Research On Data Mining And Network Pharmacology Of Yishen Xiezhuo Tongluo Method In The Treatment Of Uric Acid Nephropathy

ObjectiveThrough reviewing and sorting out the cases of UAN treated by the tutor,this paper discusses the etiology and pathogenesis of UAN and the theoretical connotation of Yishen Xiezhuo Tongluo method,and analyzes its prescription and medication law.Based on the core drugs excavated by Yishen Xiezhuo Tongluo method in the treatment of UAN,Yishen Xiezhuo Tongluo formula was formed.The network pharmacology of this formula was studied to explore the action mechanism of one in the treatment of UAN,so as to reveal the practical and theoretical significance of Yishen Xiezhuo Tongluo method in the treatment of UAN.Method1.Collected the complete cases of UAN treated by tutor in outpatient and inpatient clinics from June 2015 to October 2021,and selected the cases that meet the inclusion criteria;Inputed its basic information,pattern and prescription medication into the traditional Chinese medicine auxiliary inheritance platform 2.50,and conducted data statistical mining;Analyzed the frequency of drugs use,to obtain the Yishen Xiezhuo Tongluo formula,combined with studying the drugs natures and flavors and channel entry,common drug pairs and new formula combination,and systematically summarized the medication law and clinical experience of tutor in the diagnosis and treatment of UAN by Yishen Xiezhuo Tongluo method.2.Based on the formula of Yishen Xiezhuo Tongluo excavated from the platform of traditional Chinese medicine,the network pharmacology analysis was carried out;In TCMSP database,the effective components and action targets of our prescription were screened according to biological activity,and the gene targets of UAN were searched by Genecards database.The targets of drugs and the disease were standardized in UniProt database.Then,the intersection targets of the two were taken,and the intersection targets were investigated by PPI in STRING database and GO and KEGG enrichment analysis in Metascape database to visualize the results,To analyze the main components,targets and pathways of Yishen Xiezhuo Tongluo Recipe in the treatment of UAN.Results1.Basic information:a total of 239 UAN cases were included,including 153 males and 86 females;Patterns statistics showed that there were deficiency and excess mixed syndromes,including 59 cases of deficiency of spleen and kidney qi combinding with damp-heat brewing and binding,31 cases of deficiency of spleen and kidney qi with phlegm turbidity internal resistance,22 cases of deficiency of both qi and yin with damp-heat brewing and binding,20 cases of deficiency of spleen-kidney yang uniting with cold-damp causing internal obstruction,19 cases of deficiency of liver and kidney yin with internal static blood obstruction,8 cases of deficiency of spleen-kidney yang with phlegm turbidity internal resistance,purely excess syndromes including 44 cases of damp-heat brewing and binding,24 cases of phlegm turbidity congestion and 12 cases of cold-damp causing internal obstruction.2.Medication:among the 239 primary prescriptions,189 single traditional Chinese medicines were involved.The top ten traditional Chinese medicines were:Dioscorea 138 times,Astragalus 122 times,Atractylodes macrocephala 120 times,Atractylodes 111 times,Smooth greenbrier 104 times,Clematis 103 times,Codonopsis 101 times,Alisma orientalis 97 times,Cortex phellodendri 96 times,Achyranthes bidentata 94 times and Rhizome dioscoreae 94 times;The four natures of herbs were mainly warm,cold and neutral,the five flavors were mainly sweet,picric and pungent,and the channel entries were mostly liver,kidney spleen,stomach and lung;Commonly used herb combinations included Atractylodes and Dioscorea,Cortex Phellodendri and Atractylodes,Codonopsis and Astragalus,Rhizome dioscoreae and Smooth greenbrier,Clematis and Atractylods,Carthamus and Peach kernel;There were five new prescriptions.3.Network pharmacology research:there were 89 active components in Yishen Xiezhuo Tongluo formula after repeat removal,including 253 drug targets,1633 UAN targets,116 drug disease intersection targets and 181 KEGG pathways.The main effective components of Yishen Xiezhuo Tongluo formula in the treatment of UAN were quercetin,kaempferol,luteolin,7-O-methylisomucronulatol,wogonin,beta-sitosterol,7-Methoxy-2-methyl isoflavone,formononetin and naringin;The key targets were IL6,TP53,TNF,mapk1,CXCL8,MMP9,CASP3,VEGFA,IL1B,PTGS2,EGF and FN1;The main biological pathways were AGE-RAGE,lipid and atherosclerosis,IL-17,TNF and PI3K Akt signaling pathways.Conclusions1.Uric acid nephropathy,deficiency of both spleen and kidney,phlegm dampness and turbid evil,and obstruction of the kidney collaterals are its core pathogenesis.It always belongs to the pattern of deficiency and excess,mixed with deficiency and excess.The treatment should support righteousness and eliminate evil,so as to establish the great method of benefiting the kidney,discharging turbidity and dredging collaterals.2.The core drugs of Yishen Xiezhuo Tongluo method in the treatment of UAN are Dioscorea,Astragalus,Atractylodes macrocephala,Atractylodes,Smooth greenbrier,Clematis,Codonopsis,Alisma orientalis,Cortex phellodendri,Achyranthes bidentata,Rhizome dioscoreae,which constitute Yishen Xiezhuo Tongluo formula.3.In the process of treating UAN with Yishen Xiezhuo Tongluo method,we should pay attention to the compatibility of herbs in order to alleviate the disease,there are Astragalus with Dioscorea and Codonopsis with Astragalus for tonifying,disinhibiting dampness and turbid mainly with Atractylodes and Cortex phellodendri,Smooth greenbrier and Rhizome dioscoreae,Clematis and Atractylodes,and promote blood circulation and free network vessels mainly with Carthamus and Peach kernel.4.The network pharmacological study of Yishen Xiezhuo Tongluo Recipe in the treatment of UAN reflected that the traditional Chinese medicine compound is characterized by multi-components,multi-targets and multi-channels intervention,which provides a basis for further research.