Medication Rule Analysis And Network Pharmacology Study Of Chief Physician DuJianpeng In Treating Atrial Fibrillation

Objective:1.Using data mining methods to analyze the medication rules of chief physician Jianpeng Du in the treatment of atrial fibrillation(AF),draw the core prescription and provide clinical experience.2.The core prescription was analyzed by network pharmacology to obtain the main active components,targets and signaling pathways,and molecular docking was performed to analyze the possible mechanism.Material and method:1.Collect the outpatient cases of patients with AF diagnosed and treated by chief physician Jianpeng Du from May 2019 to May 2022,screen and summarize the data of clinical medication according to the inclusion and exclusion criteria,standardize the drug name and establish the database.Statistical analysis of gender,age,combined disease,symptoms,signs,and syndrome types was performed on the included cases.Statistical analysis of the frequency,taste,and zangfu organs of the drugs included in the prescription was performed.SPSS Modeler 18.0 software was used to analyze the association rules of high frequency Chinese medicines.SPSS Statistics 26.0 was used for cluster analysis of high frequency Chinese medicines.Combined with the follow-up learning experience,the medication rules and core prescriptions of chief physician Du in the treatment of AF were summarized.2.The active components of the core prescription were obtained by TCMSP database and literature supplement,and the protein targets of the active components were normalized by Uniprot database.GeneCards,OMIM,Drugbank and TTD databases were used to search for disease targets of AF.The common targets of active ingredients and diseases were obtained through the Venny platform,and the obtained common targets were imported into Cytoscape 3.8.2 software to construct a drug-active ingredient-disease-target network and perform visual analysis.The protein interaction network was constructed using the String database,and the GO and KEGG pathway analysis was performed using the Metascape platform,and the visualization was performed through the microbiome.Finally,molecular docking was performed using Pubchem,PDB database and CB-Dock website.To predict and explore the possible mechanism of core prescription in the treatment of AF.Results:1.A total of 95 patients and 203 prescriptions were included in this study.There were 43 male patients and 52 female patients.There were 40 patients aged 71-80,accounting for the most.Hypertension accounted for the highest proportion of comorbidities,followed by sleep disorders,coronary heart disease,anxiety and depression.The distribution of qi and yin deficiency syndrome is the most common.A total of 193 drugs were involved in the study.The ten drugs with the highest frequency were Zhigancao,Guizhi,Gansong,Dangshen,Huangqi,Maidong,Yanhusuo,Duanmuli,Suanzaoren and Shengdihuang.The medicinal properties are mainly warm,flat and cold;the medicine is mainly sweet,bitter,spicy;the main meridians are spleen,liver and lung.The association rule analysis showed that the commonly used drug combinations were:Guizhi-Zhigancao,Guizhi-Dangshen,Zhigancao-Dangshen,Dangshen-Zhigancao,Maidong-Dangshen-Guizhi.According to the clinical experience of chief physician Du,the core prescription was selected as Zhigancao Decoction,and the specific drugs included Zhigancao,Guizhi,Maidong,Dangshen,Huomaren,Ejiao,Shengjiang,Dazao and Shengdihuang.2.The core prescription was screened to obtain 164 active components and 4066 protein targets,and a total of 438 protein targets were obtained after deduplication.A total of 760 disease targets were obtained through four database screening,and 105 common targets were obtained after the intersection of drugs and disease targets.The main active ingredients include quercetin,stigmasterol,β-sitosterol,rehmannia flavonoids,7-methoxy-2-methylisoflavone,cannonol,ophiopogonan isoflavone,γ-aminobutyric acid,licochalcone,and red door phenol.The key targets include INS,VEGFA,IL6,TNF,TP53,EDN1,NOS3,FGF2,ACE,MMP9.GO functional enrichment analysis of biological processes mainly involved blood circulation,response to hormones,positive regulation of phosphorylation,response to injury,and response to oxygen levels.The cell composition mainly affects membrane rafts,endoplasmic reticulum lumen,extracellular matrix,plasma membrane protein complexes,neuronal dense core vesicles,etc.The molecular functions mainly involved adrenergic receptor activity,steroid hydroxylase activity,endopeptidase activity,protease binding,protein kinase binding,etc.KEGG pathway enrichment analysis mainly included proteoglycans in cancer,AGE-RAGE signaling pathway in diabetic complications,chemical carcinogenesis-receptor activation,cGMP-PKG signaling pathway,lipids and atherosclerosis.Molecular docking verified that the key active ingredients had strong binding ability with the target.Conclusion:1.chief physician Du believes that the main pathogenesis of AF is deficiency in origin and excess in superficiality.The location of the disease is mainly in the heart and is related to the liver and spleen.The high-frequency traditional Chinese medicines for the treatment of AF are Zhigancao,Guizhi,Gansong,Dangshen,Huangqi.The medicinal properties are mostly warm,flat and cold;the flavors are mostly sweet,bitter,spicy;the meridians are mostly spleen,liver and lung.Combined with in-depth interviews,it was concluded that the core prescription was Zhigancao Decoction.chief physician Du believes that elderly patients with AF are mostly based on qi and blood yin and yang deficiency,and each person has different deficiency.In the prescription of Zhigancao Decoction,qi,blood,yin and yang have corresponding drugs,Zhigancao,Guizhi and Shengjiang Xingan Huayang;Zhigancao,Dangshen and Dazao to supplement heart qi;shengdi,Maidong nourish heart yin;Maren,Ejiao,Dazao nourishing blood.According to the different deficiency of each patient,focusing on the use of corresponding tonic drugs can achieve better clinical efficacy.2.Mechanism studies have shown that active ingredients such as quercetin,stigmasterol andβ-sitosterol in the core prescription can exert anti-atrial fibrillation by affecting insulin,inflammatory response and vascular endothelium,and involve signaling pathways such as AGE-RAGE.Molecular docking verified that the key active ingredients have strong binding ability with the target.The results need to be further studied through animal experiments.