Study On Professor Xiaochang Ma’s Medication And Network Pharmacology In The Treatment Of Essential Hypertension

The disease definition of essential hypertension is unexplained elevation of blood pressure,which is a cardiovascular disease that increases the risk of adverse cardiac,cerebral,and renal events.The increasing incidence and lethality place a significant burden on global health care.As modern medical research on primary hypertension continues to advance,the treatment concept has evolved from the initial focus on intensive antihypertension and reduction of complications to the prevention of pre-disease risk factors.Currently,the development of new drugs and treatments can reduce the incidence of adverse events in patients with essential hypertension to a certain extent,but there are still some problems in the diagnosis,treatment and prevention of essential hypertension.The supervisor,Professor Xiaochang Ma,has been engaged in the prevention and treatment of cardiovascular diseases with Chinese and Western medicine for more than 30 years,and has unique insights into the diagnosis and treatment of essential hypertension in Chinese medicine.This study uses data mining technology to analyze and collate the mentor’s medication for the treatment of essential hypertension and to explore the rules of medication,which can inherit the mentor’s academic ideas on the one hand and lay foundation for the therapy of essential hypertension by traditional Chinese medicine on the other hand.Then,using the research method of network pharmacology,we can predict the active ingredients,action targets and main pathways of high frequency drugs used by Professor Xiaochang Ma for the treatment of essential hypertension,expecting to form a closed-loop development model from clinical to basic and then back to clinical,and continuously promote the scientific development in the field of Chinese medicine.Study 1:Exploring the dosing pattern of Professor Xiaochang Ma’s treatment of essential hypertension based on data mining technologyObjective:To induction Professor Xiaochang Ma’s medication pattern of essential hypertension through data mining technology,and to pass on his academic ideas.Methods:Through a retrospective study,outpatient records of Professor Xiaochang Ma’s treatment of essential hypertension at Xiyuan Hospital of the Chinese Academy of Traditional Chinese Medicine were assembled as the basic data,time span from January 2017 to December 2020.Valid outpatient records were screened and organized,and the corresponding entries were data standardized to establish a database.The frequency statistics of the four properties,five tastes and the attribution of the incorporated drugs were performed by the TCM transmission aid platform V3.0 software.According to clustering analysis,association rules and other data processing methods,the combination of clustering formulas and other combinations can be obtained.Results:1.General information:89 cases of essential hypertension with 323 prescriptions were included in this study.Among them,49 cases(55.06%)were males and 40 cases(44.94%)were females,male:female=1.225:1.2.Frequency of Chinese medicine:The 323 prescriptions included in this study involved a total of 157 medicinal flavors.The cumulative frequency of use was 6678,and the total number of drugs with a frequency of use≥100 was 21 flavors.The top 6 most frequently used herbs are Poria cocos,Atractylodes macrocephala,Pinellia ternate,Pericarpium citri,Herba Artemisiae capillaris and Radix puerariae.3.The nature and taste of Chinese medicine belong to the meridian:the highest frequency of the four gases of medicine is cold,followed by warm,calm,cool and hot;The five tastes of drugs are sweet,bitter,pungent,sour and salty;The frequency of meridians of drugs ranges from high to low:liver,lung,spleen,stomach,heart,kidney,gallbladder,large intestine,small intestine,pericardium,bladder and triple energizer.4.Drug combination analysis:the support degree of this study is 75%,and the confidence degree is 95%.52 pairs of drug combinations can be obtained,mainly including pinellia ternate,atractylodes macrocephala,pueraria lobata,tuckahoe,tangerine peel and wormwood.Set the number of clusters to 5,and extract a total of 5 clustering formulas.Conclusion:Professor Xiaochang Ma used the method of invigorating blood and dispelling phlegm,strengthening the spleen and resolving dampness,clearing the liver and pacifying the liver,and nourishing the liver and kidneys to treat essential hypertension.By compiling and analyzing the medical cases,we conducted a deep exploration for the inheritance of Professor Xiaochang Ma ’s academic thought,and also laid the foundation for the subsequent research on the mechanism of blood pressure reduction.Study 2:Network pharmacology study of Professor Xiaochang Ma’s treatment of essential hypertension with high frequency Chinese medicine.Objective:To investigate the mechanism of action of high-frequency herbal medicines in the treatment of essential hypertension by screening the active ingredients and targets of high-frequency herbal medicines used by Professor Xiaochang Ma through network pharmacology.Methods:Using drug similarity ≥0.18 and oral bioavailability ≥30%as the screening conditions,the active ingredients and target proteins of Chinese herbal medicines Hemisphagnum,Atractylodes macrocephala,Pueraria lobata,Poria,Pericarpium chenopodium and Inoceramus were selected and collected by UniProt correction.Genes related to the disease were collected from Genecards,DisGeNET and OMIM databases using the keyword "essential hypertension".The obtained disease-causing genes were integrated and the target proteins were normalized as EH-related target data.Then the common targets of diseases and drugs together were imported into STRING database,which can get protein interaction network.CytoNCA plug-in was used to analyze the network topology of the above results,to filter out key genes and to construct key gene networks.Finally,GO and KEGG pathway analysis of key targets were performed using R4.1.2 software.Results:The final retrieval of major active ingredients for the six drugs was 57,and the number of drug targets was 244,783 targets were retrieved related to essential hypertension,102 targets were obtained by taking the intersection.The top five Degree values were:interleukin 6,tumor necrosis factor,serine/threonine kinase,interleukin-1β,vascular endothelial growth factor A.In the GO enrichment analysis,2193 biological process entries,19 cellular component entries,and 116 molecular function entries were generated.signaling pathways obtained from the KEGG pathway involved fluid shear stress and atherosclerosis signaling pathway,lipid and atherosclerosis pathway,etc.Conclusion:A preliminary exploration of the mechanism of action of Professor Xiaochang Ma’s high-frequency Chinese medicine for the treatment of essential hypertension was conducted through network pharmacological studies,and the mechanism of its exerting antihypertensive therapy may be related to the active ingredients such as quercetin,naringenin and nobiletin to achieve antihypertensive purpose by mediating the oxidative stress process,interfering with the renin-angiotensin system and improving endothelial function.