Clinical Efficacy Of Fuzheng Yangrong Decoction In Preventing Chemotherapy-induced Liver Injury During Chemotherapy After Breast Cancer Surgery

Objective:Study the network pharmacological mechanism of Fuzheng Yangrong Decoction in preventing Chemotherapy-induced liver injury,so as to provide clinical basis and theoretical support for reducing and g toxic and side effects during chemotherapy.Design experiment to observe the clinical efficacy and safety evaluation.Methods:1.Network pharmacology research:Through TCMSP,BATMAN-TCM,Gene Cards,Dis Ge NET,OMIM,Uniprot and other databases and the Venny platform,the active ingredients and potential targets of Fuzheng Yangrong Decoction to prevent chemotherapy-induced liver injury were screened.Using Cytoscape 3.7.2 software and STRING database,the visual network diagram and protein interaction network diagram of "Fuzheng Yangrong Decoction-ingredients-targets-CILI" were constructed,and the core targets were screened out.Analyze the GO function and KEGG pathway enrichment through the DAVID database,and visualize the result through the Omicshare.Using websites and software such as Pub Chem,Chem3 D,PDB,Py Mol,Auto Dock Tools,etc.the core targets and main compound components are molecularly docked.2.Clinical research:60 patients were collected,and randomly divided into traditional Chinese medicine intervention group andcontrol group,every group was 30 patients.The control group was given corresponding chemotherapy treatment,and the traditional Chinese medicine intervention group was given the corresponding chemotherapy treatment after taking Fuzheng Yangrong Decoction 1week in advance.The TCM symptom scores,liver function damage grades,the quantity of liver protection drugs used after reaching the indication of withdrawal,and blood routine examination,and the clinical efficacy and safety were evaluated.Results:1.Network pharmacology research:A total of 143 effective chemical components and 149 TCM targets were obtained from Fuzheng Yangrong Decoction,and a total of 981 effective targets were obtained from CILI.The two intersected 53 targets,and the key targets were TP53,TNF,VEGFA,etc.The KEGG pathway includes pathways such as nonalcoholic fatty liver disease.The biological process involves the cell’s response to chemical stress,etc;the more prominent molecular function is ligand activation;the membrane valve and membrane region are the key in cell composition.Molecular docking showed that the core target had high binding to the active components.2.Clinical research:The data of the two groups before treatment were balanced and comparable(P>0.05).Judging from the effect after treatment.TCM symptom score,the number of abnormal liver function and CILI,quantity of liver-protective drugs used after reaching the indication of withdrawal were compared with the control group,the differences were statistically significant(P<0.05).ALP,TBi L after one cycle of chemotherapy and the numbers of patients who pause chemotherapy were no significant differences between the two groups(P≥0.05).Conclusions:1.Network pharmacology and molecular docking studies have revealed that the active ingredients such as quercetin,luteolin,and kaempferol in Fuzheng Yangrong Decoction are mainly at key targets such as TP53,TNF,and VEGFA,through non-alcoholic fatty liver,PI3K-Akt and other pathways play a role in the prevention and treatment of CILI.In the main non-alcoholic fatty liver pathway,the process may be quercetin,luteolin and other components that have inhibitory effects on lipid peroxidation,acting on this pathway,inhibiting TNF-α receptors,and achieving anti-cysteine Asparaginase activates and inhibits the enhancement of mitochondrial permeability,thereby slowing or even preventing apoptosis;at the same time,the antagonism of luteolin in oxidative stress affects CASP7 in this pathway that leads to hepatocyte apoptosis It inhibits the pathway of hepatocyte apoptosis,thereby preventing CILI.2.Fuzheng Yangrong Decoction can effectively prevent chemotherapy-induced liver injury caused by chemotherapy after the operation,shorten the time of liver function recovery and improve the quality of life of patients.It is safe and worthy of clinical promotion.