmodium stracifolium,Hedyotis diffusa,Herba Patriniae,millettia dielsiana,Motherwort.Six groups of commonly drug combinations are used.We obtained 6 groups of drug core combinations using cluster analysis.4.Core drugs have the characteristics of multi-component,multi-target and multi-way interaction.This study has shown that quercetin,kaempferol,luteolin,stigmasterol,and β-sitosterol may regulate a variety of biological processes by acting on TNF,IL-6,IL-1β,PTGS2,STAT3,MAPK1,MAPK14,RELA,CXCL8 and other targets and regulating AGE-RAGE,TNF,IL-17 signaling pathways,etc.to achieve the purpose of treating acute gouty arthritis.