Network Pharmacology Study On Medication Rules And Core Prescriptions Of Damp-heat Type Chronic Wounds Of Lower Extremities

Objective:Through the analysis of the data of hospitalized patients,the rules of medication for the treatment of chronic wounds of the lower extremities with damp-heat type are summarized,so as to guide the diagnosis and treatment of "simultaneous treatment of different diseases" in the later stage.In addition,using the research method of network pharmacology,the potential mechanism of action of core prescription drugs in the treatment of chronic wounds of damp-heat type of lower extremities was explored from the perspective of modern pharmacology,which provided new ideas and support for future basic research.Method:The cases of chronic wounds of lower limbs with damp-heat type were collectedfrom September 2019 to September 2022,and the data of the cases that met the inclusion and exclusion criteria were statistically analyzed.Through frequency statistical analysis,the gender ratio of patients,the frequency of Chinese herbal medicines,the four qi and five tastes and their attribution were studied;meanwhile,association rule analysis and aggregation analysis methods were used to deeply investigate the mechanism of drug interactions,excavate their core drug prescriptions,and summarize the ideas and medication rules for the treatment of chronic trauma of damp-heat type lower extremities.Analyze the potential pharmacological mechanism of core prescription drugs in the treatment of damp-heat type chronic wounds of lower limbs by network pharmacology method.The drug database in TCMSP was used to obtain the activities of various core drugs,and the targets of these components were collected in the corresponding databases.In addition,targets associated with chronic wounds of the lower extremities were collected from Genecards,OMIM,pharmgkb,and TTD disease databases.The information was input into Cytoscape software and network topology data analysis was performed to clarify the relationship between drug-active molecule-target.The String database platform was used to analyze the protein-protein interaction data,TSV files were downloaded and Cytoscape was used to screen the target proteins,and the core PPI network was drawn.Finally,GO enrichment analysis and KEGG pathway analysis were used to draw a bubble map for the intersection targets.Results:A total of 451 eligible patient data were included in this study,including 307 males(68.07%)and 144 females(31.93%);150 diabetic foot cases(33.26%),157 lower extremity atherosclerotic occlusive disease cases(34.81%),and 144 lower extremity venous ulcers(31.93%).The average age of disease was 65.5 years.Angelica sinensis,honeysuckle,achyranthes bidentata,licorice,red peony,atractylodes,forsythia,phellodendron,scrophularia and scutellaria were the 10 most frequently used herbs.The four qi cold medicines were applied more frequently,the five tastes were mostly bitter,and the attribution was mostly to the liver meridian.Correlation analysis of prescriptions showed that Huang Bai,Xuan Shen and Lian Qiao were the core drug groups with the highest gain;highfrequency drug clustering analysis finally yielded three major categories.Among the obtained active ingredients of the core prescription drugs,there are 2 types of angelica sinensis,23 types of honeysuckle,20 types of achyranthes bidentata,29 types of red peony,9 types of atractylodes,23 types of forsythia,37 types of phellodendron,9 types of scrophularia,20 types of scutellaria,and 3774 potential targets that can act on chronic wounds of lower extremities,the main active ingredients are quercetin,lignan and kaempferol.GO analysis revealed that the core drugs acted mainly through biological functions such as response to exogenous stimuli,antioxidant,response to nutrient levels,leukocyte trafficking,and positive regulation of cytokines;KEGG analysis showed that the main enriched related pathways included: lipids and atherosclerosis,fluid shear and atherosclerosis,and AGE-RAGE signaling pathway.Conclusion:1.In clinical treatment of chronic wounds of lower extremities with damp-heat type,drugs are mainly used to clear heat and damp,enrich qi and replenish blood.Most of the meridians are directed to the liver,lung and heart meridians,and cold and bitter drugs are often used.Angelica sinensis,honeysuckle,achyranthes bidentata,licorice,red peony,atractylodes,forsythia,phellodendron,scrophularia and scutellaria are the core drugs.2.Network pharmacology was used to clarify that quercetin,luteolin,and kaempferol are the main active ingredients of core prescription drugs in the treatment of chronic wounds of lower extremities,and protein targets such as PTGS1,ADRB2,and NOS2 are important targets in treatment.The core prescription drugs can regulate the signaling pathways such as lipid and atherosclerosis,fluid shear stress and atherosclerosis,AGE-RAGE signaling pathway by regulating the response to exogenous stimulation,anti-oxidation,response to nutrient level,leukocyte migration,and positive regulation of cytokines,and play a role in treating chronic wounds.