The Study For The Curative Effect And Mechanism Of Hewei Qingliang Decoction In The Treatment Of Precancerous Lesion Of Gastric Cancer

Objective:To explore the curative effect and possible mechanism of Hewei Qingliang Decoction on the precancerous lesion of gastric cancer(PLGC)according to clinical retrospective analysis.Screen the core components,key targets and pathways of Hewei Qingliang Decoction in the treatment of PLGC,and speculate its possible mechanism.It is hoped that it can provide a basis for the experimental verification of the follow-up mechanism.Method:(1)Clinical efficacy:The cases of 155 patients with gastric precancerous lesions were collected and divided into Chinese medicine treatment group(CMTG,n=52):Hewei Qingliang Decoction;United medicine treatment group(UMTG,n=53):Hewei Qingliang Decoction combined with bismuth,PPI and antibiotics;Western medicine treatment group(WMTG,n=50):Bismuth,PPI and antibiotics.The clinical data were statistically analyzed by F test,t test,X~2test,rank sum test etc.(2)Network pharmacology screening:Using the TCMSP data platform to search for drug components in Hewei Qingliang Decoction,and screen out the activities with good oral bioavailability(OB)and drug-like properties(DL)(OB≥30%and DL≥0.18).The target of each active ingredient is obtained in the database;the disease keywords are searched in the OMIM and Gene Card databases to obtain disease-related targets;the drug-disease intersection targets are taken to construct a drug-disease-target network.Screen core targets;The drug-disease intersection targets are taken to construct a drug-disease network;Go and KEGG enrichment analysis were used to predict the possible pathway and mechanism of drug action on the disease.Results:(1)Clinical efficacy:(1)Curative effect of TCM scores:The TCM syndrome scores of the 3 groups were reduced after treatment(Z=-5.02、-6.02、-4.96,P<0.01),and the effect of CMTG、UMTG were better than the WMTG,the difference was significant(P<0.0167),there was no significant difference between the TCM and the UMTG(P>0.0167).(2)Curative effect of intestinal metaplasia:the degree of intestinal metaplasia in the 3 groups was reduced after treatment(Z=-3.68、-4.23、-1.28,P<0.01),and the efficacy of CMTG was better than the WMTG(P<0.0167),there was no significant difference between the UMTG and the WMTG(P>0.0167).(3)Curative effect of gastric mucosal atrophy:the degree of atrophy in the CMTG and UMTG decreased after treatment(Z=-1.28、-3.28,P<0.05),and there was no significant improvement in the WMTG(P<0.0167),there was no significant difference between the TCM and the WMTG(P<0.0167).(4)Curative effect of dysplasia:the condition of the CMTG improved significantly after treatment(Z=-2.34,P<0.05),the other two groups did not improve(Z=-1.4、-0.91,P>0.05).(5)Comprehensive efficacy evaluation:CMTG>UMTG>WMTG(P<0.0167).(2)Network pharmacology:Hewei Qingliang Decoction has a total of 67 active ingredients and 170 targets,PLGC has a total of 984disease targets,and a total of 94 intersection targets between drugs and diseases,of which the top 10 core targets are:VEGF,AKTI,IL6,TP53,JUN,MMP9,PTGS2,CASP3,MAPK8,CXCL8,the core target KEGG enrichment pathway is AGE-RAGE signaling pathway,IL-17 signaling pathway,Kaposi’s sarcoma signaling pathway,tumor necrosis factor signaling pathway,Hepatitis signaling pathway,the core targets are concentrated in the AGE-RAGE signaling pathway.Conclusion:This study shows that Hewei Qingliang Decoction coild help reverse PLGC and prevent the occurrence of gastric cancer,and has a good clinical effect.Its mechanism needs further verification.